title: Diagnostic value of whole-body magnetic resonance imaging for bone metastases: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the overall diagnostic accuracy of whole-body magnetic resonance imaging (WB-MRI) in detecting bone metastases with a meta-analysis.
  
  
  METHODS
  The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases were searched from January 1995 to September 2010 for studies evaluating the accuracy of WB-MRI in detecting bone metastases. Histopathologic analysis and/or close clinical and imaging follow-up for at least 6 months was assessed. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristics.
  
  
  RESULTS
  A total of 11 studies with 495 patients who fulfilled all of the inclusion criteria were considered for the analysis. No publication bias was found. WB-MRI had a pooled sensitivity of 0.899 (95% confidence interval [CI], 0.845-0.939) and a pooled specificity of 0.918 (95% CI, 0.882-0.946). The subgroup without diffusion-weighted imaging (DWI) positive results had higher pooled specificity 0.961 (95% CI, 0.922-0.984) than the subgroup with DWI (P < 0.05).
  
  
  CONCLUSIONS
  WB-MRI was an accurate, cost-effective tool in detecting bone metastases. WB-MRI without DWI may improve the specificity of detecting bone metastases. DWI seems to be a sensitive but rather unspecific modality for the detection of bone metastatic disease. High-quality prospective studies regarding WB-MRI in detecting bone metastases still need to be conducted.
authors: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Lian-Ming
authors: LM
authors: Wu
authors: Hai-Yan
authors: HY
authors: Gu
authors: Jasmine
authors: J
authors: Zheng
authors: Xiao
authors: X
authors: Xu
authors: Lin-Hua
authors: LH
authors: Lin
authors: Xia
authors: X
authors: Deng
authors: Wei
authors: W
authors: Zhang
authors: Jian-Rong
authors: JR
authors: Xu