title: A systematic review of MRI, scintigraphy, FDG-PET and PET/CT for diagnosis of multiple myeloma related bone disease--which is best?
abstract: OBJECTIVE
  The purpose of the current study was to conduct a systematic review of the published literature to evaluate the diagnostic accuracy of FDG-PET, PTE/CT, MRI and scintigraphy for multiple myeloma related bone disease.
  
  
  METHODS
  Through a search of PubMed, EMBASE, and the Cochrane Library, two reviewers independently assessed the methodological quality of each study. We estimated pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and two sample Z-tests were conducted to evaluate for differences in sensitivity, specificity, area under the curve (AUC), and the Q* index between any two diagnostic modalities.
  
  
  RESULTS
  A total of 17 studies were reviewed. The MRI had a pooled sensitivity of 0.88, specificity of 0.68, AUC of 0.897, and Q*index of 0.828, whereas for MIBI, the corresponding values were 0.98, 0.90, 0.991, and 0.962, respectively, and for bone scan, they were 066, 0.83, 0.805, and 0.740, respectively. The corresponding values of MIBI were 0.98, 0.90, 0.991, and 0.962, respectively. For PET and PET/CT, the values were 0.91, 0.69, 0.927 and 0.861, respectively. Statistically significant differences were not found in the sensitivity, specificity, AUC, and Q* index between MRI, scintigraphy, FDG-PET and PET/CT.
  
  
  CONCLUSIONS
  On the condition that X ray is taken as a reference in our study, we suggested that FDG-PET, PTE/CT, MRI and scintigraphy are all associated with high detection rate of bone disease in patients with MM. Thus, in clinical practice, it is recommended that we could choose these tests according to the condition of the patient.
authors.affiliation: Department of Nuclear Medicine, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China E-mail : cjhyy_zrx@163.com.
authors.forename: Wan-Wen
authors.initials: WW
authors.lastname: Weng
authors.forename: Meng-Jie
authors.initials: MJ
authors.lastname: Dong
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Qin
authors.initials: Q
authors.lastname: Xu
authors.forename: Yang-Jun
authors.initials: YJ
authors.lastname: Zhu
authors.forename: Ning-Hu
authors.initials: NH
authors.lastname: Liu
mesh_terms: D019540:Area Under Curve; D001847:Bone Diseases / Q000175:diagnosis*; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015201:Meta-Analysis as Topic; D064847:Multimodal Imaging; D009101:Multiple Myeloma / Q000175:diagnosis*; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18