Direct comparison of diagnostic accuracies of F-18 FDG PET and MRI for detection of bone marrow involvement in lymphoma patients; A meta-analysis

Abstract Background The purpose of the current study was to compare the diagnostic accuracies of F-18 FDG PET or PET/CT and MRI for detection of bone marrow involvement (BMI) in lymphoma patients through a systematic review and meta-analysis. Methods and Materials The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through July 31, 2020, were searched for studies evaluating direct comparison of diagnostic performance of F-18 FDG PET or PET/CT and MRI for BMI in lymphoma patients. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR + and LR-), and constructed summary receiver operating characteristic curves. Results Across 5 studies (212 patients), the pooled sensitivity of F-18 FDG PET or PET/CT was 0.65 (95 % CI; 0.42−0.82) a pooled specificity of 0.90 (95 % CI; 0.85−0.94). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 6.4 (95 % CI; 3.3–12.4) and negative likelihood ratio (LR-) of 0.39 (95 % CI; 0.21−0.73). The pooled DOR was 16 (95 % CI; 5–56). The pooled sensitivity of MRI was 0.78 (95 % CI; 0.55−0.91) and a pooled specificity of 0.86 (95 % CI; 0.67−0.95). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.6 (95 % CI; 1.8–17.0) and negative likelihood ratio (LR-) of 0.26 (95 % CI; 0.1−0.65). The pooled DOR was 22 (95 % CI; 3–149). In meta-regression analysis, no variable was the source of the study heterogeneity. Conclusion F-18 FDG PET or PET/CT and MRI showed similar diagnostic performances for the detection of BMI in lymphoma patients. Further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FDG PET or PET/CT and MRI for the diagnosis of BMI in lymphoma patients.