Table_1_Whole-Body MRI Is an Effective Imaging Modality for Hematological Malignancy Treatment Response Assessment: A Systematic Review and Meta-Analysis.docx

ObjectivesTo evaluate the diagnostic accuracy of whole-body MRI (WB-MRI) for assessment of hematological malignancies’ therapeutic response.
MethodsPubMed, Embase, and Web of Science were searched up to August 2021 to identify studies reporting the diagnostic performance of WB-MRI for the assessment of hematological malignancies’ treatment response. A bivariate random-effects model was applied for the generation of the pooled diagnostic performance.
ResultsFourteen studies with 457 patients with lymphoma, multiple myeloma, and sarcoma (very small proportion) were analyzed. Overall pooled sensitivity and specificity of WB-MRI were 0.88 (95% CI: 0.73–0.95) and 0.86 (95% CI: 0.73–0.93), respectively. Studies using whole-body diffusion-weighted imaging (WB-DWI) showed higher sensitivity than those that did not (0.94 vs. 0.55, p = 0.02). The pooled concordance rate of WB-MRI to assess hematological malignancies’ treatment response with reference standard was 0.78 (95% CI: 0.59–0.96). WB-MRI and PET/CT showed similar diagnostic performance (sensitivity [0.83 vs. 0.92, p = 0.11] and specificity [0.87 vs. 0.76, p = 0.73]).
ConclusionWB-MRI has high diagnostic performance for hematological malignancies’ treatment response assessment. The adding of WB-DWI is strongly associated with increased sensitivity.

研究目的：评估全身磁共振成像（whole-body MRI, WB-MRI）对血液系统恶性肿瘤治疗反应的诊断准确性。研究方法：检索截至2021年8月的PubMed、Embase及Web of Science数据库，筛选报道全身磁共振成像评估血液系统恶性肿瘤治疗反应的诊断性能的相关研究。采用双变量随机效应模型合并计算整体诊断性能指标。研究结果：共纳入14项研究，涉及457例淋巴瘤、多发性骨髓瘤及肉瘤（占比极低）患者。全身磁共振成像的合并灵敏度为0.88（95%置信区间：0.73~0.95），合并特异度为0.86（95%置信区间：0.73~0.93）。采用全身弥散加权成像（whole-body diffusion-weighted imaging, WB-DWI）的亚组分析显示，其诊断灵敏度高于未采用该技术的亚组（0.94 vs. 0.55，p=0.02）。全身磁共振成像与参考标准评估血液系统恶性肿瘤治疗反应的合并符合率为0.78（95%置信区间：0.59~0.96）。全身磁共振成像与PET/CT的诊断性能无显著差异（灵敏度：0.83 vs. 0.92，p=0.11；特异度：0.87 vs. 0.76，p=0.73）。研究结论：全身磁共振成像在血液系统恶性肿瘤治疗反应评估中具有较高的诊断性能。联合应用全身弥散加权成像（WB-DWI）可显著提升诊断灵敏度。