Whole-body magnetic resonance imaging is superior to skeletal scintigraphy for the detection of bone metastatic tumors: a meta-analysis

OBJECTIVE: The meta-analysis aims to compare the diagnostic performance of whole-body magnetic resonance imaging (MRI) and skeletal scintigraphy (SS) for the detection of skeletal metastases. MATERIALS AND METHODS: We searched Medline, Scopus, Embase and Cochrane library databases for identifying fifteen eligible studies with a total of 1939 participants, and the quality of these studies was assessed according to Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) guidelines. Sensitivities, specificities, diagnostic odds ratios (DOR), positive likelihood ratios (PLR), and negative likelihood ratios (NLR) were calculated. Summary receiver operating characteristic curves (sROC) were generated using bivariate models for whole-body MRI and skeletal scintigraphy. RESULTS: Whole-body MRI had higher but comparable patient-based higher specificity compared to SS (99% vs. 95%). However, it had markedly higher sensitivity (94% vs. 80% respectively), DOR (966 vs. 82), and LPR (54.4 vs 17.1). LNR of whole-body MRI was < 0.1 (0.06), while LNR of SS was >0.1 (0.22). The area under curves (AUC) for whole-body MRI and SS were 0.99 and 0.95 respectively. CONCLUSIONS: We demonstrate that both whole-body MRI and SS have good diagnostic performance. However, MRI is superior for diagnostics of bone metastases, as it has higher sensitivity, higher diagnostic accuracy, and can be used for both confirmation and exclusion of metastatic bone disease.