Table 4.

Main features, advantages, and disadvantages of18F-FDG–PET/CT and WB-DW-MRI in MM

18F-FDG–PET/CTWB-DW-MRI
Scanning time 15-20 minutes (60 minutes after radiotracer infusion) 40-60 minutes 
Radiation exposure 10-25 mSv None 
Diffuse BM involvement Lower sensitivity Higher sensitivity 
Detection of FLs Lower sensitivity Higher sensitivity 
Detection of PSD Lower sensitivity Higher sensitivity 
Detection of EMD Gold-standard technique Less explored role (apparent similar sensitivity) 
Prognostic features >3 FLs, high SUVmax, other quantitative parameters (MTV, TLG, IBI, and PBI) DD, >3 large (>5 cm2) FLs, high TDV, high ADC values 
Role in response assessment Gold-standard technique (IMWG); recent IMPeTUs for definition of metabolic responses (prognostic role of DS <4) Recommended technique for British guidelines (MY-RADS criteria: prognostic role of RAC1) 
18F-FDG–PET/CTWB-DW-MRI
Scanning time 15-20 minutes (60 minutes after radiotracer infusion) 40-60 minutes 
Radiation exposure 10-25 mSv None 
Diffuse BM involvement Lower sensitivity Higher sensitivity 
Detection of FLs Lower sensitivity Higher sensitivity 
Detection of PSD Lower sensitivity Higher sensitivity 
Detection of EMD Gold-standard technique Less explored role (apparent similar sensitivity) 
Prognostic features >3 FLs, high SUVmax, other quantitative parameters (MTV, TLG, IBI, and PBI) DD, >3 large (>5 cm2) FLs, high TDV, high ADC values 
Role in response assessment Gold-standard technique (IMWG); recent IMPeTUs for definition of metabolic responses (prognostic role of DS <4) Recommended technique for British guidelines (MY-RADS criteria: prognostic role of RAC1) 

IBI, intensity of bone involvement; PBI, percentage of bone involvement; TLG, total lesion glycolysis.

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