Diagnostic value of whole-body magnetic resonance imaging for bone metastases: a systematic review and meta-analysis

Purpose: To assess the overall diagnostic accuracy of whole‐body magnetic resonance imaging (WB‐MRI) in detecting bone metastases with a meta‐analysis. Materials and Methods: The MEDLINE, EMBASE, Cancerlit, and Cochrane Library databases were searched from January 1995 to September 2010 for studies evaluating the accuracy of WB‐MRI in detecting bone metastases. Histopathologic analysis and/or close clinical and imaging follow‐up for at least 6 months was assessed. Meta‐analysis methods were used to pool sensitivity and specificity and to construct summary receiver‐operating characteristics. Results: A total of 11 studies with 495 patients who fulfilled all of the inclusion criteria were considered for the analysis. No publication bias was found. WB‐MRI had a pooled sensitivity of 0.899 (95% confidence interval [CI], 0.845–0.939) and a pooled specificity of 0.918 (95% CI, 0.882–0.946). The subgroup without diffusion‐weighted imaging (DWI) positive results had higher pooled specificity 0.961 (95% CI, 0.922‐0.984) than the subgroup with DWI (P < 0.05). Conclusion: WB‐MRI was an accurate, cost‐effective tool in detecting bone metastases. WB‐MRI without DWI may improve the specificity of detecting bone metastases. DWI seems to be a sensitive but rather unspecific modality for the detection of bone metastatic disease. High‐quality prospective studies regarding WB‐MRI in detecting bone metastases still need to be conducted. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.