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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews.

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

Review published: 2011.

Bibliographic details: Wu LM, Gu HY, Zheng J, Xu X, Lin LH, Deng X, Zhang W, Xu JR.  Diagnostic value of whole-body magnetic resonance imaging for bone metastases: systematic review and meta-analysis. Journal of Magnetic Resonance Imaging 2011; 34(1): 128-135. [PubMed: 21618333]

Quality assessment

This review concluded that whole-body magnetic resonance imaging (MRI) was an accurate, cost-effective tool for detecting bone metastases and that whole-body MRI without diffusion-weighted imaging may improve specificity. Poor reporting, weaknesses in the analyses, small number and size of studies and lack of cost-effectiveness data mean that these conclusions are unlikely to be reliable. Full critical summary


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.

Copyright © 2011 Wiley-Liss, Inc.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2014 University of York.

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