Table 1 Summary of findings

Ultrasound

- Normal echotexture does not rule out splenic or hepatic myeloid metaplasia in MF (da-)

- Focal splenic myeloid metaplasia and solid tumor metastases can show a similar appearance (da-)

Elastography

- Increased hepatic stiffness in MF possibly reflects myeloid metaplasia (da-)

- Splenic elastography might aid in differentiating MF patients from healthy controls (da-)

^b Splenic stiffness combined with clinical parameters might be able to identify MF patients with grades 0–1 or grades 2–3 fibrosis (accuracy of 97% and 94–95% at best cut-off values; Iurlo et al.)

- Changes in splenic stiffness have been observed during cytoreductive treatment

Splenic sound speed measurement

- Was not found to differentiate all MF patients from healthy controls or patients with other causes of splenomegaly (da-)

- Splenic sound speed might indirectly reflect BM fibrosis grade in MF, as well as changes herein during treatment (da-)

Splenic attenuation

- Was not found to differentiate MF patients from healthy controls (da-)

DXA

- Was not found to differentiate ET and PV patients from healthy controls (da-)

- An increased Z-score probably reflects osteosclerosis in MF (da-)

Radiography

^b Is probably insufficient in detecting or excluding the presence of osteosclerosis in MF (derived sensitivities 60–100%, derived specificities 43–61%; Pettigrew/Hickling/Pawelski et al.)^b

- The presence of sclerosis probably rules out pure hypercellular disease (da-)

CT

- HR-pQCT was not found to differentiate ET and PV patients from healthy controls (da-)

- HR-pQCT might be able to identify MF patients with advanced osteosclerosis (da-)

- qCT might reflect the degree of osteosclerosis in MF (da-)

MRI -

T1-weighted imaging and STIR

- The skeletal T1 signal reflects BM fat content, and thereby probably indirectly reflects BM cellularity in ET/PV and cellularity and/or fibrosis in MF (da-)

- Skeletal T1 and STIR signals might reflect the presence of fibrosis in MF and changes herein during treatment (da-), but the correlation with histopathology was not unequivocal

- T1-weighted imaging of the axial and femoral BM might aid in differentiating MF patients from both healthy controls and ET patients (da-), but a decreased signal does not exclude ET/PV

- T1 + STIR signal distribution in the axial and femoral BM possibly corresponds to disease severity and prognosis in MF

MRI - CSI

- Skeletal CSI can theoretically indirectly quantify BM cellularity in PV and cellularity and/or fibrosis in MF (da-) and was shown to reflect changes herein during treatment (da-)

- Skeletal CSI might aid in differentiating PV and MF patients from healthy controls (da-)

(D)CE-MRI

- The CE T1 signal possibly reflects BM perfusion in MF (da-)

^b CEmax as measured by DCE-MRI might aid in discerning MF patients from both ET/PV patients and healthy controls (PPV 83–85%, NPV 87%, sensitivity 88%, specificity 83–84%; Courcoutsakis et al.)

- Changes in contrast amplitude on DCE-MRI have been observed during treatment

31-P MRS

- Increased peaks theoretically reflect increased splenic membrane metabolism in PV/MF (da-)

- Was not found to differentiate between various causes of splenomegaly (da-)

¹⁸F-FDG and ¹⁸F-FLT PET/CT

- ¹⁸F-FLT PET and ¹⁸F-FDG PET probably indirectly reflect BM fibrosis in MF and changes herein during treatment (da-)

- ¹⁸F-FLT PET might aid in differentiating ET, PV and MF patients from healthy controls (da-)

- ¹⁸F-FDG PET might aid in differentiating PV patients from healthy controls (da-)

- Axial ¹⁸F-FDG uptake might correspond to prognosis in MPN

^{b 18}F-FDG PET might be able to detect residual disease after stem cell transplantation in MF (NPV 100%, PPV 86%, sensitivity 100%, specificity 83%; Derlin et al.), with good reproducibility of peripheral uptake rating (interobserver and intraobserver Cohen’s k 0.95 and 1.0, respectively)

^99mTc-colloid and ¹¹¹In-Cl3 scintigraphy /SPECT

- Both tracers have been shown to reflect BM cellularity and indirectly fibrosis in MF (da-)

- Increased splenic ¹¹¹In-Cl3 uptake possibly reflects myeloid metaplasia (da-)

^b Tc99-colloid scintigraphy might aid in differentiating PV from secondary polycythemia (derived sensitivity 83%, derived specificity 100%; Rudberg et al)*

- Both tracers might aid in differentiating early PV from MF (da-), but discriminative power will probably decrease in later PV stages given the overlap in described uptake patterns

Labeled RBC scintigraphy

- Increased fixation theoretically reflects splenic hypervascularization−/cellularity in MF and PV (da-)

- Was not found to differentiate between various hematological diseases (da-)

Scintigraphy – other

- Skeletal ⁵²Fe distribution might correspond to prognosis in MF

- Axial ^99mTc-AGAb uptake might aid in discerning MF patients from controls (da-)

- Skeletal ^99mTc-LDL uptake might reflect hematopoietic/macrophage cellularity in MF and PV (da-)

- ^99mTc-MDP might be able to detect bone new formation in MF and PV (da-)

Radionuclide - blood flow^a

- Seemed to indicate BM hypervascularization in PV and MF compared with healthy controls (da-)

Thermo-graphy

- Possibly indirectly reflects BM vascularization in MF (da-)

- Might aid in discerning MF patients from healthy controls (da-)