ReviewWhole body MR imaging: Applications in oncology
Introduction
Accurate diagnosis and staging of cancer is imperative to optimise treatment strategies with the ultimate goal of improved long term survival and possible cure. Cognoscente of the hazards of repeated ionizing radiation examinations, notably CT, interest has become focused on the potential use of whole body MRI techniques to stage and follow up oncologic disease.1
Section snippets
Background
Whole body imaging can be afforded by radiographic skeletal survey, whole body CT, scintigraphy and more recently by positron emission tomography (PET). Each technique has advantages and disadvantages, choice often being made on the basis of availability, cost, sensitivity, specificity, radiation dose and acquisition time. Ideally, the imaging modality chosen should have both high sensitivity and specificity, but often a compromise must be made. Therefore, if one imaging strategy is minimally
Technique
The combination of moving tabletop, tabletop extender and image melding software now facilitates practical whole body imaging in three planes in less than 15 min.5
Turbo spin echo images with inversion recovery pulses are performed using a body coil. Pathology normally appears as high signal intensity foci. The inversion recovery component nulls the signal from fat (which normally also has a high signal intensity) and in doing so enhances the conspicuity of those lesions surrounded by fat, such
Applications
Whole body turboSTIR MRI has been employed in the evaluation of metastatic disease particularly to bone,7 lymphoma8 and myeloma. Non-oncologic applications include assessment of multifocal muscle disease, total body fat stores and whole body MR angiography to estimate atherosclerotic burden.
Conclusion
Recent advances in MR imaging, particularly the development of fast imaging techniques, have markedly reduced imaging time without compromising image quality. This has made feasible the clinical introduction of whole body MRI as a practical diagnostic tool. Whole body MRI is a valid, non-ionising and, in our experience, sensitive clinical tool. The technique will likely have its greatest impact in the evaluation of patients with suspected bone marrow or skeletal involvement by either metastases
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Cited by (38)
Whole body MRI in paediatric oncology
2014, Diagnostic and Interventional ImagingCitation Excerpt :The most important clinical application of WB-MRI in children, as in adults, is the screening of the metastatic spread of cancer. In most of the series published, MRI discovers more lesions than the so-called conventional techniques, and in particular, more than the examinations in nuclear medicine with which they are in direct competition [25–27]. Lymphoma is the third most common malignancy in the child, after leukaemia and brain tumours.
Comparison of whole-body MRI and skeletal scintigraphy for detection of bone metastatic tumors: A meta-analysis
2013, Surgical OncologyCitation Excerpt :Moreover, osteoarthritis, fractures, and degenerative changes may lead to a high false-positive rate and decrease the specificity of skeletal scintigraphy. Whole-body magnetic resonance imaging (MRI) has become feasible with recent developments in MRI, including fast image acquisition, hardware innovation such as tabletop extenders, and the implementation of dedicated software [6]. This imaging modality has been shown to be of greater sensitivity and comparable specificity compared to bone scintigraphy in the detection of skeletal metastases [7–10].
Imaging of Lymphoma of the Musculoskeletal System
2010, Magnetic Resonance Imaging Clinics of North AmericaWhole-body MRI in the pediatric patient
2009, European Journal of RadiologyCitation Excerpt :Overall, a WBMRI scan in our department is scheduled with 70 min. Oncological staging, with a focus on the detection of pathological signals, was the major stimulus for the development and use of WBMRI, primarily in adults [8–10]. In children and adolescents the technique was used in some initial studies, and up to now only in a limited number of patients was systematically evaluated.
Whole-Body Diffusion-Weighted and Proton Imaging: A Review of This Emerging Technology for Monitoring Metastatic Cancer
2009, Seminars in RoentgenologyCitation Excerpt :Similar results were found by Antoch et al,86 where the authors reported a diagnostic accuracy of 93% for whole-body MRI, compared to a diagnostic accuracy of 94% for PET-CT for assessment of the M-stage in the tumor nodal metastasis staging criteria.41 Moreover, others have reported high sensitivities using WB-MR, ranging from 71% to 95%.17,28,29,31,32,36,39-44,85,87,88 The ability to obtain high spatial resolution and “functional” images of the whole body for assessment of pathological disorders is of major importance to the oncologist, radiologist, and, more importantly, the patient.
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Cappagh National Orthopaedic Hospital is a clinical sciences research site for Philips Medical Systems, Best Holland.