Whole-body magnetic resonance imaging (WB-MRI) in oncology: recommendations and key uses

Petralia, Giuseppe; Padhani, Anwar R.; Pricolo, Paola; Zugni, Fabio; Martinetti, Marco; Summers, Paul; Grazioli, Luigi; Colagrande, Stefano; Giovagnoni, Andrea; Bellomi, Massimo

doi:10.1007/s11547-018-0955-7

Cited by 62 publications

(75 citation statements)

References 91 publications

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“…Osseous metastases are screened for by whole-body imaging. They are not ruled out by various modalities because of false negatives and poor sensitivity of some studies [3][4][5]. Positron-emission computed tomography (PET-CT) is the method of choice because of its sensitivity; however, it is expensive and not available in most centres [5].…”

Section: Introductionmentioning

confidence: 99%

“…They are not ruled out by various modalities because of false negatives and poor sensitivity of some studies [3][4][5]. Positron-emission computed tomography (PET-CT) is the method of choice because of its sensitivity; however, it is expensive and not available in most centres [5]. CT scans of the chest, abdomen, and pelvis are commonly used for assessment of extra-osseous metastasis, but they are associated with radiation exposure [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Whole-body diffusion-weighted imaging with background body signal suppression in the detection of osseous and extra-osseous metastases

et al. 2019

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Purpose: To assess the reproducibility of detection of osseous and extra-osseous metastases in cancer patients using whole-body diffusion-weighted imaging with background body signal suppression (WB-DWIBS). Material and methods: A prospective study was conducted on 39 consecutive patients (21 females, 18 males; mean age 48 years) with metastases, who underwent WB-DWIBS on a 1.5-T MR scanner. Image analysis was performed independently by two blinded observers. Inter-observer agreement was assessed for the detection of osseous (spinal, appendicular) and extra-osseous (hepatic, pulmonary, nodal, and peritoneal) metastases. Results: The overall inter-observer agreement of WB-DWIBS in the detection of osseous and extra-osseous metastases was excellent (k = 0.887, agreement = 94.44%, p = 0.001). There was excellent inter-observer agreement of both observers for the detection of osseous spinal (k = 0.846, agreement = 92.3%), osseous appendicular (k = 0.898, agreement = 94.8 %), hepatic (k = 0.847, agreement = 92.3%), pulmonary (k = 0.938, agreement = 97.4%), nodal metastases (k = 0.856, agreement = 94.9%), and peritoneal metastasis (k = 0.772, agreement = 94.9%). Conclusion: We concluded that WB-DWIBS is reproducible for detection of osseous and extra-osseous metastases in cancer patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Whole-body diffusion-weighted imaging with background body signal suppression in the detection of osseous and extra-osseous metastases

et al. 2019

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“…Whole-body magnetic resonance imaging (WB-MRI) has become established for the management of patients with multiple epithelial and non-epithelial cancers, and recently its use has been extended to early cancer detection in subjects with cancer predisposition syndromes [1,2]. However, there is increasing interest in applying WB-MRI to detect cancers in the general population given the high sensitivity of the method that is free from ionising radiation.…”

Section: Introductionmentioning

confidence: 99%

Whole-body magnetic resonance imaging (WB-MRI) for cancer screening in asymptomatic subjects of the general population: review and recommendations

et al. 2020

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Background: The number of studies describing the use of whole-body magnetic resonance imaging (WB-MRI) for screening of malignant tumours in asymptomatic subjects is increasing. Our aim is to review the methodologies used and the results of the published studies on per patient and per lesion analysis, and to provide recommendations on the use of WB-MRI for cancer screening. Main body: We identified 12 studies, encompassing 6214 WB-MRI examinations, which provided the rates of abnormal findings and findings suspicious for cancer in asymptomatic subjects, from the general population. Eleven of 12 studies provided imaging protocols that included T1-and T2-weighted sequences, while only five included diffusion weighted imaging (DWI) of the whole body. Different categorical systems were used for the classification and the management of abnormal findings. Of 17,961 abnormal findings reported, 91% were benign, while 9% were oncologically relevant, requiring further investigations, and 0.5% of lesions were suspicious for cancer. A per-subject analysis showed that just 5% of subjects had no abnormal findings, while 95% had abnormal findings. Findings requiring further investigation were reported in 30% of all subjects, though in only 1.8% cancer was suspected. The overall rate of histologically confirmed cancer was 1.1%. Conclusion: WB-MRI studies of cancer screening in the asymptomatic general population are too heterogeneous to draw impactful conclusions regarding efficacy. A 5-point lesion scale based on the oncological relevance of findings appears the most appropriate for risk-based management stratification. WB-MRI examinations should be reported by experienced oncological radiologists versed on WB-MRI reading abnormalities and on onward referral pathways.

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“…Recent advances have changed the role of imaging modalities in the diagnosis and staging of multiple myeloma (MM) [1][2][3][4][5][6][7][8][9]. Whole-body magnetic resonance imaging (WB-MRI) is of particular note because of its excellent soft tissue contrast, which allows evaluation of the bone marrow space, and has improved the prognosis of MM by facilitating the early detection of bone marrow lesions [10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Role of whole-body MRI for treatment response assessment in multiple myeloma: comparison between clinical response and imaging response

et al. 2020

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Background: Whole-body MRI (WB-MRI) including diffusion-weighted image (DWI) have been widely used in patients with multiple myeloma. However, evidence for the value of WB-MRI in the evaluation of treatment response remains sparse. Therefore, we evaluated the role of WB-MRI in the response assessment.Methods: In our WB-MRI registry, we searched multiple myeloma patients treated with chemotherapy who underwent both baseline and follow-up WB-MRI scans. Clinical responses were categorized as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD), using IMWG criteria. Using RECIST 1.1, MD Anderson (MDA) criteria, and MDA-DWI criteria, imaging responses on WB-MRI were rated as CR, PR, SD, or PD by two radiologists independently. Then, discrepancy cases were resolved by consensus. Weighted Kappa analysis was performed to evaluate agreement between the imaging and clinical responses. The diagnostic accuracy of image responses in the evaluation of clinical CR, objective response (CR and PR), and PD was calculated. Results: Forty-two eligible patients were included. There was moderate agreement between imaging and clinical responses (κ = 0.54 for RECIST 1.1, κ = 0.58 for MDA criteria, κ = 0.69 for MDA-DWI criteria). WB-MRI showed excellent diagnostic accuracy in assessment of clinical PD (sensitivity 88.9%, specificity 94.7%, positive predictive value [PPV] 84.2%, negative predictive value [NPV] 96.4% in all three imaging criteria). By contrast, WB-MRI showed low accuracy in assessment of clinical CR (sensitivity 4.5%, specificity 98.1%, PPV 50.0%, NPV 71.2% in all three imaging criteria). As to the clinical objective response, the diagnostic accuracy was higher in MDA-DWI criteria than RECIST 1.1 and MDA criteria (sensitivity/specificity/PPV/NPV, 84.2%/94.4%/98.0%/65.4, 54.4%/100%/100%/40.9, and 61.4%/94.4%/97.2%/43.6%, respectively). Conclusions:In the imaging response assessment of multiple myeloma, WB-MRI showed excellent performance in the evaluation of PD, but not in the assessment of CR or objective response. When adding DWI to imaging response criteria, diagnostic accuracy for objective response was improved and agreement between imaging and clinical responses was increased.

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Whole-body magnetic resonance imaging (WB-MRI) in oncology: recommendations and key uses

Cited by 62 publications

References 91 publications

Whole-body diffusion-weighted imaging with background body signal suppression in the detection of osseous and extra-osseous metastases

Whole-body diffusion-weighted imaging with background body signal suppression in the detection of osseous and extra-osseous metastases

Whole-body magnetic resonance imaging (WB-MRI) for cancer screening in asymptomatic subjects of the general population: review and recommendations

Role of whole-body MRI for treatment response assessment in multiple myeloma: comparison between clinical response and imaging response

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