The Many Uses Of Whole-Body MRI

Who should get whole-body MRI (WB-MRI)?  Patients with diabetes, rheumatic diseases, primary benign bone tumors, bone-marrow diseases, malignant melanoma, and breast or colorectal cancer. Who shouldn’t? Patients who just want a general health screening.

So concludes a group of German researchers who undertook “a selective literature review on recent technical innovations in the field of WB-MRI and the clinical uses of this new method, with particular emphasis on diagnostic imaging in oncology.” Their findings appear in the current issue of Deutsches Ärzteblatt International.

Here are some specific uses the researchers examined, along with their conclusions:

• Tumor screening. Because it does not involve ionizing radiation, WB-MRI may have some potential for screening of general, asymptomatic populations—but its time has not yet come, because of the low percentage of patients in which tumors were detected (less than 2%) and the lack of proven cost-effectiveness.
• Tumor staging. WB-MRI appears particularly effective in TNM staging of patients with gastrointestinal tumors, breast cancer, or malignant melanoma (diagnostic accuracy of 91%). It seems less effective in detecting lymph node or lung metastases or the staging of pulmonary tumors.
• Multiple myeloma and other bone-marrow diseases. Because of its good bone-marrow contrast, WB-MRI may be the best choice for detecting plasma cell neoplasms, particularly in early stages of the disease.
• Rheumatic diseases. MRI provides especially useful information in the early stages of rheumatic joint disease. Because rheumatoid arthritis can affect the whole body, WB-MRI might find early manifestations of this disease.
• Diabetes. “WB-MRI seems suitable for early diagnosis of secondary complications and for potentially more effective treatment planning in patients with diabetes mellitus, who have a high prevalence of cardiovascular diseases.”
• Benign bone tumors. Patients with multiple cartilaginous exostoses face considerable risk that the tumors will transform from benign to cancerous. WB-MRI can be particularly helpful in these cases because osteochondromas often occur in many different areas of the body and because many patients are young and thus would be at higher risk from repeated radiation exposure.

Technical advances now allow WB-MRI to be completed in less than an hour without loss of image quality. It seems likely that we’ve just started exploring its usefulness.

Related seminar: Head To Toe Imaging