Abstract
Whole-body magnetic resonance imaging (WB-MRI) is an imaging method without ionising radiation that can provide WB coverage with a core protocol of essential imaging contrasts in less than 40 minutes, and it can be complemented with sequences to evaluate specific body regions as needed. In many cases, WB-MRI surpasses bone scintigraphy and computed tomography in detecting and characterising lesions, evaluating their response to therapy and in screening of high-risk patients. Consequently, international guidelines now recommend the use of WB-MRI in the management of patients with multiple myeloma, prostate cancer, melanoma and individuals with certain cancer predisposition syndromes. The use of WB-MRI is also growing for metastatic breast cancer, ovarian cancer and lymphoma as well as for cancer screening amongst the general population. In light of the increasing interest from clinicians and patients in WB-MRI as a radiation-free technique for guiding the management of cancer and for cancer screening, we review its technical basis, current international guidelines for its use and key applications.
Highlights
The introduction of multiple receiver coils and table movement for multi-station scanning in the late 1990s transformed magnetic resonance imaging (MRI) from a segmental to a whole-body (WB) imaging modality [1,2,3]
Review increasing interest from clinicians and patients in Whole-body magnetic resonance imaging (WB-MRI) as a radiation-free technique for guiding the management of cancer and for cancer screening, we review its technical basis, current international guidelines for its use and key applications
That WB-MRI shows higher sensitivity (94%) for lymphoma detection in patients with variable FDG avidity lymphoma subtypes than FDG-positron emission tomography (PET)/computed tomography (CT) (61%) and contrast-enhanced CT (71%) [87] (Figure 3)
Summary
T1-weighted images are usually obtained with gradient-echo (GRE) Dixon acquisitions [16], producing in- and opposed-phase images that allow the calculation of fat-only and water-only images. These are useful in the detection, characterisation and response assessment of bone metastases. T2-weighted images, acquired using single-shot or half-acquisition turbo spin echo (HASTE) sequences without fat suppression, can be used for the evaluation of disease in organs other than bone [18] with a good trade-off between duration and signal to noise ratio (SNR) [19], and can be helpful in confirming the presence of spinal cord compression [20]. The choice of SLT remains somewhat variable; recommendations are for the use of contiguous slices with a thickness between 5 and 7 mm [11, 13]
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