Learning objectives
To illustrate the utility of whole body MRI for metastases screening. To emphasize the combination of a dedicated body-part imaging with contrast enhanced imaging as part of the whole body imaging protocol to increase the accuracy of whole body MRI for metastases detection.
Background
Whole body MRI has emerged as a new tool in onco-imaging. In onco-imaging, the utility of any total body imaging tool depends on its accuracy in detecting metastases. For tumor and nodal staging, no total body imaging tool is solely relied upon, be it PET-CT or whole body MRI. For instance, in breast carcinoma, nodal staging would be determined by at least a sentinel node biopsy irrespective of the nodal stage determined by a total body imaging tool. Thus in clinical practice, it is effective...
Imaging findings OR Procedure details
48 patients (11 males, 37 females) of known carcinoma underwent whole body MRI (WB MRI) from May 2005 to December 2006 for evaluation of metastatic disease. 3 patients were evaluated twice and one patient was evaluated thrice (total 53 examinations). Primary Sites Breast Ovary Lung GI Tract Liver Prostate Testis Renal cell carcinoma Choriocarcinoma 30 3 3 6 1 2 1 1 1 Protocol for whole body MRI (performed on a 1.5 T MRI with TIM) 1 STIR & TrueFISP coronal, STIR axial - whole...
Conclusions
Whole body MRI is an effective tool for metastatic screening. It is a promising alternative to CT-PET. It has high accuracy for bone and liver metastases. Adding on dedicated body part imaging and contrast enhanced imaging increases sensitivity and specificity for detection of metastases. CT Chest compliments whole body MRI for lung metastases <4mm in size.
Personal Information
Dr. Joshita Singh Consultant Radiologist CT/MRI division Deenanath Mangeshkar Hospital and Research Center Pune India
[email protected] Dr. Dhananjay S Kelkar Consultant Surgical Oncologist Deenanath Mangeshkar Hospital and Research Center Pune Dr. Sonali Pingley Consultant Radiation Oncologist Deenanath Mangeshkar Hospital and Research Center Pune
References
Antoch G, Vogt FM, Freudenberg LS, Nazaradeh F, Goehde SC, Barkhausen J et al. Whole-body dual-modality PET/CT and whole -body MRI for tumor staging in oncology. JAMA 2003;290:3199-3206. Lauenstein TC, Goehde SC, Herborn CU, Goyen M, OberhoffC, DebatinJF et al. Whole body MR Imaging: evaluation of patients for metastases. Radiology 2004;233:139-148. Schmidt GP, Baur-Melnyk A, Herzog P, Schmid R, Tiling R, Schmidt M et al. High-resolution whole-body magnetic resonance image tumor staging with the use of parallel imaging versus dual-modality positron emission tomography-computed tomography: experience...
