Clinical Applications and Controversies of Whole-Body MRI: <i>AJR</i> Expert Panel Narrative Review

Ahlawat, Shivani; Debs, Patrick; Amini, Behrang; Lecouvet, Frédéric; Omoumi, Patrick; Wessell, Daniel E.

doi:10.2214/ajr.22.28229

Cited by 14 publications

(9 citation statements)

References 97 publications

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“…The importance of high-quality imaging with the use of appropriate sequences is understood by rheumatologists and radiologists alike, with recent guidance helping to establish the essential components of whole-body MR imaging [ 6 , 16 ]. WBMRI can play a key role in the management of IA due to its sensitivity in in detecting synovitis, soft tissue inflammation and bone marrow oedema [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Whole-body MRI for the investigation of joint involvement in inflammatory arthritis

Freeston,

Marzetti,

Larkman

et al. 2023

Skeletal Radiol

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Objectives This study aimed to develop a novel whole-body MRI protocol capable of assessing inflammatory arthritis at an early stage in multiple joints in one examination. Materials and methods Forty-six patients with inflammatory joint symptoms and 9 healthy volunteers underwent whole-body MR imaging on a 3.0 T MRI scanner in this prospective study. Image quality and pathology in each joint, bursae, entheses and tendons were scored by two of three radiologists and compared to clinical joint scores. Participants were divided into three groups based on diagnosis at 1-year follow-up (healthy volunteers, rheumatoid arthritis and all other types of arthritis). Radiology scores were compared between the three groups using a Kruskal-Wallis test. The clinical utility of radiology scoring was compared to clinical scoring using ROC analysis. Results A protocol capable of whole-body MR imaging of the joints with an image acquisition time under 20 min was developed with excellent image quality. Synovitis scores were significantly higher in patients who were diagnosed with rheumatoid arthritis at 12 months (p < 0.05). Radiology scoring of bursitis showed statistically significant differences between each of the three groups—healthy control, rheumatoid arthritis and non-rheumatoid arthritis (p < 0.05). There was no statistically significant difference in ROC analysis between MRI and clinical scores. Conclusion This study has developed a whole-body MRI joint imaging protocol that is clinically feasible and shows good differentiation of joint pathology between healthy controls, patients with rheumatoid arthritis and patients with other forms of arthritis.

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Section: Discussionmentioning

confidence: 99%

Whole-body MRI for the investigation of joint involvement in inflammatory arthritis

Freeston,

Marzetti,

Larkman

et al. 2023

Skeletal Radiol

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Section: Whole-body Mr Imaging For Non-neoplastic Marrow Conditions: ...mentioning

confidence: 99%

“…Thanks to the difference between normal marrow and malignant lesions, DWI has been established as a method of reference to assess bone marrow involvement in the oncologic setting. [41][42][43] DWI has also been used to differentiate between benign and malignant bone marrow lesions.…”

Section: Lesion Characterization and Evaluation Of Vertebral Compress...mentioning

confidence: 99%

“…MRI acquisition protocols vary, but experts agree it should include T1-weighted, STIR, and DWI sequences, with recent trends toward using T2-weighted Dixon images to replace T1-weighted and STIR. 8,9, 41,81 Non-oncologic applications of whole-body MRI include the investigation of fever of unknown origin (FUO) in children, 82,83 the diagnosis and assessment of disease activity and treatment response in chronic recurrent multifocal osteomyelitis, [84][85][86][87][88][89] and synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO). 90 Whole-body MRI has also been used to detect clinically occult inflammatory lesions and to provide a simultaneous evaluation of the axial and appendicular skeleton in inflammatory arthritis.…”

Section: Whole-body Mr Imaging For Non-neoplastic Marrow Conditions: ...mentioning

confidence: 99%

“…100 However, the incorporation of whole-body MRI into the routine clinical workflow remains challenging because of examination duration, the need for an experienced reader, and, in many countries, potential billing difficulties. 41 The use of gradient-echo techniques, FSE T2-weighted Dixon sequences, and acceleration techniques, such as simultaneous multislice sequences and potentially reconstruction algorithms based on artificial intelligence, may contribute to decreasing acquisition time and allow wider use. 101,102 Other Techniques of Marrow Imaging Using MRI 1 H-MRS spectroscopy provides concentrations of specific metabolites, and its main application in marrow imaging is the quantification of fat.…”

Section: Whole-body Mr Imaging For Non-neoplastic Marrow Conditions: ...mentioning

confidence: 99%

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Advances in Bone Marrow Imaging: Strengths and Limitations from a Clinical Perspective

Mourad

Cosentino

Lalonde

et al. 2023

Semin Musculoskelet Radiol

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Conventional magnetic resonance imaging (MRI) remains the modality of choice to image bone marrow. However, the last few decades have witnessed the emergence and development of novel MRI techniques, such as chemical shift imaging, diffusion-weighted imaging, dynamic contrast-enhanced MRI, and whole-body MRI, as well as spectral computed tomography and nuclear medicine techniques. We summarize the technical bases behind these methods, in relation to the common physiologic and pathologic processes involving the bone marrow. We present the strengths and limitations of these imaging methods and consider their added value compared with conventional imaging in assessing non-neoplastic disorders like septic, rheumatologic, traumatic, and metabolic conditions. The potential usefulness of these methods to differentiate between benign and malignant bone marrow lesions is discussed. Finally, we consider the limitations hampering a more widespread use of these techniques in clinical practice.

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Observations Regarding the Detection of Abnormal Findings Following a Cancer Screening Whole‐Body MRI in Asymptomatic Subjects: The Psychological Consequences and the Role of Personality Traits Over Time

Conti,

Mazzoni,

Marzorati

et al. 2024

Magnetic Resonance Imaging

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BackgroundThe use of whole‐body MRI (WB‐MRI) in oncology has uncovered frequent unexpected abnormal findings (AFs). However, the impact of AFs on the patients' mental well‐being is still poorly examined.PurposeTo investigate the long‐term psychological consequences of AF detection following WB‐MRI for cancer screening in asymptomatic individuals.Study TypeProspective, longitudinal.Population121 consecutive subjects of the general population (mean age = 52.61 ± 11.39 years; 63% males) scheduled for cancer screening by WB‐MRI.Field Strength/Sequence1.5‐T and 3‐T; protocol complied with Oncologically Relevant Findings Reporting and Data System (ONCO‐RADS) guidelines.AssessmentParticipants completed the first psychological investigation (T0) immediately after the WB‐MRI. Subsequently, it was repeated after 1‐year (T1), and 4‐years (T2, subgroup of 61 participants) without an MRI exam, assessing personality traits, tumor risk perception, quality of life, depressive, and anxious symptoms. Radiologists directly reported WB‐MRI findings to the participants, explaining the clinical implications and the location of the AFs. The number and severity of AFs were assessed.Statistical TestsPearson's correlations and analysis of variance with repeated measures assessed the psychological health variables' relationship and their changes over time. A P‐value <0.05 was considered statistically significant.ResultsAll participants presented AFs, with 101 individuals categorized as ONCO‐RADS 2 and 19 as ONCO‐RADS 3. The AFs were most prevalent in bones (31.5%). The overall participants showed only a slight increase in depressive symptoms at T1 [F(1,112) = 7.54]. The severity and the number of AFs were not significantly related to psychological changes [ranging from P = 0.503 to P = 0.997]. Depressive and anxious symptoms over time were significantly affected by the traits of conscientiousness [T1: F(1,112) = 7.87; T2: F(1.708,90.544) = 3.40] and openness [T1: F(1,112) = 4.41].Data ConclusionDisclosing AFs by WB‐MRI exams for cancer screening may not lead to long‐term psychosocial consequences. Certain personality traits may, however, influence the psychological distress experienced by individuals with AFs after WB‐MRI exams.Level of Evidence2.Technical EfficacyStage 5.

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Clinical Applications and Controversies of Whole-Body MRI: AJR Expert Panel Narrative Review

Cited by 14 publications

References 97 publications

Whole-body MRI for the investigation of joint involvement in inflammatory arthritis

Whole-body MRI for the investigation of joint involvement in inflammatory arthritis

Advances in Bone Marrow Imaging: Strengths and Limitations from a Clinical Perspective

Observations Regarding the Detection of Abnormal Findings Following a Cancer Screening Whole‐Body MRI in Asymptomatic Subjects: The Psychological Consequences and the Role of Personality Traits Over Time

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