The role of whole-body MRI in pediatric oncology

Pediatric whole-body (WB) magnetic resonance imaging (MRI) is an established technique that, with improved accessibility and advances in technology, is being used with increasing frequency for a wide variety of applications. The advantages of WB MRI (over other imaging modalities), particularly its lack of ionizing radiation (of particular concern in pediatric imaging due to children's increased sensitivity to ionizing radiation) and the ability of MRI to image the bone marrow, solid organs, and soft tissues with superior soft-tissue contrast resolution to other techniques, promise that WB MRI has great potential in conditions that are diffuse or multifocal. There is particular interest in its role in the field of pediatric oncology (eg, lymphoma, neuroblastoma, sarcoma, and Langerhans cell histiocytosis). The main disadvantages of WB MRI are its relatively long scanning times, artifacts from motion (requiring patient cooperation or general anesthesia), and limited specificity. However, advances in hardware and imaging techniques, including additional sequences (out-of-phase imaging, diffusion-weighted imaging, and contrast enhancement) are reducing the impact of some of these challenges.