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MRI and PET/MRI in hematologic malignancies.

Marius E Mayerhoefer1,2, Stephen J Archibald3, Christina Messiou4

  • 1Department of Biomedical Imaging and Image-guided Therapy, Division of General and Pediatric Radiology, Medical University of Vienna, Austria.

Journal of Magnetic Resonance Imaging : JMRI
|July 2, 2019
PubMed
Summary

Whole-body MRI (WB-MRI) shows high sensitivity for myeloma detection and staging. However, its role in lymphoma and leukemia is limited, with research focusing on advanced MRI and PET/MRI techniques for hematological malignancies.

Keywords:
MRIPETleukemialymphomamyeloma

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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Magnetic Resonance Imaging (MRI) applications vary significantly across hematological malignancies like lymphoma, leukemia, and myeloma.
  • Whole-body MRI (WB-MRI) is a sensitive tool for myeloma assessment, supported by clinical guidelines for detection and staging.
  • Current recommendations do not favor WB-MRI for lymphoma or leukemia, with limited roles outside clinical trials.

Purpose of the Study:

  • To review the current clinical applications of MRI and PET/MRI in hematological malignancies.
  • To highlight key research areas, including functional MRI techniques and novel PET imaging probes.
  • To discuss the evolving role of advanced imaging in diagnosing and managing blood cancers.

Main Methods:

  • Review of current literature on MRI and PET/MRI in hematological malignancies.
  • Focus on functional MRI techniques: diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI).
  • Exploration of novel PET imaging probes, including CXCR4 ([68Ga]Ga-Pentixafor) and amino acid ([11C]methionine) tracers.

Main Results:

  • WB-MRI is highly sensitive and guideline-endorsed for myeloma detection and staging.
  • WB-MRI is an alternative to [18F]FDG-PET/CT for lymphoma, particularly in pediatric cases, despite DWI's reported sensitivity.
  • MRI and PET imaging are not routinely recommended for leukemia outside clinical trials.

Conclusions:

  • MRI plays a distinct and established role in myeloma, while its utility in lymphoma and leukemia is still under investigation.
  • Functional MRI techniques and novel PET tracers show promise for improving diagnosis and monitoring treatment response in hematological malignancies.
  • Further research into advanced MRI and PET/MRI techniques is crucial for expanding their clinical application in blood cancers.