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Updated: Aug 24, 2025
Whole-body PET/MRI of Pediatric Patients: The Details That Matter
Published on: December 19, 2017
Analysis of whole-body MRI artifacts in a pediatric population with a special emphasis on the effect of hands
Solène Le Cam1, Paul de Boissieu2, Jean-Paul Teglas3
1Faculty of Medicine, Paris Saclay Université, 94270 Le Kremlin, Bicêtre, France; AP-HP, Bicêtre Hospital, Pediatric Imaging Department, 94270 Le Kremlin, Bicêtre, France.
Insights
Whole-body MRI (WB-MRI) in children reveals varying artifact prevalence between STIR and T1-weighted sequences. Optimizing patient positioning, particularly hand placement, can reduce artifacts for improved diagnostic accuracy.
Area of Science:
- Radiology
- Medical Imaging
- Pediatric Imaging
Background:
- Whole-body magnetic resonance imaging (WB-MRI) is increasingly utilized in pediatric care.
- Understanding imaging artifacts is crucial for accurate interpretation in pediatric WB-MRI.
Purpose of the Study:
- To determine the prevalence of artifacts in pediatric whole-body MRI (WB-MRI) examinations.
- To identify the causes and contributing factors of these artifacts, including sequence type and patient positioning.
Main Methods:
- Retrospective analysis of 107 pediatric WB-MRI examinations (ages 2-16).
- Artifacts were categorized and analyzed across short-tau inversion recovery (STIR) and T1-weighted sequences.
- Prevalence was assessed concerning patient age and hand position.
Main Results:
- A total of 3436 artifacts were identified.
- STIR sequences showed higher rates of 'noise' and 'cross-talk' artifacts compared to T1-weighted sequences.
- T1-weighted sequences exhibited more 'equipment' and 'stair-step' artifacts. Specific hand positions influenced artifact occurrence, with implications for wrists and abdomen. Older children (>10 years) had more 'susceptibility' and 'equipment' artifacts.
Conclusions:
- Artifact prevalence differs significantly between STIR and T1-weighted sequences in pediatric WB-MRI.
- The combined use of both sequence types is recommended for comprehensive evaluation.
- Optimizing patient hand positioning is essential for minimizing artifacts and ensuring diagnostic quality and safety.
Purpose:
The purpose of this retrospective study was to determine the prevalence of artifacts on whole-body (WB) magnetic resonance imaging (MRI) examination in pediatric patients and identify their causes.
Materials And Methods:
A total of 107 pediatric patients who underwent a total of 107 WB-MRI examinations, including short-tau inversion recovery (STIR) and T1-weighted sequences, were included. There were 62 girls and 45 boys with a mean age of 11 ± 3 (SD) years (age range: 2-16 years). WB-MRI examinations were analyzed for the presence of artifacts on STIR and T1-weighted sequences. Artifacts were further assigned to one of eight categories (motion, partial volume, cross-talk, phase sampling, susceptibility, equipment, noise, and "other") and 19 anatomical sites by a 4-year resident. Prevalence of artifacts were analyzed especially according to hands position during the examination for the upper limbs and patients' age. Age was expressed as a binary variable using median age (10 years) as the cut-off value. All qualitative variables were compared using chi-square test.
Results:
A total of 3436 artifacts were found. The STIR sequences showed more "noise" artifacts (93/1038; 8.96%) and more "cross-talk" (102/1038; 9.83%) artifacts than T1-weighted sequences (12/1038 [1.16%] and 7/1038 [0.67%], respectively) (P < 0.001 for both). T1-weighted sequences showed more "equipment" (84/1038; 8.09%) and "stair-step" (a subset of "other") (41/1038; 3.95%) artifacts than the STIR sequences (39/1038 [3.76%] and 21/1038 [2.02%], respectively) (P < 0.001 and P = 0.01, respectively). T1-weighted sequences showed fewer artifacts on the wrists when the hands were under the bottom (P = 0.001). T1-weighted sequences showed less "equipment" artifacts when the hands were alongside the body (22/296; 7%) than on the abdomen (48/432; 11%) or under the bottom (14/128; 11%) (P < 0.001). STIR sequences showed more "motion" artifacts when the hands were on the abdomen (54/432; 13%) than alongside the body (30/296; 10%) or under the bottom (15/128; 12%) (P < 0.001). WB-MRI examinations had more "susceptibility" artifacts (38/960; 4%) and more "equipment" artifacts (81/960; 8.4%) in patients older than 10 years than in those under 10 years (23/752 [3.1%] and 42/752 [5.6%]) (P = 0.01 and P < 0.001, respectively).
Conclusion:
Artifacts on WB-MRI do not affect coronal STIR and T1-weighted sequences equally, so the use of both sequence types appears useful. Hands position should be considered with respect to both diagnostic benefit and safety.
