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Whole-Body MRI in Musculoskeletal Oncology: A Comprehensive Review with Recommendations
Isabela A N Cruz1, Laura M Fayad1, Shivani Ahlawat1
1From the Department of Musculoskeletal Radiology, Fleury Medicina e Saúde Higienópolis, R. Mato Grosso 306, Higienópolis, SP, Brazil 01239-040 (I.A.N.C., M.A.C.N., A.G.O.F., J.B.G.); Department of Radiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil (I.A.N.C., H.M.L., J.B.G.); The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins School of Medicine, Baltimore, Md (L.M.F., S.A.); and Department of Radiology, Pediatric Oncology Institute, Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), São Paulo, Brazil (H.M.L., J.B.G.).
Whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI) offers accurate oncologic evaluation for musculoskeletal cancers. This radiation-free imaging method provides a comprehensive assessment of the skeleton and soft tissues, serving as a PET/CT alternative.
Area of Science:
- Radiology and Imaging
- Oncology
- Musculoskeletal Imaging
Background:
- Whole-body MRI (WB-MRI) is an emerging oncologic imaging technique.
- It offers a comprehensive assessment of both skeletal and soft tissues.
- Diffusion-weighted imaging (DWI) adds functional information, complementing anatomical data.
Purpose of the Study:
- To review the technical aspects, clinical utility, and diagnostic accuracy of WB-MRI in musculoskeletal oncology.
- To highlight WB-MRI's role as a potential replacement for conventional imaging modalities.
- To discuss WB-MRI with DWI as an alternative to fluorodeoxyglucose PET/CT.
Main Methods:
- Review of technical considerations for whole-body MRI acquisition.
- Inclusion of diffusion-weighted imaging (DWI) for microstructural analysis.
- Evaluation of clinical applications in cancer diagnosis, staging, and follow-up.
Main Results:
- WB-MRI with DWI demonstrates comparable accuracy to PET/CT for oncologic evaluation.
- WB-MRI offers the advantage of avoiding ionizing radiation.
- Technological advancements have increased the accessibility and application of WB-MRI.
Conclusions:
- WB-MRI, particularly with DWI, is a valuable tool in musculoskeletal oncology.
- It provides a radiation-free, comprehensive assessment for various cancer management stages.
- Its routine use is expanding for pediatric and adult oncology patients.
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