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The Diagnostic Yield of Whole-Body MRI as a Multi-disease Screening Modality: A Systematic Review and Meta-analysis
Muhammad Danyal Ahsan1,2, Nicole Frontera3, Anoop Gurram4
1Weill Cornell Medicine, New York, NY, USA. mua2023@qatar-med.cornell.edu.
Background:
Disease screening is a mainstay of modern healthcare. Whole-body magnetic resonance imaging (WBMRI) is marketed as a multi-disease screening modality. The diagnostic yield and clinical utility of WBMRI for population-based disease screening are uncertain.
Objectives:
Our systematic review and meta-analysis aimed to synthesize and critically appraise the available literature on WBMRI without an evidence-based indication. Our objective was to evaluate the diagnostic yield of WBMRI and assess the scope of findings.
Design:
We conducted a systematic review and meta-analysis searching MEDLINE, Embase, and CENTRAL from inception through August 2025. This review was registered with PROSPERO (No.: CRD42024554848). Prespecified criteria for study inclusion included literature that reported WBMRI findings in a population without an evidence-based indication for WBMRI. Data appraisal was performed by two independent reviewers with summary data extracted from published reports.
Main Measures:
Outcomes evaluated included pooled proportions of individuals with no clinical findings reported, any clinical finding, non-malignant actionable findings that required subsequent diagnostic workup, and new cancer diagnoses.
Key Results:
In a pooled cohort of 18,043 individuals from 17 heterogeneous low-quality studies who underwent WBMRI, 16.9% (95% CI 5.1; 43.7) had no findings reported, while 78.0% (95% CI 44.9; 93.9) had a finding reported. Clinically actionable non-malignant findings were reported in 14.8% (95% CI 6.6-30.0%); 58.2% (95% CI 36.0; 77.5) of these individuals pursued additional laboratory work and/or imaging, and 20.8% (95% CI 9.7; 39.2) pursued a subsequent procedure. The prevalence of malignancy was 1.4% (95% CI 0.9-2.2%). Clinical outcomes associated with discovery of lesions could not be determined.
Conclusions:
The majority of WBMRIs performed in a population without an evidence-based indication result in findings that are normal or do not require follow-up. Clinical outcomes associated with discovery of actionable lesions are unknown. High-quality observational data or randomized trials are needed to inform the efficacy of WBMRI for multi-disease screening.
Clinical Trial Number:
Not applicable.
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