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Whole-body MRI for the staging and follow-up of patients with metastasis
European Journal of Radiology, 06/17/09

Schmidt GP et al. - In a review of whole-body MRI (WB-MRI) for the staging and follow-up of pts with metastasis, this article summarizes recent developments and applications of WB-MRI and highlights its performance within the scope of systemic oncologic staging and surveillance.

• Hardware innovations, such as the introduction of multi-receiver channel whole-body scanners at 1.5 T and recently 3 T, combined with acquisition acceleration techniques, have made high-resolution WB-MRI clinically feasible.
• A dedicated assessment of individual organs with various soft tissue contrast, spatial resolution, and contrast media dynamics can be combined with whole-body anatomic coverage in a multi-planar imaging approach.
• More flexible protocols, eg, including T1-weighted TSE- and STIR-imaging, dedicated lung imaging, or dynamic contrast-enhanced studies of the abdomen can be performed within <45 min.

• For initial tumor staging, PET-CT as a competing whole-body modality in oncologic imaging has proved more accurate for the definition of T-stage and lymph node assessment, using additional metabolic information of PET for the assessment of tumor viability and therapy response.
• New applications, such as MR-whole-body diffusion imaging, may significantly increase sensitivity in near future.
• WB-MRI has shown advantages for detection of distant metastatic disease, especially from tumors frequently spreading to the liver or brain and it is especially useful as a radiation-free alternative for surveillance of tumor pts with multiple follow-up exams.
• It has been introduced as a whole-body bone marrow screening application.
• Within this context, WB-MRI is highly accurate for detection of skeletal metastases and staging of hematologic diseases, such as multiple myeloma or lymphoma.

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