Modern medicine is developing very dynamically, allowing for increasingly precise detection of various diseases, including cancers. Identifying changes at the earliest possible stage of illness enables the implementation of effective treatment methods, significantly increasing the chances of full recovery for the patient. Therefore, whole-body scans are becoming more popular, serving as screening tests or being used in monitoring treatment outcomes. However, it is crucial to understand the capabilities and limitations of this technique to accurately interpret the results obtained. This article aims to provide insight into whole-body magnetic resonance imaging (WBMR). This term encompasses various types of examinations, and the possibilities depend on the applied protocol, the equipment used, and the experience of the team responsible for conducting and interpreting the results.
In our facilities, we conduct whole-body scans according to the ONCO-RADS protocol, utilizing the modern Siemens Magnetom SOLA 1.5T MRI system. The ONCO-RADS guidelines were developed by international experts and approved by the Radiological Society of North America (RSNA), which is a leading radiological society worldwide, to standardize diagnostic procedures in magnetic resonance imaging and ensure the appropriate quality of examinations.
What does a whole-body MRI examination include?
Whole-body MRI examination covers the area from the top of the head to the mid-thigh, allowing for the assessment of many internal organs in search of possible inflammatory or neoplastic changes. The whole-body scan includes the following regions: the head (including the brain, skull, and internal structures), the neck (including cervical vertebrae and surrounding structures), the chest (lungs, heart, blood vessels), the abdomen (internal organs such as the liver, pancreas, and intestines), and the pelvis (reproductive organs and bladder). The scan lasts about 60 minutes and is tailored for detecting oncological changes. This is particularly important for oncology patients, as it enables early detection of disease spread and more effective monitoring of its progression.
The introduction of a standardized whole-body MRI scanning protocol aims to unify the methods of conducting, interpreting, and reporting these examinations. Guidelines developed by international experts help reduce discrepancies in the approach to whole-body MRI (WBMR). Standardization of these procedures allows for more effective comparison of results and better control over the treatment process. In our facility, each whole-body MRI examination is conducted according to the ONCO-RADS protocol, which is optimized for detecting cancerous diseases.
When should a whole-body MRI examination be performed?
According to RSNA recommendations, whole-body scans can be used as screening tests or for monitoring the progression of cancer. RSNA advises performing whole-body scans for patients at high risk of developing cancers that may spread to various organs. As emphasized by RSNA, annual whole-body MRI plays a particularly important role for patients with genetic syndromes predisposing them to cancer, such as Li-Fraumeni syndrome (LFS) or hereditary paraganglioma. This technique not only enables early detection of cancerous changes but also allows for precise monitoring of treatment, helping doctors better tailor therapy to individual patient needs. Such an approach facilitates quicker and more effective responses to disease progression, improving both prognosis and quality of life for patients.
Unlike other whole-body imaging techniques, such as PET or CT scans, MRI does not use ionizing radiation, making it a safer option. Therefore, radiological societies recommend it as a screening test. Whole-body MRI allows for the assessment of various organs for the presence of metastases, which is very important as it can detect changes that may be difficult to identify with traditional examinations. However, it is essential to remember that no examination, including MRI, can detect all possible changes in the body. While whole-body scans are a significant tool in diagnostics, in some cases, additional tests may be necessary for a more comprehensive health assessment.
What is the difference between a whole-body MRI and MRI of individual areas?
A whole-body MRI should not be considered equivalent to an MRI of all anatomical regions. If a patient wishes to examine their spine for degenerative changes, a more appropriate examination would be a scan of the entire spine or specific segments, using a tailored protocol for that purpose.
An examination conducted according to the ONCO-RADS protocol can be helpful in detecting systemic changes, but for a complete diagnosis, more targeted tests are often necessary. While the whole-body scan is very useful, it should not be viewed as the sole diagnostic tool. It is one of many elements that help assess a patient’s health, particularly in the context of cancer. Other tests, such as computed tomography (CT) or MRI of specific body areas, provide more detailed information in specific locations.
After the examination, the radiologist analyzes the results according to the ONCO-RADS guidelines, identifying areas in the patient’s body that may indicate cancerous changes. In such cases, further diagnostic workup is recommended, such as performing an MRI of a specific organ with contrast enhancement or conducting a highly specialized PET scan.
BioScanner in Oncology Diagnostics
In our facilities, we offer not only magnetic resonance imaging (MRI) but also the most advanced whole-body imaging, including positron emission tomography (PET) combined with MRI and computed tomography (CT). Patients can also undergo MRI of any area as well as CT scans. We are able to provide such a wide range of diagnostics thanks to the use of four advanced machines available to our patients:
Biograph mMR 3T – a unique PET/MR system that combines PET and MRI imaging, resulting in fusion images that allow for more accurate diagnostics.
Discovery 710 by GE, which enables precise examinations using positron emission tomography and computed tomography (64 slices).
Magnetom Vida 3T, the latest machine from market leader Siemens Healthineers utilizing 3T technology.
Magnetom Sola 1.5T, which employs various AI (artificial intelligence) and DL (deep learning) solutions to achieve high-quality images in a relatively short scanning time, thus enhancing patient comfort.
Thanks to this variety, we can tailor examinations to the individual needs of each patient. As a result, patients can receive comprehensive diagnostics in one location.
Bibliography
- Oncologically Relevant Findings Reporting and Data System (ONCO-RADS): Guidelines for the Acquisition, Interpretation, and Reporting of Whole-Body MRI for Cancer Screening. Giuseppe Petralia, MD • Dow-Mu Koh, MD • Raj Attariwala, MD, PhD • Joseph J. Busch, MD • Ros Eeles, MD • David Karow, MD, PhD • Gladys G. Lo, MD • Christina Messiou, MD • Evis Sala, MD, PhD • Hebert A. Vargas, MD • Fabio Zugni, MD • Anwar R. Padhani, MD Radiology 2021; 299:494–507.
- Applying ONCO-RADS to whole-body MRI cancer screening in a retrospective cohort of asymptomatic individuals. Yong-Sin Hu, Chia-An Wu, Dao-Chen Lin, Po-Wei Lin, Han-Jui Lee, Lo-Yi Lin & Chung-Jung Li.
- Radiologic screening and surveillance in hereditary cancers.
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