Whole‑body MRI for metastatic workup in patients diagnosed with cancer

Rezheen J Rashid, Soran H Tahir, Fahmi H Kakamad, Sami S Omar, Abdulwahid M Salih, Shaho F Ahmed, Shalaw H Abdalla, Sharo Naqar, Rawezh Q Salih, Suhaib H Kakamad, Karukh K Mohammed, Shevan M Mustafa, Marwan N Hassan, Shvan H Mohammed, Rezheen J Rashid, Soran H Tahir, Fahmi H Kakamad, Sami S Omar, Abdulwahid M Salih, Shaho F Ahmed, Shalaw H Abdalla, Sharo Naqar, Rawezh Q Salih, Suhaib H Kakamad, Karukh K Mohammed, Shevan M Mustafa, Marwan N Hassan, Shvan H Mohammed

Abstract

Early diagnosis and appropriate staging workup are crucial for cancer patients. Whole-body magnetic resonance imaging (WB-MRI) has been proposed as another practical whole-body approach for assessing local invasiveness and distant metastases in patients newly diagnosed with cancer. The current study aimed to evaluate the efficacy of WB-MRI in assessing metastasis in patients newly diagnosed with cancer using histopathologic data as the reference method. A prospective observational study was performed from April 2018 to July 2020. MRI sequences were utilized to acquire anatomical and functional images in three orthogonal planes. The discovery was classified as nodal, skeletal and visceral metastases. Patient-based analysis was used for visceral metastasis and region-based for skeletal, systemic and lymph node metastases. A total of 43 consecutive patients (mean age, 56±15.2 years) were assessed successively. In 41 patients, there was a concordance between the WB-MRI and histological confirmation. The most prevalent site of metastasis was the skeletal system (18 patients). There were 12 individuals with liver metastasis, 10 with lung metastasis and 4 with peritoneal metastasis, with just one brain metastatic lesion found. On WB-MRI, 38 lymph node groups were deemed positive. Out of the total, 66 skeletal locations contained metastases. The accuracy of WB-MRI for nodal, skeletal and visceral metastases was (98.45, 100 and 100%, respectively). In conclusion, WB-MRI in three orthogonal planes, including the diffusion-weighted MRI with background body signal suppression sequence, may be utilized efficiently and accurately for assessing metastasis staging and may thus be utilized in patients with newly diagnosed cancer.

Keywords: DWIBS; WB-DWI; WB-MRI; bone scan; cancer; metastasis.

Conflict of interest statement

The authors declare that they have no competing interests.

Copyright: © Rashid et al.

Figures

Figure 1
Figure 1
Whole-body MRI of a 69-year-old male who developed prostate cancer presented with skeletal and lung metastases. (A) Inverted black-white coronal diffusion-weighted MRI with background body signal suppression sequence displaying multiple rib, vertebral and right iliac bone lesions, and also pulmonary lesions at upper lobes bilaterally. (B) T1-weighted image displaying hypointense dorsal and lumbar skeletal lesions. (C) Axial T2-weightedimage showing abnormal focal pulmonary lesions.

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