Abstract:
Whole-body MRI (WB-MRI) is increasing in clinical acceptance and utilization for a range of indications. WB-MRI is currently an established screening tool for children and adults at high risk of developing malignancy, with the strongest supporting evidence in patients with Li-Fraumeni syndrome. WB-MRI has been added to professional society guidelines for staging disease in patients with certain malignancies including multiple myeloma and has been proposed as a technique to screen for metastatic disease in patients with visceral malignancies including prostate cancer and breast cancer. Emerging data support the utility of WB-MRI in children with malignancies such as Ewing sarcoma, in adults with myxoid liposarcoma, and in pregnant patients with occult or newly detected malignancy. WB-MRI can further help evaluate disease extent and treatment response in patients with nononcologic conditions such as chronic nonbacterial osteomyelitis, myopathy, inflammatory arthritis, and fever of unknown origin. This AJR Expert Panel Narrative Review summarizes available evidence and recommendations supporting the clinical applications of WB-MRI. This article also highlights limitations, barriers, and controversies associated with utilization of WB-MRI in routine clinical practice.
摘要:
全身MRI(WB-MRI)在临床上越来越多地接受和利用一系列适应症。WB-MRI目前是针对患有恶性肿瘤的高风险儿童和成人的既定筛查工具,在Li-Fraumeni综合征患者中具有最强的支持证据。WB-MRI已被添加到专业协会指南中,用于对包括多发性骨髓瘤在内的某些恶性肿瘤患者进行疾病分期,并已被提议作为一种技术来筛查包括前列腺癌和乳腺癌在内的内脏恶性肿瘤患者的转移性疾病。新的数据支持WB-MRI在患有Ewing肉瘤等恶性肿瘤的儿童中的应用,成人粘液样脂肪肉瘤,以及隐匿性或新发现的恶性肿瘤的孕妇。WB-MRI可以进一步帮助评估患有慢性非细菌性骨髓炎等非肿瘤性疾病的患者的疾病程度和治疗反应。肌病,炎性关节炎,和不明原因的发烧。本AJR专家小组叙事综述总结了支持WB-MRI临床应用的现有证据和建议。本文还强调了局限性,障碍,以及与常规临床实践中使用WB-MRI相关的争议。