Whole-body MR imaging: evaluation of patients for metastases.
OBJECTIVE
To compare the results of whole-body magnetic resonance (MR) imaging with staging based on computed tomographic (CT), dedicated MR imaging, and nuclear scintigraphic results as standard of reference.


METHODS
Fifty-one patients with known malignant tumors were included in the study. Patients were placed on a rolling table platform capable of moving the patient rapidly through the isocenter of the magnet bore. The thorax and the abdomen were imaged by using fast breath-hold T2-weighted sequences in the transverse plane. After intravenous administration of a paramagnetic contrast agent, three-dimensional gradient-echo data sets were collected in five stations and covered the body from the skull to the knees. Location and size of cerebral, pulmonary, hepatic, and osseous metastases were documented by two experienced radiologists. Whole-body MR imaging findings were compared with results obtained at skeletal scintigraphy, CT, and dedicated MR imaging.


RESULTS
The mean examination time for whole-body MR imaging was 14.5 minutes. All cerebral, pulmonary, and hepatic metastases greater than 6 mm in diameter could be identified with whole-body MR imaging. Small pulmonary metastases were missed with MR imaging, which did not change therapeutic strategies, but MR imaging depicted a single hepatic metastasis that was missed with CT. Skeletal scintigraphy depicted osseous metastases in 21 patients, whereas whole-body MR imaging revealed osseous metastases in 24 patients. The additional osseous metastases seen with MR imaging were confirmed at follow-up examinations but did not result in a change in therapy. Whole-body MR imaging performed on a per-patient basis revealed sensitivity and specificity values of 100%.


CONCLUSIONS
Whole-body MR imaging for the evaluation of metastases compared well with the reference techniques for cerebral, pulmonary, and hepatic lesions. Whole-body MR imaging was more sensitive in the detection of hepatic and osseous metastases than were the reference techniques.
Departments of Diagnostic and Interventional Radiology and Obstetrics and Gynecology, University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany. thomas.lauenstein@uni-essen.de
Thomas C
TC
Lauenstein
Susanne C
SC
Goehde
Christoph U
CU
Herborn
Matthias
M
Goyen
Carsten
C
Oberhoff
Jörg F
JF
Debatin
Stefan G
SG
Ruehm
Jörg
J
Barkhausen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000556:secondary; D001932:Brain Neoplasms / Q000556:secondary; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D003287:Contrast Media