title: Diagnostic Performance of Whole-Body MRI as a Tool for Cancer Screening in Children With Genetic Cancer-Predisposing Conditions.
abstract: OBJECTIVE
  Children with cancer-predisposing conditions are at increased risk to develop and die of cancer. Limited data exist on the utility of whole-body MRI as a cancer screening tool in children. In this study, we examined the diagnostic performance of whole-body MRI as a mechanism of tumor surveillance for children at increased genetic risk for cancer.
  
  
  METHODS
  Twenty-four children (six boys and 18 girls) with a mean age of 11.2 years (range, 2.1-18.2 years) underwent 50 unenhanced whole-body MRI examinations over a 5-year period. Scans were retrospectively reviewed and assessed for image quality; sequences performed; and the presence of osseous, soft-tissue, or solid organ abnormalities. Findings suggestive of a malignancy were stratified by risk as low (< 20% chance for cancer), moderate (20-80%), or high (> 80%). MRI findings were correlated with medical records, biopsy results, or additional follow-up imaging; biopsy and follow-up were considered as the reference standards.
  
  
  RESULTS
  Forty-eight of 50 (96%) examinations were of very good quality. Nine findings suspicious for malignancy were identified, including two high-risk, two moderate-risk, and five low-risk lesions. One high-risk lesion was proven by biopsy to be a papillary thyroid carcinoma, with the remaining lesions deemed nonmalignant. The sensitivity of whole-body MRI was 100%; specificity, 94%; positive predictive value, 25%; and negative predictive value (NPV), 100%.
  
  
  CONCLUSIONS
  Unenhanced whole-body MRI is safe and produces excellent images. The high sensitivity, specificity, and NPV make whole-body MRI a valuable cancer screening tool in children with a genetic predisposition for cancer.
authors.affiliation: 1 Department of Radiology, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104.|2 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Sudha A
authors.initials: SA
authors.lastname: Anupindi
authors.affiliation: 1 Department of Radiology, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Bedoya
authors.affiliation: 3 Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Lindell
authors.affiliation: 1 Department of Radiology, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104.|4 Present address: Department of Pediatrics, Newark Beth Israel Medical Center, Newark, NJ.
authors.forename: Siri J
authors.initials: SJ
authors.lastname: Rambhatla
authors.affiliation: 5 Department of Pediatrics, Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Zelley
authors.affiliation: 5 Department of Pediatrics, Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, PA.|6 Department of Oncology, Division of Cancer Predisposition, St. Jude's Children's Research Hospital, Memphis, TN.
authors.forename: Kim E
authors.initials: KE
authors.lastname: Nichols
authors.affiliation: 1 Department of Radiology, The Children's Hospital of Philadelphia, 34th St and Civic Center Blvd, Philadelphia, PA 19104.|2 Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Chauvin
mesh_terms: D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D055088:Early Detection of Cancer; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009386:Neoplastic Syndromes, Hereditary / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D051598:Whole Body Imaging
keywords: Li-Fraumeni syndrome; cancer predisposition; children; hereditary paraganglioma-pheochromocytoma syndrome; whole-body MRI