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Lecouvet FE, Chabot C, Taihi L, Kirchgesner T, Triqueneaux P, Malghem J. Present and future of whole-body MRI in metastatic disease and myeloma: how and why you will do it. Skeletal Radiol 2024:10.1007/s00256-024-04723-2. [PMID: 39007948 DOI: 10.1007/s00256-024-04723-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/05/2024] [Accepted: 06/05/2024] [Indexed: 07/16/2024]
Abstract
Metastatic disease and myeloma present unique diagnostic challenges due to their multifocal nature. Accurate detection and staging are critical for determining appropriate treatment. Bone scintigraphy, skeletal radiographs and CT have long been the mainstay for the assessment of these diseases, but have limitations, including reduced sensitivity and radiation exposure. Whole-body MRI has emerged as a highly sensitive and radiation-free alternative imaging modality. Initially developed for skeletal screening, it has extended tumor screening to all organs, providing morphological and physiological information on tumor tissue. Along with PET/CT, whole-body MRI is now accepted for staging and response assessment in many malignancies. It is the first choice in an ever increasing number of cancers (such as myeloma, lobular breast cancer, advanced prostate cancer, myxoid liposarcoma, bone sarcoma, …). It has also been validated as the method of choice for cancer screening in patients with a predisposition to cancer and for staging cancers observed during pregnancy. The current and future challenges for WB-MRI are its availability facing this number of indications, and its acceptance by patients, radiologists and health authorities. Guidelines have been developed to optimize image acquisition and reading, assessment of lesion response to treatment, and to adapt examination designs to specific cancers. The implementation of 3D acquisition, Dixon method, and deep learning-based image optimization further improve the diagnostic performance of the technique and reduce examination durations. Whole-body MRI screening is feasible in less than 30 min. This article reviews validated indications, recent developments, growing acceptance, and future perspectives of whole-body MRI.
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Affiliation(s)
- Frederic E Lecouvet
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium.
| | - Caroline Chabot
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Lokmane Taihi
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Thomas Kirchgesner
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Perrine Triqueneaux
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
| | - Jacques Malghem
- Department of Medical Imaging, Institut de Recherche Expérimentale et Clinique (IREC), Institut du Cancer Roi Albert II, Cliniques Universitaires Saint Luc, Université Catholique de Louvain (UCL), Avenue Hippocrate, 10, B-1200, Brussels, Belgium
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Di Primio G, Boyd GJ, Fung CI, Hurrell C, Brahm GL, Bird JR, Co SJ, Kirkpatrick IDC. Recommendations for the Management of Incidental Musculoskeletal Findings on MRI and CT. Can Assoc Radiol J 2023; 74:514-525. [PMID: 36710521 DOI: 10.1177/08465371231152151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The Canadian Association of Radiologists (CAR) Incidental Findings Working Group consists of both academic subspeciality and general radiologists tasked with either adapting American College of Radiology (ACR) guidelines to meet the needs of Canadian radiologists or authoring new guidelines where appropriate. In this case, entirely new guidelines to deal with incidental musculoskeletal findings that may be encountered on thoracoabdominal computed tomography or magnetic resonance imaging were drafted, focussing on which findings should prompt recommendations for further workup. These recommendations discuss how to deal with incidental marrow changes, focal bone lesions, abnormalities of the pubic symphysis and sacroiliac joints, fatty soft tissue masses, manifestations of renal osteodystrophy and finally discuss opportunistic osteoporosis evaluation.
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Affiliation(s)
- Gina Di Primio
- McMaster University, Hamilton, ON, Canada
- Department of Radiology, Oakville Trafalgar Memorial Hospital (Halton Health Care), Oakville, ON, Canada
| | - Gordon J Boyd
- Department of Radiology, Dalhousie University, Halifax, NS, Canada
| | - Christopher I Fung
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Casey Hurrell
- Canadian Association of Radiologists, Ottawa, ON, Canada
| | - Gary L Brahm
- Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Jeffery R Bird
- Department of Medical Imaging, University of Saskatchewan, Saskatoon, SK, Canada
| | - Steven J Co
- University of British Columbia, Vancouver, BC, Canada
| | - Iain D C Kirkpatrick
- Department of Diagnostic Radiology, University of Manitoba, Winnipeg, MB, Canada
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Saifuddin A, Tyler P, Rajakulasingam R. Imaging of bone marrow pitfalls with emphasis on MRI. Br J Radiol 2023; 96:20220063. [PMID: 35522786 PMCID: PMC9975530 DOI: 10.1259/bjr.20220063] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 01/27/2023] Open
Abstract
Normal marrow contains both hematopoietic/red and fatty/yellow marrow with a predictable pattern of conversion and skeletal distribution on MRI. Many variations in normal bone marrow signal and appearances are apparent and the reporting radiologist must differentiate these from other non-neoplastic, benign or neoplastic processes. The advent of chemical shift imaging has helped in characterising and differentiating more focal heterogeneous areas of red marrow from marrow infiltration. This review aims to cover the MRI appearances of normal marrow, its evolution with age, marrow reconversion, variations of normal marrow signal, causes of oedema-like marrow signal, and some common non-neoplastic entities, which may mimic marrow neoplasms.
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Affiliation(s)
- Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
| | - Philippa Tyler
- Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, United Kingdom
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Chang CY, Palmer WE. Introduction to the special section on multiple myeloma. Skeletal Radiol 2022; 51:3-4. [PMID: 34613424 DOI: 10.1007/s00256-021-03921-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Connie Y Chang
- Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA.
| | - William E Palmer
- Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street Yawkey 6E, Boston, MA, 02114, USA
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