Schmidt G P, Haug A, Reiser M F, Rist C
Institut für Klinische Radiologie, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, Marchioninistr. 15, 81377, München, Deutschland.
Radiologe. 2010 Apr;50(4):329-38. doi: 10.1007/s00117-009-1971-3.
The advent of whole-body MRI (WB-MRI) has introduced a systemic approach to oncologic imaging compared to established sequential, multi-modal diagnostic algorithms. Hardware innovations, such as whole-body scanners at 1.5 Tesla and also recently 3 Tesla, combined with acquisition acceleration techniques, have made WB-MRI clinically feasible. With this method dedicated assessment of individual organs with various soft tissue contrast, high spatial resolution and contrast media dynamics can be combined with whole-body anatomic coverage.PET/CT has established itself as a powerful modality in the staging of patients suffering from malignant tumors. In addition to the morphologic information provided by the CT component of this hybrid modality, the PET component contributes invaluable metabolic information, which greatly enhances accuracy in the assessment of lymphatic spread and viability of tumor tissue. Whole-body MR diffusion imaging is a novel and promising technique which may contribute to superior sensitivity in the detection of tumor manifestations. In the assessment of distant metastatic spread WB-MRI is highly sensitive and has advantages over PET/CT, especially in those tumors frequently spreading to the liver, bone or brain. WB-MRI is also very attractive as a radiation-free alternative for imaging of pediatric tumor patients in whom multiple follow-up examinations may be required.WB-MRI allows for precise assessment of the bone marrow and has been proven to be highly accurate for the staging of hematologic diseases, such as multiple myeloma. In this article recent developments and applications of WB-MRI in oncologic imaging are addressed and compared to the results of PET/CT.
与已确立的序贯多模态诊断算法相比，全身磁共振成像（WB-MRI）的出现引入了一种系统性的肿瘤成像方法。硬件创新，如1.5特斯拉的全身扫描仪以及最近的3特斯拉全身扫描仪，再加上采集加速技术，使WB-MRI在临床上切实可行。通过这种方法，对各个器官进行具有多种软组织对比、高空间分辨率和造影剂动力学的专门评估，可与全身解剖覆盖相结合。正电子发射断层显像/计算机断层扫描（PET/CT）已成为恶性肿瘤患者分期的一种强大手段。除了这种混合模式的CT部分提供的形态学信息外，PET部分还提供了宝贵的代谢信息，这大大提高了评估淋巴转移和肿瘤组织活性的准确性。全身磁共振扩散成像（WB-MRI）是一种新颖且有前景的技术，可能在检测肿瘤表现方面具有更高的敏感性。在评估远处转移扩散方面，WB-MRI高度敏感，优于PET/CT，尤其是在那些经常转移至肝脏、骨骼或大脑的肿瘤中。WB-MRI作为一种无辐射的替代方法，对于可能需要多次随访检查的儿科肿瘤患者成像也非常有吸引力。WB-MRI能够精确评估骨髓，并且已被证明在血液系统疾病（如多发性骨髓瘤）的分期中高度准确。本文探讨了WB-MRI在肿瘤成像方面的最新进展和应用，并与PET/CT的结果进行了比较。
