Stefan Oswald Schoenberg MD, PhD, Presenter: Institutional research agreement, Siemens AG

1) To understand the indications for whole-body MRI in non-oncologic applications. 2) To optimize the protocols with regard to the type of disease, acquisition speed and standardized reporting. 3) To show the additional diagnostic value of whole-body MRI in comparison to routine diagnostic tests.

For many disease entities, magnetic resonance imaging (MRI) is the technique of choice for assessment of focal organ involvement including vascular occlusive disease as well as rheumatic and pediatric diseases. Many of these, however, affect multiple sites within the entire body with different types of disease manifestations, favoring a systemic whole-body (wb) imaging approach. A wb-MRI protocol has to be tailored to the individial type of disease by including high-resolution imaging of bony structures, time-resolved display of inflammatory changes, assessment of the vascular status by angiography and information on cellular density for detection of infiltrative diseases. Therefore, techniques such as contrast-enhanced MR angiography, sequences for cardiac function and delayed contrast enhancement, diffusion weighted imaging and fat-suppressed T1 and T2 weighted studies before and after contrast media injection have to be integrated into the wb-MRI protocol. For robust and time-efficient implementation, innovative approaches such as parallel acquisition techniques, continuous table movement and multi-contrast imaging sequences are required. Clinically established indications include screening for macro-vascular complications in vasculitis, detection and therapy monitoring of joint and ligamentous affection in rheumatic diseases and screening for malignant features in hereditary multifocal exostoses. Arising applications are e.g. cardiovascular risk assessment including whole-body fat quantification, detection of micro- and macro-vascular complications in diabetes and screening for inflammatory foci in immunocompromised patients with fever of unknown origin. For a reliable clinical application, standardized reporting schemes and severity scores are being developed and the results have to be compared to currently applied diagnostic reference standards.

http://www.ikrn.de/RSNA2014/Whole-Body-MRI/

Schoenberg, S, Whole Body MRI—Non-oncologic Applications.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/13013019.html