Whole-body MRI may be as effective as PET/CT for cancer staging, even at half the price
Both whole-body MRI and PET scans can offer clinicians vital information needed to stage cancer, but one modality comes with a significantly lower price tag.
A new paper details the comparable performances of WB-MRI and WB 18F-fluorodeoxyglucose PET/CT for detecting extra-nodal metastatic lesions in lung adenocarcinoma. Though both modalities offer valuable insight into the extent of a patient’s disease, WB-MRI, experts determined, may be more beneficial than the current go-to approach.
“18F-fluorodeoxyglucose positron emission tomography/computed tomography is the current standard of care for metastatic staging in non-small cell lung cancer and has been shown superior to computed tomography alone for detecting bone metastasis,” Jeevitesh Khoda, from department of radiology at Tata Medical Center in Kolkata, India, and colleagues noted. “However, repeated FDG-PET/CT studies expose patients to cumulative ionizing radiation and incur significant financial cost. Whole-body magnetic resonance imaging, combining diffusion-weighted imaging with anatomical sequences, offers a radiation-free staging alternative.”
To get a better idea of how MRI holds up against PET/CT for staging purposes, the team conducted a prospective analysis that included 70 patients with biopsy-proven lung adenocarcinoma. Patients underwent both exams, giving the team an opportunity to compare the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and agreement between each modality.
More lesions were detected with WB-MRI (278 versus 260); the radiation-free modality also yielded a comparable performance in terms of sensitivity, specificity and accuracy, even outperforming PET/CT in sensitivity by around 4%. Inter-modality agreement was almost perfect between the two.
What’s more, the group also estimated that WB-MRIs for extranodal staging cost patients approximately 66% less than PET/CT. That, combined with the benefit of being radiation-free, warrants the consideration of using WB-MRI for staging, the authors suggested, adding that the modality could improve issues related to accessibility as well.
“WB-MRI demonstrates diagnostic performance comparable to FDG-PET/CT for extra-nodal metastatic staging in lung adenocarcinoma, with the advantages of no ionizing radiation, lower cost (66.7 % reduction), and simultaneous brain screening in a single sitting,” the group noted. “These findings support WB-MRI as a viable alternative staging modality, particularly in resource-constrained healthcare settings.”
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.