Whole-body magnetic resonance imaging (WB-MRI) reportedly offers superior soft tissue contrast for malignancy detection than fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) at lower costs and without ionizing radiation. However, a new meta-analysis cites challenges with high and variable incidental findings as well as low cancer detection rates for WB-MRI in asymptomatic individuals.
For the meta-analysis, recently published in European Radiology, researchers reviewed data from 10 studies and a total of 9,024 asymptomatic participants (mean age of 53.8) who had WB-MRI. The reviewed studies included prospective and retrospective research, according to the meta-analysis.
The meta-analysis authors found that WB-MRI had a pooled cancer detection rate of 1.57 percent.
The researchers pointed out incomplete data on follow-up and diagnostic outcomes in several of the reviewed studies. They also noted significant variability with reported biopsy rates (ranging from 2 percent in a 2024 study to 22 percent in a 2020 publication) and cancer yield rates (ranging between 5 to 57 percent).
“This highlights the heterogeneity in downstream management and the absence of standardized protocols for clinical decision-making after WB-MRI. Such inconsistencies may result in over-investigation and
unnecessary procedures, particularly in cases involving benign or indeterminate findings, with potential psychological burden for patients,” noted lead meta-analysis author Joao Martins de Fonesca, M.D., a research fellow affiliated with the Department of Radiology at the University of Florida in Gainesville, Fla., and colleagues.
The researchers noted preliminary research suggesting the promise of combining WB-MRI with multi-cancer early detection (MCED) blood tests for asymptomatic people with high cancer risk.
Three Key Takeaways
1) Low detection yield. WB-MRI demonstrated a pooled cancer detection rate of only 1.57 percent in asymptomatic individuals, raising questions about its value for population-level screening.
2) High variability and incidental findings. Wide differences in biopsy and cancer yield rates, coupled with frequent incidental findings, highlight the lack of standardized protocols for WB-MRI and the potential for unnecessary procedures and psychological burden.
3) Unclear clinical impact. With no available survival outcomes or cost-effectiveness data, current evidence does not support routine use of WB-MRI for cancer screening in asymptomatic populations.
However, the meta-analysis authors also acknowledged that none of the reviewed studies provided formal cost-effectiveness analyses nor information on progression-free or overall survival rates with the use of WB-MRI in asymptomatic individuals.
“Overall, current evidence does not support routine population-level WB-MRI application in asymptomatic individuals for cancer detection. Despite theoretical advantages, low detection rates, inconsistent reporting, lack of survival outcomes, and frequent incidental findings raise concerns about clinical utility, cost-effectiveness, and potential harm,” emphasized de Fonesca and colleagues.
(Editor’s note: For related content, see “Whole-Body MRI in Preventive Medicine: Evaluating the Current Evidence,” “FDA Clears 5T Whole-Body MRI System” and “The Reading Room Podcast: A Closer Look at Remote MRI Safety.”)
In regard to limitations with the meta-analysis, the authors acknowledged variability with the cohort sizes of the reviewed studies and conceded differences among the studies with respect to MRI field strength, incorporated imaging sequences and contrast agent use.
