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Whole-Body MR Imaging: Evaluation of Patients for Metastases¹

¹ From the Departments of Diagnostic and Interventional Radiology (T.C.L., S.C.G., C.U.H., M.G., J.F.D., S.G.R., J.B.) and Obstetrics and Gynecology (C.O.), University Hospital Essen, Hufelandstrasse 55, D-45122 Essen, Germany. Received May 18, 2003; revision requested July 22; final revision received January 9, 2004; accepted February 24. Address correspondence to T.C.L. (e-mail: thomas.lauenstein@uni-essen.de).

View larger version (60K): [in a new window]   Figure 1. Patients are placed in supine position on the rolling table platform (left) that is capable of pulling the patient through the magnet bore and a phased-array surface coil (right). The rolling table platform is mounted on top of the original patient table. Signal reception is accomplished by using two elements of the spine coil integrated in the patient table and the body phased-array coil, which remains stationary because it is attached to the patient table within the bore. For demonstration purposes, the phased-array coil is not placed in the center of the magnet.

View larger version (25K): [in a new window]   Figure 2. Imaging protocol of the 3D gradient-echo sequence. After intravenous administration of a paramagnetic contrast agent, 3D data sets of the abdomen are acquired in early arterial and portal venous phases. Subsequently, the rolling table platform is moved to the thorax, pelvis, femur, skull, and back to the abdomen to acquire data sets in an equilibrium contrast phase.

View larger version (62K): [in a new window]   Figure 3. Reformatted coronal images of transverse T1-weighted gradient-echo data sets (3.1/1.17, 30° flip angle) in a 67-year-old man with malignant melanoma. Cerebral metastases (1), pulmonary metastasis (2), and metastasis in the right adrenal gland (3) were detected at whole-body MR imaging.

View larger version (102K): [in a new window]   Figure 4a. MR images in a 48-year-old woman with breast cancer. A single cerebral metastasis (arrow) was detected on (a) transverse whole-body image (3.1/1.17, 30° flip angle) and was confirmed on (b) dedicated contrast-enhanced image (525/17, 70° flip angle).

View larger version (125K): [in a new window]   Figure 4b. MR images in a 48-year-old woman with breast cancer. A single cerebral metastasis (arrow) was detected on (a) transverse whole-body image (3.1/1.17, 30° flip angle) and was confirmed on (b) dedicated contrast-enhanced image (525/17, 70° flip angle).

View larger version (132K): [in a new window]   Figure 5a. Images in a 55-year-old man with thyroid cancer. Pulmonary metastases (arrows) were depicted at transverse whole-body MR imaging by using (a) contrast-enhanced 3D gradient-echo (3.1/1.17, 30° flip angle) and (b) T2-weighted RARE (1200/60, 150° flip angle) sequences. (c) Corresponding CT scan confirms the results.

View larger version (128K): [in a new window]   Figure 5b. Images in a 55-year-old man with thyroid cancer. Pulmonary metastases (arrows) were depicted at transverse whole-body MR imaging by using (a) contrast-enhanced 3D gradient-echo (3.1/1.17, 30° flip angle) and (b) T2-weighted RARE (1200/60, 150° flip angle) sequences. (c) Corresponding CT scan confirms the results.

View larger version (130K): [in a new window]   Figure 5c. Images in a 55-year-old man with thyroid cancer. Pulmonary metastases (arrows) were depicted at transverse whole-body MR imaging by using (a) contrast-enhanced 3D gradient-echo (3.1/1.17, 30° flip angle) and (b) T2-weighted RARE (1200/60, 150° flip angle) sequences. (c) Corresponding CT scan confirms the results.

View larger version (132K): [in a new window]   Figure 6a. Transverse images in a 71-year-old woman with ovarian cancer. (a) While pulmonary metastases were not detected with 3D gradient-echo MR sequence (3.1/1.17, 30° flip angle), (b) single pulmonary metastasis (arrow) was detected with T2-weighted RARE sequence (1200/60, 150° flip angle).

View larger version (122K): [in a new window]   Figure 6b. Transverse images in a 71-year-old woman with ovarian cancer. (a) While pulmonary metastases were not detected with 3D gradient-echo MR sequence (3.1/1.17, 30° flip angle), (b) single pulmonary metastasis (arrow) was detected with T2-weighted RARE sequence (1200/60, 150° flip angle).

View larger version (135K): [in a new window]   Figure 7a. Images in a 51-year-old woman with breast cancer. A single hepatic metastasis arrow) was found in the right hepatic lobe at both (a) transverse whole-body MR (3.1/1.17, 30° flip angle) and (b) CT imaging.

View larger version (130K): [in a new window]   Figure 7b. Images in a 51-year-old woman with breast cancer. A single hepatic metastasis arrow) was found in the right hepatic lobe at both (a) transverse whole-body MR (3.1/1.17, 30° flip angle) and (b) CT imaging.

View larger version (96K): [in a new window]   Figure 8a. Images in a 49-year-old woman with breast cancer. Transverse T1-weighted whole-body MR images (3.1/1.17, 30° flip angle) depict osseous metastases in (a) the lumbar spine (left arrow) and pelvis (right arrow). (b) Skeletal scintigrams helped confirm the metastases (arrows).

View larger version (107K): [in a new window]   Figure 8b. Images in a 49-year-old woman with breast cancer. Transverse T1-weighted whole-body MR images (3.1/1.17, 30° flip angle) depict osseous metastases in (a) the lumbar spine (left arrow) and pelvis (right arrow). (b) Skeletal scintigrams helped confirm the metastases (arrows).

View larger version (96K): [in a new window]   Figure 9a. Images in a 22-year-old woman with thyroid cancer. Osseous metastases (arrows) were visualized as lesions with high signal intensity on transverse T1-weighted whole-body MR images (3.1/1.17, 30° flip angle) in the (a) lumbar spine and (b) pelvis. (c) Skeletal scintigrams do not depict metastases; they were proved at follow-up studies.

View larger version (102K): [in a new window]   Figure 9b. Images in a 22-year-old woman with thyroid cancer. Osseous metastases (arrows) were visualized as lesions with high signal intensity on transverse T1-weighted whole-body MR images (3.1/1.17, 30° flip angle) in the (a) lumbar spine and (b) pelvis. (c) Skeletal scintigrams do not depict metastases; they were proved at follow-up studies.

View larger version (73K): [in a new window]   Figure 9c. Images in a 22-year-old woman with thyroid cancer. Osseous metastases (arrows) were visualized as lesions with high signal intensity on transverse T1-weighted whole-body MR images (3.1/1.17, 30° flip angle) in the (a) lumbar spine and (b) pelvis. (c) Skeletal scintigrams do not depict metastases; they were proved at follow-up studies.