ArticleEuropean radiology2023
Whole-body MRI in oncology: can a single anatomic T2 Dixon sequence replace the combination of T1 and STIR sequences to detect skeletal metastasis and myeloma?
Article in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- ESR Essentials: bone marrow MRI in oncology-practice recommendations by the European Society of Musculoskeletal Radiology.European radiology · 2026Guideline
- Whole-body imaging for distant staging of bone chondrosarcoma: a systematic review.La Radiologia medica · 2025Pooled it
- STIR or T2-Dixon? A false dilemma in musculoskeletal MRI.European radiology · 2026Article
- Beyond STIR versus Dixon: musculoskeletal MRI protocol design as a moving target.European radiology · 2026Article
- Imaging response assessment in metastatic renal cell carcinoma: a radiologist's guide to contemporary therapeutic strategies.Abdominal radiology (New York) · 2026Review
- Influence of imaging method on fat fraction estimation for assessing bone marrow in metastatic prostate cancer.European radiology · 2025Article
- Whole-Body Magnetic Resonance Neurography-Technique, Current Perspectives, and Future Directions.Magnetic resonance imaging clinics of North America · 2025Review
- Review of whole-body magnetic resonance imaging in multiple myeloma.Japanese journal of radiology · 2024Review
- ESR essentials: MRI of the knee-practice recommendations by ESSR.European radiology · 2024Review
- Present and future of whole-body MRI in metastatic disease and myeloma: how and why you will do it.Skeletal radiology · 2024Review
- Current state-of-the-art imaging techniques in the domain of whole-body MRI and its advantages over other whole-body PET in different musculoskeletal diseases.European radiology · 2023Article
- Morphological assessment of cartilage and osteoarthritis in clinical practice and research: Intermediate-weighted fat-suppressed sequences and beyond.Skeletal radiology · 2023Review
- Advances in Bone Marrow Imaging: Strengths and Limitations from a Clinical Perspective.Seminars in musculoskeletal radiology · 2023Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo compare the diagnostic accuracy of a single T2 Dixon sequence to the combination T1+STIR as anatomical sequences used for detecting tumoral bone marrow lesions in whole-body MRI (WB-MRI) examinations.
methodsBetween January 2019 and January 2020, seventy-two consecutive patients (55 men, 17 women, median age = 66 years) with solid (prostate, breast, neuroendocrine) cancers at high risk of metastasis or proven multiple myeloma (MM) prospectively underwent a WB-MRI examination including coronal T1, STIR, T2 Dixon and axial diffusion-weighted imaging sequences. Two radiologists independently assessed the combination of T1+STIR sequences and the fat+water reconstructions from the T2 Dixon sequence. The reference standard was established by consensus reading of WB-MRI and concurrent imaging available at baseline and at 6 months. Repeatability and reproducibility of MRI scores (presence and semi-quantitative count of lesions), image quality (SNR: signal-to-noise, CNR: contrast-to-noise, CRR: contrast-to-reference ratios), and diagnostic characteristics (Se: sensitivity, Sp: specificity, Acc: accuracy) were assessed per-skeletal region and per-patient.
resultsRepeatability and reproducibility were at least good regardless of the score, region, and protocol (0.67 ≤ AC1 ≤ 0.98). CRR was higher on T2 Dixon fat compared to T1 (p < 0.0001) and on T2 Dixon water compared to STIR (p = 0.0128). In the per-patient analysis, Acc of the T2 Dixon fat+water was higher than that of T1+STIR for the senior reader (Acc = +0.027 [+0.025; +0.029], p < 0.0001) and lower for the junior reader (Acc = -0.029 [-0.031; -0.027], p < 0.0001).
conclusionsA single T2 Dixon sequence with fat+water reconstructions offers similar reproducibility and diagnostic accuracy as the recommended combination of T1+STIR sequences and can be used for skeletal screening in oncology, allowing significant time-saving. KEY POINTS: • Replacement of the standard anatomic T1 + STIR WB-MRI protocol by a single T2 Dixon sequence drastically shortens the examination time without loss of diagnostic accuracy. • A protocol based on fat + water reconstructions from a single T2 Dixon sequence offers similar inter-reader agreement and a higher contrast-to-reference ratio for detecting lesions compared to the standard T1 + STIR protocol. • Differences in the accuracy between the two protocols are marginal (+ 3% in favor of the T2 Dixon with the senior reader; -3% against the T2 Dixon with the junior reader).
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