ArticleRevista da Associacao Medica Brasileira (1992)2026
Whole-body magnetic resonance imaging vs. positron emission tomography-computed tomography in pediatric oncology: enhancing diagnostic precision for solid tumors.
Article in Revista da Associacao Medica Brasileira (1992), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePediatric solid tumors require accurate imaging for staging, treatment planning, and follow-up. Whole-body magnetic resonance imaging has emerged as a promising radiation-free alternative to positron emission tomography-computed tomography, offering superior soft tissue contrast. This study compares the diagnostic performance of whole-body magnetic resonance imaging and positron emission tomography-computed tomography in detecting primary tumors, metastases, and recurrences in pediatric solid tumors.
methodsThis retrospective study included 47 pediatric patients (27 boys and 20 girls; age range: 3-18 years; mean age: 11.3±3.5 years) with suspected or confirmed solid tumors who underwent both whole-body magnetic resonance imaging and positron emission tomography-computed tomography between 2017 and 2020. Lesional and per-patient agreement between modalities was evaluated using positron emission tomography-computed tomography as the reference. Statistical analysis was performed to assess inter-modality agreement.
resultsPositron emission tomography-computed tomography detected pathological findings in 35 patients (74.4%), including 27 primary tumors (57.4%), 18 metastases (38.2%), and one recurrence (2.1%). Whole-body magnetic resonance imaging showed high diagnostic concordance, detecting all primary tumors and the recurrence, and 16 of 18 metastatic cases. Per-lesion analysis revealed 66 lesions on positron emission tomography-computed tomography and 64 on whole-body magnetic resonance imaging, with two metastatic lesions (an ossified pulmonary metastasis and an osteoblastic femur lesion) missed by magnetic resonance imaging. Cohen's kappa (κ) for abnormality detection was 0.89, indicating almost perfect agreement (95%CI 0.75-1.00). McNemar's test showed no statistically significant difference between the modalities (p=0.479).
conclusionWhole-body magnetic resonance imaging demonstrates excellent agreement with positron emission tomography-computed tomography for evaluating pediatric solid tumors, offering a radiation-free alternative, particularly advantageous in long-term follow-up. While limitations remain in detecting sclerotic metastases, whole-body magnetic resonance imaging is a primary alternative in specific scenarios.
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