Whole-Body MRI in Children and Juveniles

The imaging of systemic disorders without radiation exposure by whole-body MRI (wb-MRI) represents a paradigm shift for pediatric radiology. The reduction of multiple regional examinations, if necessary under sedation, results in a faster treatment start. Modern scanner techniques using automatic table movement and allowing the combination of multiple coil elements and synchronized signal recording with numerous independent receiving channels are the basic prerequisite for high-resolution wb-MRI. The main indications are the evaluation of multifocal bone involvement in different disorders, rheumatic disorders including fever of unknown origin or metastatic spread in solid tumors. Based on the research, there is currently no absolute indication. However, wb-MRI has been shown to yield a higher diagnostic performance than bone scintigraphy and comparable results to FDG-PET for the detection of bone metastases. Due to the low number of published studies, it is uncertain for which entity of solid tumors wb-MRI is the modality of choice and for which tumors wb-MRI will play only a complementary role in the diagnostic work-up. Methodical strategies, pitfalls in image analysis, indications and diagnostic accuracy will be discussed based on already published results as well as our own experience from over 400 examinations, thus providing an overview of the recent research as well as supplying relevant aspects of the daily routine in pediatric wb-MRI.