Whole-body screening for early detection of metastatic disease and whole-body staging to evaluate the extent of existing disease is critical for timely intervention and treatment. 18Fluorodeoxyglucose based positron emission tomography (FDG-PET) combined with computed tomography (PET/CT) is still the gold standard for whole-body screening and staging. However, there are concerns with limited sensitivity for certain tumors and increased exposure to ionizing radiation, particularly in younger patients with need for repeated exposures during long follow-up periods.
MRI has become an attractive approach due to the excellent soft tissue contrast combined with its lack of ionizing radiation. In recent years, diffusion-weighted imaging (DWI) using echo planar acquisitions has gained increased attention for whole-body screening but suffers from poor signal to noise ratio (SNR) and image distortions when used with larger fields of view. Towards this goal, we are currently developing alternative approaches to DWI, using a Dual-Echo T2-weighted image for Enhanced Conspicuity of the Tumors (DETECT) with simultaneous fat, blood, and fluid suppression (Wang X et. al. Magn. Reson. Med. 2018). This is currently evaluated for detection and therapy response assessment in multiple myeloma and patients with bone metastases, that can affect anywhere in the body.
