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Whole body MR may support faster, less expensive cancer treatment planning

por John R. Fischer, Senior Reporter | May 15, 2019
MRI

Taylor and his colleagues plan to continue their studies on WB-MR, having applied for a grant to research its use in staging breast cancer. They also plan to work with Imperial College London in studying the influence of AI and machine learning applications on interpretations of such scans.

“WB-MR consists of many images (as several sequences are acquired through the whole body),” he said. “Thus, they are quite difficult and time-consuming to interpret. AI and machine learning may be able to highlight areas of abnormality on the scans for radiologists to check, speeding up the time it take to interpret the study and potentially increasing accuracy by reducing perceptual errors.”

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To perform their research, a multidisciplinary panel compared the diagnostic accuracy and efficiency of whole body MR to that of standard imaging tests recommended by the National Institute for Health and Care Excellence (NICE). The findings of the latter were used to make a first-treatment decision, and then images from the WB-MR were evaluated. If the NICE tests indicated a need for further testing, it was carried out, as it allowed the panel to determine if the first treatment decision would have been different, based on WB-MR results.

The final decision took into consideration the findings of WB-MR and standard testing, with patients followed up after 12 months to assess the accuracy of both, and retrospectively evaluate what the optimal treatment decision should have been. The final multidisciplinary panel treatment decision in the colorectal cancer trial was 95 percent for standard investigations and WB-MR. For the lung cancer trial, it was 99 percent and 98 percent, respectively.

The researchers caution that the findings may not be relevant to tumors in other areas of the body, as they are only specific to colorectal and non-small cell lung cancer, and that sensitivity in detecting the spread of cancers, including the development of secondary tumors and the spread of lymph nodes, is low when using both standard imaging methods and WB-MR. Another limitation is the fact that the waiting times in the trials may not represent those of other U.K. providers or hospitals in other countries.

The findings were published in The Lancet Gastroenterology & Hepatology and The Lancet Respiratory Medicine.

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