2 new trials explore the potential of whole-body MRI for improving cancer care

Whole-body MRI (WB-MRI) shows promise as an alternative to multi-modality staging of colorectal cancer and non-small-cell lung cancer (NSCLC), according to new studies published in The Lancet Gastroenterology & Hepatology and The Lancet Respiratory Medicine.

The research included two trials—the Streamline C trial focused on colorectal cancer and the Streamline L trial focused on NSCLC—carried out at 16 hospitals in England. All patients in both trials were 18 years old or older with newly diagnosed cancer. While 299 patients completed the Streamline C trial, 187 patients completed the Streamline L trial.

For colorectal cancer patients studied during the Streamline C trial, sensitivity was 67% for WB-MRI, compared to 63% for standard multi-modality staging. Agreement with the final treatment decision was 96% for WB-MRI and 95% for multi-modality staging.

For NSCLC patients studied during the Streamline L trial, sensitivity was 50% for WB-MRI and 54% for standard multi-modality staging. Agreement with the final treatment decision was 98% for WB-MRI and 99% for multi-modality staging.

In both studies, specificity was not affected negatively by moving from standard techniques to WB-MRI. No adverse events related to imaging were reported.

Also, costs were reduced from an average of £285 (roughly $371) to £216 (roughly $281) for colorectal cancer patients and from an average of £620 (roughly $807) to £317 (roughly $412) for lung cancer patients. The time to complete staging was also quicker with WB-MRI for both trials, dropping a median of 13 days to a median of 8 days for colorectal cancer patients and from a median of 19 days to a median of 13 days for NSCLC patients. 

“Our results, obtained in a real-world NHS setting, suggest that whole body MRI could be more suitable for routine clinical practice than the multiple imaging techniques recommended under current guidelines,” lead author Stuart Taylor, MD, a professor at University College London, said in a prepared statement. “While demands on NHS MRI scanners is currently high, MRI can image the whole body in one-hour or less. Adopting whole body MRI more widely could save rather than increase costs, as well as reducing the time before a patient’s treatment can begin.”

The authors emphasized that their findings were specific to these two cancers and may not apply to others.