Diagnostic Accuracy of Whole-Body MRI Versus PET/CT in Cancer Staging: A meta anlysis
Keywords:
Whole-body MRI, PET/CT, cancer staging, diagnostic accuracy, metastasis, diffusion-weighted imaginAbstract
Background:Accurate staging of solid malignancies is essential for appropriate treatment planning and prognostication. While 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) remains a standard imaging modality for systemic staging, whole-body magnetic resonance imaging (WB-MRI), particularly with diffusion-weighted imaging (DWI), has emerged as a promising radiation-free alternative. This systematic review aimed to compare the diagnostic accuracy of WB-MRI versus FDG PET/CT in staging adult patients with solid tumors.
Methods:A systematic search of six databases (PubMed, Embase, Scopus, Web of Science, CINAHL, and Cochrane Library) was conducted up to July 2025. Studies were eligible if they included adult patients with solid tumors, employed head-to-head comparisons of WB-MRI and FDG PET/CT, and reported diagnostic performance metrics. Risk of bias was assessed using the QUADAS-2 tool. A narrative synthesis was performed due to heterogeneity in study designs and outcome reporting.
Results:Ten open-access studies (N ≈ 3,400 patients) were included, spanning diverse tumor types including lung, colorectal, breast, prostate, and cervical cancers. Across studies, WB-MRI and PET/CT demonstrated comparable sensitivity (range: 67%–97.9%) and specificity (range: 89%–100%) in detecting metastases. WB-MRI showed superior performance in detecting bone lesions, while PET/CT was more sensitive for nodal and pulmonary metastases. Risk of bias was low in most studies.
Conclusions:WB-MRI provides diagnostic accuracy comparable to FDG PET/CT for staging solid tumors and offers distinct advantages in radiation safety and bone metastasis detection. Further research is needed to refine its role across tumor types and clinical settings
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