The Diagnostic Yield of Whole-Body MRI as a Multi-disease Screening Modality: A Systematic Review and Meta-analysis.
Abstract
Background
Disease screening is a mainstay of modern healthcare. Whole-body magnetic resonance imaging (WBMRI) is marketed as a multi-disease screening modality. The diagnostic yield and clinical utility of WBMRI for population-based disease screening are uncertain.
Objectives
Our systematic review and meta-analysis aimed to synthesize and critically appraise the available literature on WBMRI without an evidence-based indication. Our objective was to evaluate the diagnostic yield of WBMRI and assess the scope of findings.
Design
We conducted a systematic review and meta-analysis searching MEDLINE, Embase, and CENTRAL from inception through August 2025. This review was registered with PROSPERO (No.: CRD42024554848). Prespecified criteria for study inclusion included literature that reported WBMRI findings in a population without an evidence-based indication for WBMRI. Data appraisal was performed by two independent reviewers with summary data extracted from published reports. MAIN MEASURES Outcomes evaluated included pooled proportions of individuals with no clinical findings reported, any clinical finding, non-malignant actionable findings that required subsequent diagnostic workup, and new cancer diagnoses. KEY
Results
In a pooled cohort of 18,043 individuals from 17 heterogeneous low-quality studies who underwent WBMRI, 16.9% (95% CI 5.1; 43.7) had no findings reported, while 78.0% (95% CI 44.9; 93.9) had a finding reported. Clinically actionable non-malignant findings were reported in 14.8% (95% CI 6.6-30.0%); 58.2% (95% CI 36.0; 77.5) of these individuals pursued additional laboratory work and/or imaging, and 20.8% (95% CI 9.7; 39.2) pursued a subsequent procedure. The prevalence of malignancy was 1.4% (95% CI 0.9-2.2%). Clinical outcomes associated with discovery of lesions could not be determined.
Conclusions
The majority of WBMRIs performed in a population without an evidence-based indication result in findings that are normal or do not require follow-up. Clinical outcomes associated with discovery of actionable lesions are unknown. High-quality observational data or randomized trials are needed to inform the efficacy of WBMRI for multi-disease screening. CLINICAL TRIAL NUMBER Not applicable.