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• Clinical Article •
Diagnostic value of whole-body magnetic resonance imaging for incidental lesions in postoperative breast cancer patients
FANG Fang  ZHANG Dandan  SUN Yu  LEI Lu  SHI Heshui  LÜ Xuefei 

DOI:10.12015/issn.1674-8034.2025.12.013.


[Abstract] Objective To explore the diagnostic value of whole-body MRI (WB-MRI) in postoperative incidental lesions of breast cancer.Materials and Methods The WB-MRI images of 222 patients with breast cancer after operation in Wuhan Red Cross Hospital from January 2022 to February 2025 were retrospectively analyzed. Based on international guidelines, all incidental lesions were divided into significant and non-significant groups. The diagnostic efficacy of WB-MRI was compared with conventional imaging examinations (CT plain scan and ultrasound) with pathological or follow-up results as the gold standard, and the relationship between age, postoperative time and the number of lesions was analyzed.Results A total of 736 incidental lesions were detected in 222 patients by WB-MRI, and the detection rate was 98.20% (218/222), among which 132 were significant lesions (17.93%). These were mainly distributed in chest (16.67%), liver (12.12%), pancreas (9.85%), uterine adnexa (10.61%) and skeleton (10.61%). For the detection of pulmonary lesions, the sensitivity of WB-MRI was lower than that of CT plain scan (63.64% vs. 95.45%), with a statistically significant difference (P = 0.009), and the specificity of both was low. For the detection of abdominal solid organ lesions. The sensitivity of WB-MRI was higher than that of CT and ultrasound (91.18% vs. 55.88%/41.18%), with statistically significant differences (both P < 0.001), its specificity (66.7%) was also better than that of ultrasound (33.3%). For the detection of uterine adnexal lesions. There was no significant difference in sensitivity between WB-MRI and ultrasound (84.3% vs. 92.2%, P = 0.354), but the specificity was equal (both were 50%). The sensitivity of WB-MRI in detecting bone lesions was significantly higher than that of CT (97.1% vs. 67.4%), and the difference was statistically significant (P = 0.004), and the specificity was also better than that of CT. There was no significant correlation between patients' age and postoperative time and the proportion of significant lesions (Age: P = 0.121; Postoperative time: P > 0.05).Conclusions WB-MRI has strong ability to detect postoperative incidental lesions of breast cancer patients, especially abdominal, pelvic and bone lesions, and can be used as an effective tool for systemic screening. It is suggested that it should be combined with CT and other examinations to provide more accurate diagnostic information for clinic.
[Keywords] breast cancer；incidental lesions；whole-body magnetic resonance imaging；diagnostic value；postoperative follow-up；magnetic resonance imaging

FANG Fang1   ZHANG Dandan1   SUN Yu1   LEI Lu1   SHI Heshui2   LÜ Xuefei1*  

1 Department of Radiology, Wuhan Red Cross Hospital, Wuhan 430015, China

2 Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China

Corresponding author: LÜ X F, E-mail: 33491584@qq.com

Conflicts of interest   None.

Received  2025-05-12
Accepted  2025-12-07
DOI: 10.12015/issn.1674-8034.2025.12.013
DOI:10.12015/issn.1674-8034.2025.12.013.

[1]
WANG H X, YIN Y M, HU X C. Expert consensus on BRCA1/2 gene testing and clinical application in Chinese breast cancer patients(2025 edition)[J]. China Oncol, 2025, 35(7): 710-734. DOI: 10.19401/j.cnki.1007-3639.2025.07.010.
[2]
HUNG M H, LIU C J, TENG C J, et al. Risk of second non-breast primary cancer in male and female breast cancer patients: a population-based cohort study[J/OL]. PLoS One, 2016, 11(2): e0148597 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/26894298/. DOI: 10.1371/journal.pone.0148597.
[3]
The Society of Breast Cancer China AntiCancer Association, Breast Oncology Group of the Oncology Branch of the Chinese Medical Association. Guidelines for breast cancer diagnosis and treatment by China Anti-cancer Association(2024 edition)[J]. China Oncol, 2023, 33(12): 1092-1187. DOI: 10.19401/j.cnki.1007-3639.2023.12.004.
[4]
National Health and Wellness Committee Medical Administration Hospital Authority. Guidelines for Diagnosis and Treatment of Breast Cancer (2022 Edition)[J]. Chin J Oncol, 2023, 45(10): 803-833. DOI: 10.3760/cma.j.cn112152-20230706-00281.
[5]
ALBANO D, STECCO A, MICCI G, et al. Whole-body magnetic resonance imaging (WB-MRI) in oncology: an Italian survey[J]. Radiol Med, 2021, 126(2): 299-305. DOI: 10.1007/s11547-020-01242-7.
[6]
RASHID R J, TAHIR S H, KAKAMAD F H, et al. Whole-body MRI for metastatic workup in patients diagnosed with cancer[J/OL]. Mol Clin Oncol, 2023, 18(4): 33 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/36925744/. DOI: 10.3892/mco.2023.2629.
[7]
TRAN E, JOE B N. Use of whole-body MRI in metastatic breast cancer[J/OL]. Radiol Imaging Cancer, 2022, 4(6): e229023 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/36367448/. DOI: 10.1148/rycan.229023.
[8]
GAO Y H, WANG Q, ZHANG L, et al. Clinical application update of whole-body MRI[J]. Chin J Radiol, 2023, 57(4): 438-440. DOI: 10.3760/cma.j.cn112149-20230131-00059.
[9]
LIU H Q, GAO W X, BA C H, et al. Application progress of whole body-magnetic resonance imaging in common tumors and screening progress in high-risk groups[J]. Chin J Magn Reson Imag, 2022, 13(6): 164-167. DOI: 10.12015/issn.1674-8034.2022.06.035.
[10]
WANG Y B, LIU Y Y, CHANG X D. WB-DWI for the postoperative clinical evaluation of breast cancer patients[J]. Image Technol, 2024, 36(1): 53-57. DOI: 10.3969/j.issn.1001-0270.2024.01.11.
[11]
DOLEK B A, CILIZ D S, OZDEMIR N, et al. Comparative analysis of whole-body diffusion-weighted imaging and PET/CT in metastasis detection: a prospective study[J/OL]. Cureus, 2024, 16(11): e74756 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/39735112/. DOI: 10.7759/cureus.74756.
[12]
PREEZ H D, LASKER I, RAJAKULASINGAM R, et al. Whole-body magnetic resonance imaging: Incidental findings in paediatric and adult populations[J/OL]. Eur J Radiol, 2020, 130: 109156 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/32645680/. DOI: 10.1016/j.ejrad.2020.109156.
[13]
YEE J, KUMAR N N, GODARA S, et al. Extracolonic abnormalities discovered incidentally at CT colonography in a male population[J]. Radiology, 2005, 236(2): 519-526. DOI: 10.1148/radiol.2362040166.
[14]
YIN M, QIN W H, SUN Z G. Research progress of MRI radiomics in lung cancer[J]. Chin J Magn Reson Imag, 2023, 14(6): 129-132, 150. DOI: 10.12015/issn.1674-8034.2023.06.023.
[15]
DONG Z Y, LI Y X, SHI X Y, et al. Research progress of diffusion-weighted magnetic resonance imaging technology in the diagnosis and treatment of lung cancer[J]. Chin J Magn Reson Imag, 2025, 16(8): 215-220. DOI: 10.12015/issn.1674-8034.2025.08.032.
[16]
TAKASHIMA K, TAKIMOTO Y, NAKAZAWA E, et al. Discovery and informing research participants of incidental findings detected in brain magnetic resonance imaging studies: Review and multi-institutional study[J/OL]. Brain Behav, 2017, 7(5): e00676 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/28523219/. DOI: 10.1002/brb3.676.
[17]
MUNDEN R F, BLACK W C, HARTMAN T E, et al. Managing incidental findings on thoracic CT: lung findings. a white paper of the ACR incidental findings committee[J]. J Am Coll Radiol, 2021, 18(9): 1267-1279. DOI: 10.1016/j.jacr.2021.04.014.
[18]
JU S H, SONG B, ZHANG H M, et al. Brief introduction of the white paper of accidental lesions committee of American radiological college (ACR)[J]. Radiol Pract, 2018, 33(2): 113-114. DOI: 10.13609/j.cnki.1000-0313.2018.02.004.
[19]
SEBASTIAN S, ARAUJO C, NEITLICH J D, et al. Managing incidental findings on abdominal and pelvic CT and MRI, Part 4: white paper of the ACR Incidental Findings Committee II on gallbladder and biliary findings[J]. J Am Coll Radiol, 2013, 10(12): 953-956. DOI: 10.1016/j.jacr.2013.05.022.
[20]
HELLER M T, HARISINGHANI M, NEITLICH J D, et al. Managing incidental findings on abdominal and pelvic CT and MRI, part 3: white paper of the ACR Incidental Findings Committee II on splenic and nodal findings[J]. J Am Coll Radiol, 2013, 10(11): 833-839. DOI: 10.1016/j.jacr.2013.05.020.
[21]
MEGIBOW A J, BAKER M E, MORGAN D E, et al. Management of incidental pancreatic cysts: a white paper of the ACR incidental findings committee[J]. J Am Coll Radiol, 2017, 14(7): 911-923. DOI: 10.1016/j.jacr.2017.03.010.
[22]
KIRKPATRICK I D C, BRAHM G L, MNATZAKANIAN G N, et al. Recommendations for the management of the incidental renal mass in adults: endorsement and adaptation of the 2017 ACR incidental findings committee white paper by the Canadian association of radiologists incidental findings working group[J]. Can Assoc Radiol J, 2019, 70(2): 125-133. DOI: 10.1016/j.carj.2019.03.002.
[23]
PATEL M D, ASCHER S M, HORROW M M, et al. Management of incidental adnexal findings on CT and MRI: a white paper of the ACR incidental findings committee[J]. J Am Coll Radiol, 2020, 17(2): 248-254. DOI: 10.1016/j.jacr.2019.10.008.
[24]
WANG P S, SCHOECK O G, HORROW M M. Benign-appearing incidental adnexal cysts at US, CT, and MRI: putting the ACR, O-RADS, and SRU guidelines all together[J]. Radiographics, 2022, 42(2): 609-624. DOI: 10.1148/rg.210091.
[25]
ELSHOLTZ F H J, ASBACH P, HAAS M, et al. Introducing the node reporting and data system 1.0 (node-RADS): a concept for standardized assessment of lymph nodes in cancer[J]. Eur Radiol, 2021, 31(8): 6116-6124. DOI: 10.1007/s00330-020-07572-4.
[26]
CHANG C Y, GARNER H W, AHLAWAT S, et al. Society of Skeletal Radiology-white paper. Guidelines for the diagnostic management of incidental solitary bone lesions on CT and MRI in adults: bone reporting and data system (Bone-RADS)[J]. Skeletal Radiol, 2022, 51(9): 1743-1764. DOI: 10.1007/s00256-022-04022-8.
[27]
BHALUDIN B N, TUNARIU N, SENTHIVEL N, et al. Does the addition of whole-body MRI to routine imaging influence real-world treatment decisions in metastatic breast cancer?[J/OL]. Cancer Imaging, 2022, 22(1): 26 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/35672838/. DOI: 10.1186/s40644-022-00464-4.
[28]
ELSALAM S M ABD, ELBADAWI M A, DIAB W A, et al. Diagnostic value of whole-body diffusion weighted imaging added to bone scan in early diagnosis of bone metastases in breast cancer patients[J/OL]. Egypt J Radiol Nucl Med, 2023, 54(1): 102 [2025-05-11]. https://link.springer.com/article/10.1186/s43055-023-01050-9. DOI: 10.1186/s43055-023-01050-9.
[29]
ZUGNI F, PADHANI A R, KOH D M, et al. Whole-body magnetic resonance imaging (WB-MRI) for cancer screening in asymptomatic subjects of the general population: review and recommendations[J/OL]. Cancer Imag, 2020, 20(1): 34 [2025-05-11]. https://link.springer.com/article/10.1186/s40644-020-00315-0. DOI: 10.1186/s40644-020-00315-0.
[30]
KUMASAKA S, MOTEGI S, KUMASAKA Y, et al. Whole-body magnetic resonance imaging (WB-MRI) with diffusion-weighted whole-body imaging with background body signal suppression (DWIBS) in prostate cancer: Prevalence and clinical significance of incidental findings[J/OL]. Br J Radiol, 2022, 95(1131): 20210459 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/34111963/. DOI: 10.1259/bjr.20210459.
[31]
SCHMIDT C O, SIEROCINSKI E, HEGENSCHEID K, et al. Impact of whole-body MRI in a general population study[J]. Eur J Epidemiol, 2016, 31(1): 31-39. DOI: 10.1007/s10654-015-0101-y.
[32]
WANG S, XU D, XIAO L Y, et al. Radiation-induced lung injury: from mechanism to prognosis and drug therapy[J/OL]. Radiat Oncol, 2025, 20(1): 39 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/40082925/. DOI: 10.1186/s13014-025-02617-8.
[33]
PENG B Q, WU J, TIAN S, et al. Effect of chemotherapy and different chemotherapy regimens on bone health among Chinese breast cancer women in different menstrual status: a self-control study[J/OL]. Support Care Cancer, 2023, 31(9): 540 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/37642751/. DOI: 10.1007/s00520-023-07960-8.
[34]
Pancreatology Committee of Chinese Medical Association, National Center for ClinicalMedicine of Digestive System Diseases (Shanghai)Evidence-based guideline on the standardized diagnostic imaging report for pancreatic cystic neoplasms in China[J]. Chin J Pancreatol, 2024, 24(2): 114-124. DOI: 10.3760/cma.j.cn115667-20240226-00045.
[35]
ZHOU Y, FAN Y J, MA L, et al. Effect of toremifene on endometrium and neurocognitive function in patients with breast cancer based on resting-state functional magnetic resonance imaging[J/OL]. World Neurosurg, 2021, 149: 436-443 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/33217593/. DOI: 10.1016/j.wneu.2020.11.051.
[36]
FAN L, XIA Y, LIU S Y. Opportunities and challenges of pulmonary magnetic resonance imaging: Achievements and prospects over the past decade in China[J]. Chin J Magn Reson Imag, 2022, 13(10): 61-65. DOI: 10.12015/issn.1674-8034.2022.10.008.
[37]
AFAQ A, FAUL D, CHEBROLU V V, et al. Pitfalls on pet/mri[J]. Semin Nucl Med, 2021, 51(5): 529-539. DOI: 10.1053/j.semnuclmed.2021.04.003.
[38]
JACOBS M A, MACURA K J, ZAHEER A, et al. Multiparametric whole-body MRI with diffusion-weighted imaging and ADC mapping for the identification of visceral and osseous metastases from solid tumors[J]. Acad Radiol, 2018, 25(11): 1405-1414. DOI: 10.1016/j.acra.2018.02.010.
[39]
KOSMIN M, PADHANI A R, GOGBASHIAN A, et al. Comparison of whole-body MRI, CT, and bone scintigraphy for response evaluation of cancer therapeutics in metastatic breast cancer to bone[J]. Radiology, 2020, 297(3): 622-629. DOI: 10.1148/radiol.2020192683.
[40]
CRUZ I A N, FAYAD L M, AHLAWAT S, et al. Whole-body MRI in musculoskeletal oncology: a comprehensive review with recommendations[J/OL]. Radiol Imaging Cancer, 2023, 5(3): e220107 [2025-05-11]. https://pubmed.ncbi.nlm.nih.gov/37144975/. DOI: 10.1148/rycan.220107.
[41]
SHENG Y, LI C Y, GAO L N, et al. Analysis on the trend of disease burden and risk factors of young breast cancer in China from 1990 to 2021[J]. Chin J Cancer Prev Treat, 2025, 32(18): 1107-1113. DOI: 10.16073/j.cnki.cjcpt.2025.18.05.

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