MRI and PET/MRI in Hematology and Oncology

Dear Colleagues,

Accurate staging and precise measurement of tumor burden are essential to plan effective therapy of cancer patients. Evaluation of therapeutic changes is equally essential to modify the therapeutic strategy. FDG-PET /CT has become a cornerstone in the staging and restaging of neoplasms, in the evaluation of therapeutic efficacy during or after treatment and in the planning of radiotherapy, proving to be more sensitive than contrast-enhanced CT in the staging of lymphoma and in the diagnosis of diffuse neoplasms.

To date, MRI has been considered only an alternative method for the diagnosis and staging of various hematologic and oncologic diseases especially in younger patients, due to the absence of ionizing radiation, high soft tissue contrast and good spatial resolution. The use of advanced sequences, such as DWI, however, has further improved the diagnostic accuracy of MRI in oncology. The recently developed whole body (WB) MRI technique has significantly increased the diagnostic accuracy of MRI in onco-hematological imaging, providing an excellent total body imaging.

In myeloma only WB-MRI is now recognized as a highly sensitive test for diagnosis and staging. Instead in lymphoma, WB-DWI-MRI merely serves as an alternative technique to FDG-PET/CT, especially in pediatric patients, although its use is increasingly important in adult patients as well. Despite the high sensitivity in the diagnosis and follow up of lymphomas and non-hematologic malignancies, WB DWI MRI is not recommended in current guidelines yet.

PET/MRI is a relatively new hybrid imaging technique, recently introduced into routine clinical practice. Several comparative studies between hybrid PET/CT and PET/MRI imaging techniques recently been performed in relatively small patient populations have provided preliminary satisfactory results in favour of MRI.

The aim of this issue is to discuss the current clinical applications of the up-to-date MRI techniques in oncology and hematology as well as to propose research topics in the field of hematology and oncology.

Prof. Dr. Francesca Maccioni
Prof. Dr. Leonardo Pace
Topic Editors