Relatively new to the diagnostic imaging world is the use of whole body magenetic resonance imaging (WBMRI). Just as the name suggests, this MRI is taken from the patient’s head to toes. While the image is comprehensive, the image resolution is lower than with standard MRIs. Even so, a recent study from the Copenhagen Center for Arthritis Research gave preliminary indication that WBMRIs could help with detecting enthesitis in arthritic patients.

The study was performed on 36 patients with psoriatic arthritis (PsA) or axial spondyloarthritist (axSpA), as well as a control group of 12 healthy patients. Patients underwent a physical examination and an imaging session that included contrast enhancement and coronal slice orientation for spine, hip, knee and ankle, sagittal orientation for the neck, and axial orientation for the feet. One study summary identified that part of the study included determining whether or not the WBMRIs were “readable” or “not readable.” Readable enthesitis images were defined as “the presence of bone marrow edema, soft tissue edema, change in tendon thickness, erosions or enthesophytes in adjacent bones, and fluid in or around tendons or adjacent bursae.”

The study’s results showed that WBMRIs did indicate enthesitis in the PsA and axSpA patients more than the healthy patients and that enthesitis was identified in 17% of the readable sites through WBMRIs and clinical enthesitis was present in 22% of the readable sites. This study was the first of its kind, but has given hope to doctors that WBMRIs could help rule out other inflammatory diseases and perhaps help doctors with diagnoses and treatment plans.

If more studies are performed, a larger sample would be used and cost-effectiveness would become more of a consideration.

Last month, a study was released during the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago that provided evidence of sub-stage specific surveillance PET/CT imaging detecting relapses of melanoma in patients. 232 patients in various stages of melanoma of the arm participated in the study. Eleven patients were in stage IIIA, 50 patients were in stage IIIB, and 25 patients were in stage IIIC.

The stage of the disease the patient was in determined the amount of scans he or she received. Stage IIIA patients received two scans, patients with stage IIIB received seven scans, and patients with stage IIIC had 5 different scans. Out of the 232 patients that participated in the study, there was a 29% relapse rate and 80% of those who relapsed were asymptomatic when they were scanned. Overall, the study’s results indicated the sensitivity of this approach for detecting relapses was 88% and specificity was 84% – a significantly favorable conclusion.

These results encourage further imaging than what is currently practiced. The Centers for Medicare & Medicaid Services currently covers three post-treatment scans, but a growing amount of studies indicate that further stages of specific imaging can help catch relapses in asymptomatic patients. Hopefully, the amount of imaging covered will increase in response to these studies.

One of the most critical aspects of cancer treatment follow-ups and remission is continued attention to the affected areas of the patient’s body. In June 2013, the Centers for Medicare & Medicaid Services (CMS) decided to cover the costs of up to three PET/IC scans in an effort to provide adequate management of an “anti-tumor treatment strategy after completion of initial anticancer therapy.” This decision motivated a careful study of how necessary follow-up scans are for lung cancer patients, as well as other cancer patients, in order to provide the best possible cancer treatment.

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) recently completed the retrospective study in February 2015. Their research showed that 28.1% patients that received four or more follow-up PET/CTs received a change in treatment management than the initially prescribed method. This preliminary study included a sample size of 1,171 cases of lung cancer patients who received treatment between the years of 2001 and 2013. Out of those 1,171 cases, 285 patients received a fourth scan. Over half of the patients that received the fourth scan had PET/CTs that were interpreted as positive and resulted in treatment changes for 80 of those patients.

While this is only the first published study with these specific parameters and 55.3% of participating patients died between 2001 and 2013, the initial results do show some benefits of performing four or more PET/ICs after the first phase of anticancer therapy. Understanding how cancer redevelops could help with cancer prevention and even get researchers closer to finding a cure. For now, further research could move the CMS to offer increased coverage or financial reimbursement for more than three PET/IC scans and other long-termed imaging.