Whole-body MRI for opportunistic cancer detection in asymptomatic individuals: a systematic review and meta-analysis.

Abstract

The rising global cancer burden underscores the need for efficient screening strategies. Whole-body magnetic resonance imaging (WB-MRI) has emerged as a promising modality for cancer screening, with growing use in research and commercial settings. This study aimed to evaluate the opportunistic cancer detection rate and the feasibility of WB-MRI in asymptomatic individuals. A systematic review and meta-analysis were conducted per PRISMA guidelines. A literature search was performed across multiple databases from January 2015 to April 2025. Eligible studies used WB-MRI for cancer detection in asymptomatic individuals. Studies were excluded if they combined WB-MRI with other imaging methods or included patients with active malignancy or comorbidities/genetic syndromes associated with increased cancer risk. Random-effects meta-analyses estimated pooled proportions of confirmed cancer diagnoses. Risk of bias was assessed using the ROBINS-I tool. Sensitivity and subgroup analyses, publication bias assessment, and meta-regression were performed. Ten studies were included, comprising 9024 participants. The pooled detection rate for confirmed cancer was 1.57% (95% CI: 1.22-2.03%; I² = 31.3%). Results were robust in sensitivity and meta-regression analyses. No significant subgroup differences or publication bias were found. Most studies had a moderate to serious risk of bias. Although WB-MRI shows potential as an opportunistic non-invasive cancer detection tool, modest detection rates, frequent incidental findings, unstandardized protocols, and lack of long-term outcome or cost-effectiveness data limit its current clinical utility. Question Can whole-body magnetic resonance imaging (WB-MRI) serve as an effective cancer detection tool for asymptomatic individuals across various clinical and geographic settings? Findings This meta-analysis of over 9000 asymptomatic individuals found a lack of information on cost-effectiveness, unstandardized protocols, a modest cancer detection rate and high rates of incidental findings. Clinical relevance Despite the need for effective cancer screening tools and growing popularity in commercial and research centers, whole-body MRI lacks sufficient diagnostic yield, follow-up reports and standardization for opportunistic cancer detection in asymptomatic individuals and may lead to unnecessary investigations.