Download PDF
Rofo 2009; 181(8): 748-759
DOI: 10.1055/s-0028-1109510
Rapid Communication

© Georg Thieme Verlag KG Stuttgart · New York

Whole-Body Magnetic Resonance Imaging of Healthy Volunteers: Pilot Study Results from the Population-Based SHIP Study

Ganzkörper-Magnetresonanztomografie von gesunden Probanden: Pilotstudienergebnisse der populationsbasierten SHIP StudieK. Hegenscheid1 , J. P. Kühn1 , H. Völzke2 , R. Biffar3 , N. Hosten1 , R. Puls1
  • 1Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald
  • 2Institut für Community Medicine, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald
  • 3Zentrum für Zahn-, Mund- und Kieferheilkunde, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald
Further Information

Publication History

received: 15.1.2009

accepted: 14.5.2009

Publication Date:
13 July 2009 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Ziel: Pilotstudienergebnisse einer Ganzkörper-MRT-Untersuchung im Rahmen der prospektiven Bevölkerungsstudie „Study of Health in Pomerania (SHIP)”. Material und Methoden: 200 gesunde Probanden (99 Frauen, 101 Männer, mittleres Alter 48,3 Jahre) unterzogen sich einer standardisierten Ganzkörper-MRT-Untersuchung. Bei 61 Männern (60,4 %) wurden zusätzlich eine kontrastmittelgestützte Herz-MRT und MR-Angiografie und bei 44 Frauen (44,4 %) eine kontrastmittelgestützte Herz-MRT und MR-Mammografie durchgeführt. Die MRT-Daten wurden unabhängig von 2 Radiologen mittels eines standardisierten Befundbogens ausgewertet. Pathologische Befunde wurden anhand der Notwendigkeit einer weiteren klinischen Abklärung klassifiziert und in einem Advisory Board vorgestellt und diskutiert. Ergebnisse: Bei 176 (88 %) Probanden wurden insgesamt 431 pathologische Befunde detektiert, von denen 386 (89,6 %) gutartige Veränderungen darstellten und keine weitere klinische Abklärung nach sich zogen. 45 (10,4 %) Pathologien bedurften einer weiteren klinischen Abklärung. Die Interrater-Reliabilität war hinsichtlich der Detektion pathologischer Befunde sehr gut (κ = 0,799). Schlussfolgerung: Diese Ergebnisse zeigen, dass eine Ganzkörper-MRT-Untersuchung im Rahmen einer großen, prospektiven epidemiologischen Studie realisierbar ist und dass die Ergebnisse der standardisierten MR-Analyse reproduzierbar sind. Eine Vielzahl pathologischer Befunde bietet wertvolle Informationen über die Prävalenz von Erkrankungen in einer breiten Bevölkerungsgruppe.

Abstract

Purpose: Approximately 4000 volunteers will undergo whole-body magnetic resonance imaging (WB-MRI) within the next 3 years in the population-based Study of Health in Pomerania (SHIP). Here we present a pilot study conducted (a) to determine the feasibility of adding a WB-MRI protocol to a large-scale population-based study, (b) to evaluate the reliability of standardized MRI interpretation, and (c) to establish an approach for handling pathological findings. Materials and Methods: The institutional review board approved the study, and oral and written informed consent was obtained from each participant. Two hundred healthy volunteers (99 women, 101 men; mean age 48.3 years) underwent a standardized WB-MRI protocol. The protocol was supplemented by contrast-enhanced cardiac MRI and magnetic resonance (MR) angiography in 61 men (60.4 %) and cardiac MRI and MR mammography in 44 women (44.4 %). MR scans were evaluated independently by two readers. Abnormalities were discussed by an advisory board and classified according to the need for further clinical work-up. Results: One hundred ninety-four (97.0 %) WB-MRI examinations were successfully completed in a mean scan time per subject of 90 minutes. There were 431 pathological findings in 176 (88 %) of the participants. Of those 45 (10.4 %) required further clinical work-up and 386 (89.6 %) characterized as benign lesions did not. The interobserver agreement for the detection of pathological findings was excellent (κ = 0.799). Conclusion: The preliminary results presented here indicate that a large prospective, population-based study using WB-MRI is feasible and that the results of image analysis are reproducible. A variety of positive findings provide valuable information regarding disease prevalence in a general adult population.

Key words

MR imaging - epidemiology - technology assessment

References

  • 1 John U, Greiner B, Hensel E. et al . Study of Health In Pomerania (SHIP): a health examination survey in an east German region: objectives and design.  Soz Praventivmed. 2001;  46 186-194
    Google Scholar
  • 2 Koch B, Schaper C, Ittermann T. et al . Reference Values for Cardiopulmonary Exercise Testing in Healthy Volunteers-the SHIP Study.  Eur Respir J. 2008;  33 389-397
    Google Scholar
  • 3 Levey A S, Bosch J P, Lewis J B. et al . A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group.  Ann Intern Med. 1999;  130 461-470
    Google Scholar
  • 4 Bryan R N, Manolio T A, Schertz L D. et al . A method for using MR to evaluate the effects of cardiovascular disease on the brain: the cardiovascular health study.  AJNR Am J Neuroradiol. 1994;  15 1625-1633
    Google Scholar
  • 5 Landis J R, Koch G G. The measurement of observer agreement for categorical data.  Biometrics. 1977;  33 159-174
    Google Scholar
  • 6 Jack C R. MR imaging of the brain in epidemiologic research: the Cardiovascular Health Study.  Radiology. 1997;  202 17-19
    Google Scholar
  • 7 Longstreth Jr W T, Dulberg Jr C, Manolio T A. et al . Incidence, manifestations, and predictors of brain infarcts defined by serial cranial magnetic resonance imaging in the elderly: the Cardiovascular Health Study.  Stroke. 2002;  33 2376-2382
    Google Scholar
  • 8 Vermeer S E, Koudstaal P J, Oudkerk M. et al . Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study.  Stroke. 2002;  33 21-25
    Google Scholar
  • 9 Natori S, Lai S, Finn J P. et al . Cardiovascular function in multi-ethnic study of atherosclerosis: normal values by age, sex, and ethnicity.  Am J Roentgenol. 2006;  186 357-365
    Google Scholar
  • 10 Vogt F M, Ruehm S, Hunold P. et al . Rapid total body fat measurement by magnetic resonance imaging: quantification and topography.  Fortschr Röntgenstr. 2007;  179 480-486
    Google Scholar
  • 11 Okada E, Matsumoto M, Ichihara D. et al . Aging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging study.  Spine. 2009;  34 206-712
    Google Scholar
  • 12 Baumeister S E, Schumann A, Meyer C. et al . Effects of smoking cessation on health care use: is elevated risk of hospitalization among former smokers attributable to smoking-related morbidity?.  Drug Alcohol Depend. 2007;  88 197-203
    Google Scholar
  • 13 Antoch G, Vogt F M, Freudenberg L S. et al . Whole-body dual-modality PET/CT and whole-body MRI for tumor staging in oncology.  JAMA. 2003;  290 3199-3206
    Google Scholar
  • 14 Ketelsen D, Röthke M, Aschoff P. et al . Detection of bone metastasis of prostate cancer – comparison of whole-body MRI and bone scintigraphy.  Fortschr Röntgenstr. 2008;  180 746-752
    Google Scholar
  • 15 Fenchel M, Jost D, Kramer U. et al . Cardiovascular whole-body MR imaging in patients with symptomatic peripheral arterial occlusive disease.  Fortschr Röntgenstr. 2006;  178 491-499
    Google Scholar
  • 16 Klessen C, Asbach P, Hein P A. et al . Whole-body MR angiography: comparison of two protocols for contrast media injection.  Fortschr Röntgenstr. 2006;  178 484-490
    Google Scholar
  • 17 Quick H H, Vogt F M, Maderwald S. et al . High spatial resolution whole-body MR angiography featuring parallel imaging: initial experience.  Fortschr Röntgenstr. 2004;  176 163-169
    Google Scholar
  • 18 Bohlscheid A, Nuss D, Lieser S. et al . Tumor search with diffusion-weighted imaging – first experience.  Fortschr Röntgenstr. 2008;  180 302-309
    Google Scholar
  • 19 Beer M, Stenzel M, Girschick H. et al . Whole-body MR imaging in children with suspected osteonecrosis after intensive chemotherapy: preliminary results.  Fortschr Röntgenstr. 2008;  180 238-245
    Google Scholar
  • 20 Kramer H, Schoenberg S O, Nikolaou K. et al . Cardiovascular screening with parallel imaging techniques and a whole-body MR imager.  Radiology. 2005;  236 300-310
    Google Scholar
  • 21 Schmidt G P, Baur-Melnyk A, Tiling R. et al . Comparison of high resolution whole-body MRI using parallel imaging and PET-CT. First experiences with a 32-channel MRI system.  Radiologe. 2004;  44 889-898
    Google Scholar
  • 22 Vernooij M W, Ikram M A, Tanghe H L. et al . Incidental findings on brain MRI in the general population.  N Engl J Med. 2007;  357 1821-1828
    Google Scholar
  • 23 Lo G G, Ai V, Au-Yeung K M. et al . Magnetic resonance whole body imaging at 3 Tesla: feasibility and findings in a cohort of asymptomatic medical doctors.  Hong Kong Med J. 2008;  14 90-96
    Google Scholar
  • 24 Tsushima Y, Taketomi-Takahashi A, Endo K. Prevalence of abnormal findings on brain magnetic resonance (MR) examinations in adult participants of brain docking.  BMC Neurol. 2005;  5 18
    Google Scholar
  • 25 Yue N C, Longstreth W T, Elster A D. et al . Clinically serious abnormalities found incidentally at MR imaging of the brain: data from the Cardiovascular Health Study.  Radiology. 1997;  202 41-46
    Google Scholar
  • 26 Katzman G L, Dagher A P, Patronas N J. Incidental findings on brain magnetic resonance imaging from 1000 asymptomatic volunteers.  JAMA. 1999;  282 36-39
    Google Scholar
  • 27 Leeuw F E, Groot de J C, Achten de E. et al . Prevalence of cerebral white matter lesions in elderly people: a population based magnetic resonance imaging study. The Rotterdam Scan Study.  J Neurol Neurosurg Psychiatry. 2001;  70 9-14
    Google Scholar
  • 28 Schmidt Jr R, Fazekas F, Kapeller P. et al . MRI white matter hyperintensities: three-year follow-up of the Austrian Stroke Prevention Study.  Neurology. 1999;  53 132-139
    Google Scholar
  • 29 Onizuka M, Suyama K, Shibayama A. et al . Asymptomatic brain tumor detected at brain check-up.  Neurol Med Chir. 2001;  41 431-434
    Google Scholar
  • 30 Souza J M, Domingues R C, Cruz L C. et al . Susceptibility-weighted imaging for the evaluation of patients with familial cerebral cavernous malformations: a comparison with t2-weighted fast spin-echo and gradient-echo sequences.  AJNR Am J Neuroradiol. 2008;  29 154-158
    Google Scholar
  • 31 Illes de J, Kirschen M P, Karetsky Jr K. et al . Discovery and disclosure of incidental findings in neuroimaging research.  J Magn Reson Imaging. 2004;  20 743-747
    Google Scholar
  • 32 Illes J, Kirschen M P, Edwards E. et al . Ethics. Incidental findings in brain imaging research.  Science. 2006;  311 783-784
    Google Scholar
  • 33 Kirschen M P, Jaworska A, Illes J. Subjects’ expectations in neuroimaging research.  J Magn Reson Imaging. 2006;  23 205-209
    Google Scholar
  • 34 Vermeer S E, Hollander M, Dijk E J. et al . Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study.  Stroke. 2003;  34 1126-1129
    Google Scholar
  • 35 Olivero W C, Lister J R, Elwood P W. The natural history and growth rate of asymptomatic meningiomas: a review of 60 patients.  J Neurosurg. 1995;  83 222-224
    Google Scholar
  • 36 Nakamura van M, Roser F, Michel J. et al . The natural history of incidental meningiomas.  Neurosurgery. 2003;  53 62-70
    Google Scholar
  • 37 Illes J, Rosen A C, Huang L. et al . Ethical consideration of incidental findings on adult brain MRI in research.  Neurology. 2004;  62 888-890
    Google Scholar

PD Dr. Ralf Puls

Institut für Diagnostische Radiologie und Neuroradiologie, Universitätsklinikum der Ernst-Moritz-Arndt-Universität Greifswald

F.-Sauerbruch-Str. 1

17489 Greifswald

Germany

Phone: ++ 49/38 34/86 69 33

Fax: ++ 49/38 34/86 69 58

Email: puls@uni-greifswald.de