Whole-body MRI screening (asymptomatic adults)

Zugni et al. (Cancer Imaging, 2020; PMID 32393345) - review and recommendations on whole-body MRI for cancer screening in asymptomatic subjects from the general population, pooling 12 studies and 6,214 examinations without a formal risk-of-bias appraisal. Of 17,961 abnormal findings reported, 91 percent were benign, 9 percent were oncologically relevant and required further investigation, and 0.5 percent of lesions were suspicious for cancer. On a per-subject basis, 5 percent of people had no abnormal findings and 95 percent had one or more; 30 percent had findings requiring further investigation; cancer was suspected in 1.8 percent and histologically confirmed in 1.1 percent. Kwee et al. (J Magn Reson Imaging, 2019; PMID 30932247): systematic review and meta-analysis of 12 studies and 5,373 asymptomatic adults; critical or indeterminate incidental findings in 32 percent, with no long-term verification. Martins da Fonseca et al. (Eur Radiol, 2026; PMID 40884613): 10 studies and 9,024 people; confirmed cancer in 1.57 percent, most studies at moderate to serious risk of bias, no outcome data. Ahsan et al. (J Gen Intern Med, 2026; PMID 42823587): 17 low-quality studies and 18,043 people; actionable non-malignant findings in 14.8 percent, of whom 20.8 percent went on to a procedure; malignancy in 1.4 percent; clinical outcomes could not be determined. Chen et al. (Cochrane Database Syst Rev, 2026; PMID 42639816): a protocol for a Cochrane review of whole-body MRI or CT screening on morbidity and mortality, the first formal search for trials; a protocol, not a review. Grade D, Route 1.