Introduction
Diffusion imaging is the closest tool, beetween diagnostic radiology and MRI, that have so far come to “functional” tissue imaging, and therefore also represents a sort of cultural bridgehead towards the functional methods of nuclear medicine.
Tumours are the second most frequent cause of death in the developed world (the third most frequent in
developing countries), accounting for 12.5% of all deaths, and the need for their diagnosis, staging and posttreatment follow-up makes diagnostic imaging a key element in the management of oncological patients.
MR imaging based on the phenomenon of diffusion (DWI), which was originally developed for neuroradiological applications, has only recently been extended to the whole body because of the technical problems intrinsic to the cardinal sequences of DWI (echo planar imaging – EPI) and difficulties such as artefacts due to magnetic susceptibilitye and anatomical distorsions. The technical evolutions of MR coils and equipment, together with the introduction of parallel imaging, made it possible to overcome these problems and thus laid the foundations for the extension of DWI to the whole body. These developments have included the introduction of the “rolling table” and the use of increasingly more suitable sequences for the study of extra-cranial districts, which have also
made it possible to obtain multiplanar reconstructions such as DWIBS.
Atherosclerosis is a global problem and not a disease affecting just one sector. The increasing average life expectancy of patients is leading to the more frequent observation of the co-existence of complex problems that may affect different body’s districts but are often attributable to the same underlying pathology of atheromatous vascular disease. Further technical advances such as the use of “fresh blood” sequences make it possible to hypothesise the increasing application of study protocols to routine clinical practice.
However, whole-body imaging is still in its pioneering phase and there are still many unanswered questions concerning its precise place in the process of clinical patient management. We believe that these questions will be answered by future multicentric trials, which will therefore be instrumental in offering radiologists a further cultural, as well as technical, evolution.
A. Carriero, A. Stecco, A. Saponaro