Multiparametric Whole-Body MRI Protocols in Contemporary Clinical Practice: Indications, Technical Considerations, and Emerging Applications.

Abstract

Multiparametric whole-body MRI (WB-MRI) is an advanced cross-sectional imaging technique that integrates anatomic sequences into functional modalities, including diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) mapping and Dixon-based imaging. WB-MRI can evaluate the body from the vertex to the feet in a single session, offering advantages such as generating important biomarkers, robust musculoskeletal tissue assessment, high signal-to-noise ratio, and speed optimization, among others. This review examines current evidence and provides recommendations for multiparametric WB-MRI across a broad spectrum of oncologic and nononcologic indications, including multiple myeloma, lymphoma, melanoma, metastatic prostate cancer, cancer predisposition syndromes, MSK tumors, inflammatory arthritis, and diffuse neuromuscular disorders. Readers will gain an understanding of key technical considerations, including field strength selection, coil configuration, sequence design, and protocol optimization, that radiologists must navigate when implementing WB-MRI in clinical practice. Emerging applications such as AI-assisted lesion segmentation, automated quantitative biomarker analysis, and accelerated image reconstruction are also discussed, which spotlight the evolving role of WB-MRI in disease characterization and the following treatment response. As protocols become more standardized and evidence continues to grow, this review equips radiologists with a practical framework for incorporating multiparametric WB-MRI into contemporary clinical and research settings.