Whole-Body Magnetic Resonance Imaging versus Dedicated MRI Imaging of Neurofibromatosis Type 1 Patients for Detecting Malignant Peripheral Nerve Sheath Tumor

Purpose or Learning Objective: Neurofibromatosis type 1 is associated with an increased risk of malignant peripheral nerve sheath tumor, a highly aggressive sarcoma with a poor prognosis. At the Manchester Foundation Trust and at other trusts in the United Kingdom, whole-body magnetic resonance imaging is performed for surveillance in neurofibromatosis type 1 patients to assess disease burden and to identify and treat potential malignant peripheral nerve sheath tumor. This study looks at confirmed cases of malignant peripheral nerve sheath tumor and whether they were detected by whole-body magnetic resonance imaging or dedicated magnetic resonance imaging. Our objective was to evaluate the effectiveness and efficacy of using whole-body magnetic resonance imaging as a method of surveillance, and whether or not its use is justified by the pickup rate.

Methods or Background: A retrospective analysis was conducted on neurofibromatosis type 1 patients diagnosed with malignant peripheral nerve sheath tumor at Manchester Foundation Trust from 2009 onward. A total of 53 confirmed malignant peripheral nerve sheath tumor cases were reviewed to determine whether they were picked up via whole-body magnetic resonance imaging screening or dedicated magnetic resonance imaging.

Results or Findings: Among the 53 confirmed malignant peripheral nerve sheath tumor cases, 45 (85%) were identified using dedicated magnetic resonance imaging. Only 8 cases (15%) were detected through whole-body magnetic resonance imaging.

Conclusion: Although whole-body magnetic resonance imaging remains valuable for general neurofibromatosis type 1 surveillance and can be important on a case-by-case basis depending on the clinical picture, it does not provide any advantage to detecting potential malignant peripheral nerve sheath tumor when compared with dedicated imaging. Given the significant time investment required for whole-body magnetic resonance imaging, there could be justification to reassess the preferred method of surveillance for neurofibromatosis type 1 patients.

Publication History

Article published online:
02 June 2025