DIAGNOSTIC PERFORMANCE OF WHOLE-BODY MAGNETIC RESONANCE IMAGING COMPARED WITH COMPUTED TOMOGRAPHY IN THE STAGING OF ONCOLOGIC PATIENTS

Introduction: Accurate staging is essential for therapeutic decision-making and prognostic assessment in oncology, and cross-sectional imaging plays a central role in this process. Whole-body magnetic resonance imaging has emerged as a radiation-free alternative to computed tomography, with potential advantages in soft-tissue contrast and bone marrow assessment. However, its diagnostic performance relative to computed tomography across different tumor types and metastatic sites remains a subject of ongoing investigation. Objective: The main objective of this systematic review was to compare the diagnostic performance of whole-body magnetic resonance imaging with computed tomography in the staging of oncologic patients. Secondary objectives included evaluating detection rates for nodal and distant metastases, assessing performance across different cancer types, analyzing inter-modality concordance, examining the impact on clinical management, and evaluating the certainty of evidence supporting each imaging strategy. Methods: A systematic search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, LILACS, ClinicalTrials.gov, and the International Clinical Trials Registry Platform. Studies comparing whole-body magnetic resonance imaging and computed tomography for oncologic staging were included based on predefined eligibility criteria. Data synthesis was performed qualitatively, with structured comparison of diagnostic outcomes and methodological quality. Results and Discussion: A total of 20 studies met the inclusion criteria and were analyzed in this review. Overall, whole-body magnetic resonance imaging demonstrated comparable or superior sensitivity to computed tomography for detecting metastatic disease, particularly in bone and soft tissues, while computed tomography maintained advantages in lung lesion detection. Heterogeneity across studies was moderate, and the certainty of evidence ranged from low to moderate depending on tumor type and outcome assessed. Conclusion: Whole-body magnetic resonance imaging represents a viable alternative to computed tomography for oncologic staging in selected patient populations, offering high diagnostic performance without ionizing radiation. Its integration into clinical practice should be guided by tumor characteristics, availability, and multidisciplinary discussion.