DWB (an acronym that stands for Whole-Body Diffusion) is an MRI technique that aims to detect, in a single session and in the whole body (from the vertex to mid-thighs, including the proximal portion of the upper limbs), the occurrence of malignant tumours as small as a few millimetres, according to ONCO-RADS guidelines.
It is an innovative, highly sophisticated examination: by generating three-dimensional and panoramic reconstructions of the human body, it has proven to be a valuable prevention tool, because it is capable of detecting very small malignant tumour areas of 3-4 millimetres.
QThis means having the possibility of real early diagnosis and thus the chance to intervene with the appropriate therapies in a more timely, effective and decisive manner, before aggressive disease develops.
For this type of examination, the latest generation of Magnetic Resonance Imaging equipment is used, specially equipped and configured, thus “specialised” for the detection of cancer, together with specially developed protocols.
The ASC Centre has two such machines and is one of two Italian centres (the other being the IEO, the European Institute of Oncology in Milan) able to offer such an examination. But, in particular, ASC was created to propose DWB exclusively to the asymptomatic population, i.e. not suffering from known cancer diseases.
In six years of activity, since January 2017, the Castelli Calepio centre has collected the largest European caseload in this particular type of screening.
The diagnostic procedure used in performing the Whole-Body Diffusion follows the International Guidelines on DWB (called ONCO-RADS, an acronym for Oncologically Relevant Findings Reporting and Data System), published in 2021, accepted and shared by scientists worldwide.
How it works
Usefulness of the examination
DWB is a crucial resource, which has everything it takes to complement and complete the arsenal of common cancer screening examinations (such as mammography, Pap test and faecal occult blood detection, PSA). The Whole-Body Diffusion should not be regarded as a substitute for classic screening or for those examinations specific to particular organs (e.g. colonoscopy and gastroscopy), but complements them by analysing all the remaining organs at once, in particular those referred to as orphan organs (for which no specific early-diagnosis examination is provided). ). DWB is also a safe device, because it has the great advantage of not using ionising radiation or contrast media. The test is said to be biohazard-free.
Numerous studies on cancer patients have also shown that DWB achieves diagnostic results comparable to those provided by CT (Computed Tomography) and PET (Positron Emission Tomography), but its strength lies precisely in its safety, because, we reiterate, it does not use beams that interact with tissue or substances to make body structures more visible.
Simplicity of the examination
The Whole-Body Diffusion examination is a diagnostic imaging technique that does not involve any special risks. It works like a simple MRI. Once it has been verified, by means of a questionnaire, that there are no absolute contraindications or any relative contraindications, there is no specific preparation required: there is no need to fast, to suspend any pharmacological therapies or to perform enemas. The examination takes about 35 minutes in the device, lying on a bed that runs back and forth in the MRI machine. On the day of the examination, you enter the centre with your identity documents and, after the usual check-in procedures, you go to the medical history clinic and proceed to view and fill out the information and informed consent forms.
How the examination is run
In the radiologist’s office, there is an in-depth interview for the history (the detailed collection of data and medical history), explanation of the examination and assessment of the feasibility of the test. After the doctor has approved the execution of the examination, the medical radiology technician accompanies the guest in the dressing room, where they are asked to wear a disposable gown for the scan. Once ready, the patient is helped onto the MR bed. During the instrumental performance of the examination, the user is in constant audio and visual contact with the personnel; they can choose the type of music to listen to and, thanks to a mirror, can constantly see the technician performing the examination. The DWB examination does not involve any physical discomfort or pain whatsoever
Examination End
The acquisition of the radiological images is completed after about 35 minutes. The patient then leaves the MR room, gets dressed and is escorted to the reception, where, before being dismissed, they conclude the procedures and receive all the information related to the report. There are no special post-examination recommendations: the person can return to normal daily activities with full peace of mind and no restrictions. The results of the DWB will be processed afterwards, supervised by specialised radiological medical personnel from the IEO teams and verified and signed off by Prof Giuseppe Petralia.
The value and features of the Whole-Body Diffusion explained by Prof Giuseppe Petralia, clinical head of the Whole-Body Diffusion at ASC, full professor at the University of Milan, director of the Precision Imaging and Research Unit at the European Institute of Oncology in Milan.
At the European Oncology Institute, over ten years of experimentation and use, and thanks also to collaboration with other European centres, new configurations have been made that have improved performance, both to meet clinical needs and to reduce the examination time, which was initially very long and is now around 35 minutes. Like all MRIs it does not use radiation and, in this case, it does not require the injection of contrast. . It is therefore a non-invasive test and completely free of risk to the body. It is based on a conceptually simple idea, because the examination detects the movement of water molecules, which when “trapped” in a hypercellular tissue (such as a tumour) are “bright” on magnetic resonance. In cancerous tissue, which is hypercellular by nature, the water molecules are more densely packed. This currently makes it possible to detect cancerous changes of 3-4 millimetres, small enough for effective early diagnosis.
The importance of
early diagnosis
A study published in Annals of Oncology estimates that 250,000 cancer deaths will be avoided in Europe in 2014 thanks to prevention. The reason is now well known, but it is worth repeating: the smaller a tumour is, the greater its likelihood of healing. And the lower the risk of treatment side effects.
So wrote Umberto Veronesi in L’Espresso in 2014, identifying two main avenues for early diagnosis: molecular imaging, which allows the detection of tumour markers in the blood, and the evolution of magnetic resonance imaging.
In fact, he himself promoted research at the IEO on Whole-Body Diffusion, a type of magnetic resonance imaging designed to detect cancers at an early stage.
data from “Cancer numbers in Italy 2021” edited by AIOM and AIRTUM
Italians who have been diagnosed with cancer
Examination cost
Whole-Body Diffusion examination:
- cost €1.200
- available from Monday to Friday from 9:00 AM to 5:00 PM
- waiting time for appointment 8/10 days – run time
about 60 minutes - report after about 7 working days
Whole-Body Diffusion Examination complete with visit and consultation with Prof Petralia
- cost €1.400
- this is only available on specific days, usually on Wednesday afternoons.
- waiting time for appointment 30 days – run time about 2.5 hours
- immediate report and with a consultation with Prof Petralia
Payment methods
The examination can be paid by cheque, bank transfer, debit/credit card, cash (according to the ceilings provided for by the regulations in force and remembering that in order to benefit from tax deductions when filing a tax return, payments must be made by traceable means).
