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Abstract The aim of this study was to evaluate the diagnostic accuracy of whole-body MRI (WBMRI) in the staging of neuroblastoma and comparing it to FDG PET/CT. A prospective study of 20 consecutive histopathologically proven neuroblastoma patients enrolled in this study from January 2021 to August 2022. Whole-body MRI and FDG-PET/CT were performed for all cases. Bone marrow biopsy served as a standard of reference in the evaluation of bone marrow. Sensitivity, specificity, NPV, PPV, and accuracy were calculated for WBMRI and PET/CT in the evaluation of bone marrow. Additionally, lesion-by-lesion analysis was performed and the number of bone marrow metastatic lesions in different body segments in both imaging modalities was recorded and compared. WBMRI correctly identified true positives and true negatives in all cases with a sensitivity and specificity of 100%. In contrast, FDG PET/CT showed two false negative cases that resulted in sensitivity, specificity, PPV, NPV, and accuracy of 86.7%, 100%, 100%, 71.4%, and 92% respectively. In the lesion-by-lesion analysis, WBMRI detected significantly more (24.3%) bone marrow metastatic lesions than FDG-PET/CT. |