MRI for Spleen Cancer Detection`

Spleen cancer, or “splenic cancer,” usually refers to malignancies that arise in, or primarily involve, the spleen. True primary cancers of the spleen are rare. When they do occur, they’re most often lymphomas (e.g., splenic marginal zone lymphoma or diffuse large B-cell lymphoma)¹. A very rare primary tumour is primary splenic angiosarcoma². The spleen can also be affected secondarily by cancers from elsewhere (e.g., lymphoma spread, or, less commonly, metastases)³. 

MRI is effective for assessing the spleen because it offers excellent soft-tissue contrast without ionising radiation and enables a multiparametric look at lesions: T1/T2 sequences help distinguish cystic, solid, haemorrhagic, or vascular lesions; diffusion-weighted imaging often shows restricted diffusion in malignancy and improves benign-malignant differentiation; and dynamic gadolinium enhancement characterises vascularity and enhancement timing^4–6. It also complements ultrasound/CT when findings are indeterminate or incidental. 

Why You Might Need a Spleen MRI

MRI of the spleen is usually recommended for unexplained abdominal pain or splenomegaly, when physical examination or prior imaging reveals enlargement or abnormal structure^7,8. It is also useful if abnormal blood tests suggest a possible haematologic malignancy, as it helps evaluate for lymphoma, leukaemia, or related disorders^9,10. 

As part of cancer follow-up, MRI assesses the spleen for metastatic disease, especially in those with known cancers where splenic involvement might alter treatment or prognosis^11,12. Additionally, MRI characterises incidental splenic lesions that are detected during ultrasound or CT scans, differentiating benign cysts or tumours from malignant processes for accurate management^13,14.

How to Prepare for Your Spleen MRI

Here are a few tips to help you prepare for your MRI¹⁵:

• Take your usual medications and eat normally, unless instructed to fast for sedation or contrast. Avoid heavy caffeine intake and stay hydrated.
• Inform staff about any metal implants or devices, and bring safety cards for “MR-Conditional” implants, such as pacemakers or aneurysm clips.
• Remove all metal items, including jewellery, hairpins, dental plates, and transdermal patches with foil, to prevent image distortion.
• Wear comfortable, metal-free clothing; ask about earplugs, music, or mirror goggles if you’re claustrophobic.
• If contrast is planned, fast for 4–6 hours prior to the procedure. Inform staff about any kidney issues or past reactions to contrast agents, as safer alternatives may be available.
• Arrange an escort home if you need sedation for claustrophobia.

You can read more about preparation for Ezra’s MRI Scan with Spine here.

What Happens During the Spleen Scan

Upon arrival for your MRI, you will need to check in and complete a screening form. This will allow you to confirm the presence of implants, allergies, and whether you might need any anxiety medication.

During the scan, you will lie down on a sliding table. A dedicated surface or phased-array coil is typically placed over the limb or region of interest¹⁶. Your head will be nestled in a small cushion that will keep you still. The scan typically lasts 30-45 minutes of actual “table time”, during which the technician may acquire multiple sequences (settings). Expect loud knocking noises (up to 110 dB); earplugs or headphones are provided to reduce discomfort. It’s normal to feel mild table vibrations.

You’ll stay in touch with the team via a two-way intercom and a squeeze bulb, allowing you to communicate or pause the scan if needed. If contrast is required, it’s injected halfway through, possibly causing a brief cool sensation. After the final sequence, the coil is removed, and you’re free to go. 

At Ezra, our MRI Scan with Spine scan takes around 60 minutes total, with 45 minutes of table time. Earplugs or headphones are available.

After the scan, you will be contacted by a medical provider working with Ezra within roughly a week. On the day of the appointment, you will receive a copy of your report and access to your scanned images through the online portal.

H2: MRI Safety, Risks, & Side-Effects

MRI is generally considered very safe when proper screening and protocols are followed, but certain risks and side effects should be understood:

• Metal and implants: The strong 3-Tesla magnet can pull or heat older pacemakers, aneurysm clips, or metal fragments¹⁷. Most modern “MR-Conditional” devices (like cochlear implants or pain pumps) are safe after screening, but all implants must be checked before scanning¹⁸.
• Gadolinium contrast: Macrocyclic gadolinium agents (e.g., gadobutrol) have an extremely low risk of allergic reactions or nephrogenic systemic fibrosis (NSF) when kidneys are healthy¹⁹. However, gadolinium can accumulate in tissues, and rare side effects such as headaches or skin changes have been reported. Many centres now offer contrast-free alternatives for routine follow-up²⁰. You can read more about gadolinium contrast side effects here.
• Incidental findings: Incidental bone lesions are discovered on imaging in approximately 2 to 10 per cent of cases, but the vast majority are benign and require only observation or serial imaging rather than immediate intervention²¹.
• Claustrophobia: Anxiety inside the scanner is common. Wide-bore scanners, music, mirror goggles, or a single dose of oral sedative can help alleviate symptoms. Open MRI is an option if image detail can be sacrificed.
• Zero Ionising Radiation: MRI uses magnetic fields and radio waves, not X-rays, so there is no ionising radiation exposure, making it safer for repeated scans compared to CT scans²².
• Minor Sensations: Expect loud knocking, mild table vibration, and a brief cool flush if contrast is injected. Rare side effects include headaches, fatigue, or mild skin heating.

A deeper dive into possible side effects (such as heat, headaches, and gadolinium deposition) is available in our full guide.

At Ezra, we employ a contrast-free approach using wide-bore T3 machines to deliver a comfortable scanning experience.

Terms You Might See in Your MRI Report (And What They Mean)

MRI reports of the spleen include specific terms that help clinicians assess the nature of a lesion or condition. Some common terms (and their meanings) include:

Hypointense and Hyperintense: Refer to areas on an MRI scan that appear darker or brighter, respectively, compared to surrounding tissues²³.

Enhancement: Describes how a lesion absorbs contrast agent during MRI, such as appearing nodular, uniform, or delayed, which can indicate its nature¹³.

Necrosis: Is the presence of dead tissue within a lesion, often a sign of aggressive or poorly vascularised tumours¹⁴.

Splenomegaly: The medical term for an enlarged spleen, which can result from infections, liver disease, blood disorders, or cancer¹⁰.

Multifocal lesions: Indicate that there are multiple abnormal areas within the spleen or other organ, rather than a single isolated spot¹⁴.

H2: After the MRI Scan

After the MRI scan, you will be free to go home and continue with your day without any precautions²⁴. If you received a sedative, you will need another person to pick you up. You will also not be able to drive, consume alcohol, or operate heavy machinery 24 hours after the sedative. 

A team of experts will review your results and determine whether a follow-up is necessary and recommend the appropriate treatment if needed. If abnormalities are found, you may undergo ongoing monitoring every 2-3 months to track recurrence. You can receive support in the form of counselling and advice on how to handle aspects like claustrophobia. 

If you have a scan with us here at Ezra, you will receive your report within five to seven days and have the option to discuss it with a medical practitioner. You can also access your scan images through the online portal.

H2: What MRI Can Show About Spleen Cancer

MRI is a critical imaging method for diagnosing and staging spleen cancer, allowing differentiation between solid and cystic masses, assessment of tumour vascularity and necrosis, characterisation of enhancement patterns, and evaluation for spread to adjacent organs or lymph nodes^9,23.

H3: Solid vs Cystic Masses

MRI distinguishes solid tumours such as lymphoma and angiosarcoma, which are typically hypointense on T1 and hyperintense on T2, from cystic lesions, which usually show very high T2 signal and lack enhancement, aiding accurate diagnosis^14,25,26. 

H3: Tumour Vascularity, Necrosis, and Enhancement Patterns

It is highly effective at detecting how spleen tumours absorb contrast, identifying patterns such as arterial or delayed enhancement, and visualising areas of necrosis or haemorrhage, which suggest aggressive or malignant pathology^26,27.

H3: Differentiating Benign From Malignant Lesions

MRI provides unique signal characteristics for benign lesions (e.g., hemangioma, hamartoma) versus malignant tumours (e.g., lymphoma, angiosarcoma, metastases), allowing radiologists to clarify whether a lesion requires monitoring or urgent intervention^9,14,26.

H3: Spread to Adjacent Organs or Lymph Nodes

MRI can assess for multifocal involvement, local invasion, and lymph node enlargement, helping determine the extent of disease and guiding appropriate treatment plans for spleen cancer^9,27.

H2: Types of Spleen Tumours and How They Look on MRI

H3: Benign Tumours

• Hemangioma typically appears hypo- to isointense on T1-weighted images and hyperintense on T2-weighted images, and shows a classic centripetal (peripheral-to-central) enhancement pattern after contrast administration^13,25,28.

• Sclerosing Angiomatoid Nodular Transformation (SANT) commonly presents as a well-defined, iso- to hypointense lesion on T1- and T2-weighted sequences, often with a central scar and spoke-wheel pattern of peripheral enhancement and delayed central filling²⁹.
• Splenic cysts appear as well-defined, fluid-filled masses that are hypointense on T1-weighted images and hyperintense on T2-weighted images, without and post-contrast enhancement^25,30.

Malignant Tumours

• Lymphoma of the spleen is often seen as diffuse enlargement or multiple hypointense nodules on T1-weighted images, which may show mild enhancement and occasional necrosis but typically have lower signal intensity compared to normal splenic tissue^27,31,32.
• Angiosarcoma is characterised by a large heterogeneous mass with areas of necrosis or haemorrhage, variable signal intensities on T1- and T2-weighted images, and irregular heterogeneous enhancement after contrast^33,34.

• Splenic metastases present with variable MRI appearances but are often hyperintense on T2-weighted images and hypointense on T1, showing variable enhancement and sometimes features similar to the primary tumour^13,27.

Ezra screens for over 500 conditions, including the brain.

Types of MRI Scans Used in Spleen Cancer Detection

There are multiple types of MRI scans, all using different methods to give a better visualisation of the spleen. 

• T1-weighted imaging is excellent for identifying areas of fat and internal haemorrhage in splenic tumours^27,35. 
• T2-weighted imaging highlights fluid-filled regions, with tumours and many lesions often appearing brighter than normal spleen tissue³⁶.
• Post-contrast (gadolinium-enhanced) sequences show the vascularity and enhancement pattern of splenic lesions, helping differentiate benign from malignant processes¹³.
• Diffusion-weighted imaging (DWI) is highly sensitive to differences in cellularity, making it a key sequence for detecting and distinguishing cancerous spleen lesions⁵.

MRI vs. Other Imaging Tests for Spleen Cancer Detection

MRI Scan Cost

The cost of a brain MRI scan on average ranges from £249 to £1845³⁷. At Ezra, we offer a full-body MRI scan that covers up to 13 organs, including the brain. 

At Ezra, our full-body scan (which includes the head, neck, abdomen, and pelvis) is offered at a £1495 all-inclusive price, including a 45-minute follow-up review of your scan findings with a medical practitioner. We have a location in London, with further locations across the UK coming soon.

Frequently Asked Questions

Is the scan painful?

MRI scans are not painful.

Can I eat beforehand?

You can usually eat beforehand unless specifically instructed otherwise by your healthcare provider.

Can it detect all cancers?

MRI scans can detect many types of cancers, but do not identify all cancers.

Key Takeaways

• Spleen MRI is a powerful, non-invasive tool for diagnosing splenic tumours.
• It helps distinguish benign from malignant lesions by analysing tissue-specific signals.
• Proper preparation and understanding of MRI terminology can reduce anxiety and improve patient outcomes.