Comparison of contrast-enhanced modified T1-weighted 3D TSE black-blood and 3D MP-RAGE sequences for the detection of cerebral metastases and brain tumours
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To compare a modified T1-weighted 3D TSE black-blood sequence with sub-millimetre resolution (T1-mVISTA) with a magnetization-prepared rapid gradient echo (MP-RAGE) sequence for the diagnosis of cerebral malignomas.
Forty-six patients with known or suspected intracranial tumours and 15 control patients were included in this retrospective study. All patients underwent T1-mVISTA (0.75-mm isotropic resolution, 4:43 min) and MP-RAGE (0.8-mm isotropic resolution, 4:46 minutes) at 3-Tesla in random order after application of contrast agent. Two experienced radiologists determined the number of lesions. Maximum diameter, diagnostic confidence (DC), visual assessment of contrast enhancement (VCE) and CNRlesion/parenchyma were assessed for each lesion.
Significantly more lesions were detected with T1-mVISTA compared to the MP-RAGE (61 vs. 36; p < 0.05). Further, DC and VCE was rated significantly higher in the T1-mVISTA (p < 0.05 and p < 0.001). Mean CNRlesion/parenchyma was twofold higher for T1-mVISTA (24.2 ± 17.5 vs. 12.7 ± 11.5, p < 0.001). The 25 lesions detected only in T1-mVISTA were significantly smaller than those detected in both sequences (4.3 ± 3.7 mm vs. 11.3 ± 10.7 mm; p < 0.01).
T1-mVISTA increases the contrast of lesions significantly compared to MP-RAGE and might therefore improve detection rates of small lesions in early stages of disease.
• T1-mVISTA leads to significantly higher contrast-to-noise ratios of cerebral malignomas.
• T1-mVISTA detects significantly more metastatic lesions compared to 3D-MPRAGE.
• Lesions detected only by T1-mVISTA are smaller than those detected in both sequences.
• Diagnostic confidence is significantly higher for lesions detected by T1-mVISTA.
• Application of T1-mVISTA might be of high relevance in early stages of disease.
KeywordsMagnetic resonance imaging 3-D imaging Brain imaging Clinical oncology Neoplastic processes
Abbreviations and acronyms
Echo train length
Fluid attenuated inversion recovery
Magnetization prepared rapid gradient echo
Magnetic resonance imaging
Modified Volumetric isotropic TSE Acquisition
Receiver operating characteristic
Region of interest
Sampling Perfection with Application optimized Contrasts using different flip angle Evolution
Time to echo
Time of repetition
Turbo spin echo
Visual assessment of contrast enhancement
Variable flip angles
The scientific guarantor of this publication is Nora Navina Kammer. The authors of this manuscript declare relationships with the following companies: Dr. Hendrik Kooijman is employee of Philips Healthcare. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was not required because a waiver was obtained. Written informed consent was waived by the Institutional Review Board.
Methodology: diagnostic or prognostic study, performed at one institution.
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