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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

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusions

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.

Key points

• 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.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

BB:

Black-blood

CE:

Contrast-enhanced

CNR:

Contrast-to-noise ratio

DC:

Diagnostic confidence

DWI:

Diffusion-weighted imaging

ETL:

Echo train length

FA:

Flip angles

FLAIR:

Fluid attenuated inversion recovery

GRE:

Gradient echo

MP-RAGE:

Magnetization prepared rapid gradient echo

MRI:

Magnetic resonance imaging

Ms:

Milliseconds

MSDE:

Motion-sensitized driven-equilibrium

MT:

Magnetization transfer

Mvista:

Modified Volumetric isotropic TSE Acquisition

ROC:

Receiver operating characteristic

ROI:

Region of interest

SE:

Spin echo

SI:

Signal intensity

SPACE:

Sampling Perfection with Application optimized Contrasts using different flip angle Evolution

T:

Tesla

TE:

Time to echo

TR:

Time of repetition

TSE:

Turbo spin echo

T1w:

T1-weighted

T2w:

T2-weighted

VCE:

Visual assessment of contrast enhancement

VFA:

Variable flip angles

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Acknowledgments

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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Correspondence to N. N. Kammer.

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Kammer, N.N., Coppenrath, E., Treitl, K.M. et al. 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. Eur Radiol 26, 1818–1825 (2016). https://doi.org/10.1007/s00330-015-3975-x

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Keywords

  • Magnetic resonance imaging
  • 3-D imaging
  • Brain imaging
  • Clinical oncology
  • Neoplastic processes