Comparison between gadolinium-enhanced 2D T1-weighted gradient-echo and spin-echo sequences in the detection of active multiple sclerosis lesions on 3.0T MRI
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To compare the sensitivity of enhancing multiple sclerosis (MS) lesions in gadolinium-enhanced 2D T1-weighted gradient-echo (GRE) and spin-echo (SE) sequences, and to assess the influence of visual conspicuity and laterality on detection of these lesions.
One hundred MS patients underwent 3.0T brain MRI including gadolinium-enhanced 2D T1-weighted GRE and SE sequences. The two sets of contrast-enhanced scans were evaluated in random fashion by three experienced readers. Lesion conspicuity was assessed by the image contrast ratio (CR) and contrast-to-noise ratio (CNR). The intracranial region was divided into four quadrants and the impact of lesion location on detection was assessed in each slice.
Six hundred and seven gadolinium-enhancing MS lesions were identified. GRE images were more sensitive for lesion detection (0.828) than SE images (0.767). Lesions showed a higher CR in SE than in GRE images, whereas the CNR was higher in GRE than SE. Most misclassifications occurred in the right posterior quadrant.
The gadolinium-enhanced 2D T1-weighted GRE sequence at 3.0T MRI enables detection of enhancing MS lesions with higher sensitivity and better lesion conspicuity than 2D T1-weighted SE. Hence, we propose the use of gadolinium-enhanced GRE sequences rather than SE sequences for routine scanning of MS patients at 3.0T.
• 2D SE and GRE sequences are useful for detecting active MS lesions.
• Which of these sequences is more sensitive at high field remains uncertain.
• GRE sequence showed better sensitivity for detecting active MS lesions than SE.
• We propose GRE sequence for detecting active MS lesions at 3.0T.
KeywordsMagnetic resonance imaging Brain Multiple sclerosis Contrast sensitivity Lesion conspicuity
Clinically isolated syndrome
Kurtzke Expanded Disability Status Scale
The authors thank Celine Cavallo for English language support, and Isidre Rivero and Ignasi Ferrer for their help in post-processing. The scientific guarantor of this publication is Alex Rovira. The authors of this manuscript declare relationships with the following companies: Cristina Auger has received speaking honoraria from Novartis and Genzyme; Paula Alcaide-Leon holds a MS research grant from Novartis; Jaume Sastre-Garriga has received compensation for consulting services and speaking honoraria from Merck-Serono, Biogen-Idec, Teva, Sanofi-Aventis and Novartis; Xavier Montalban has received speaking honoraria and travel expenses for scientific meetings, has been a steering committee member of clinical trials or participated in advisory boards of clinical trials in the past with Bayer Schering Pharma, Biogen Idec, EMD Merck Serono, Genentech, Genzyme, Novartis, Sanofi-Aventis, Teva Pharmaceuticals and Almirall; Alex Rovira serves on scientific advisory boards for Biogen Idec, Novartis, Genzyme, and OLEA Medical, and has received speaker honoraria from Bayer, Genzyme, Sanofi-Aventis, Bracco, Merck-Serono, Teva Pharmaceutical Industries Ltd, OLEA Medical, Stendhal, Novartis and Biogen Idec. The rest of authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.This study has received funding by Bayer HealthCare Pharmaceuticals. One of the authors has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all patients in this study. We declare that none of the study subjects or cohorts have been previously reported. Methodology: prospective, observational, performed at one institution.
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