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AJNR - American Journal of Neuroradiology

Publication Preview: Published February 12, 2009

American Journal of Neuroradiology 2009;30:923.

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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1506

BRAIN

Usefulness of Contrast-Enhanced T1-Weighted Sampling Perfection with Application-Optimized Contrasts by Using Different Flip Angle Evolutions in Detection of Small Brain Metastasis at 3T MR Imaging: Comparison with Magnetization-Prepared Rapid Acquisition of Gradient Echo Imaging

Y. Kato, S. Higano, H. Tamura, S. Mugikura, A. Umetsu, T. Murata and S. Takahashi

From the Departments of Diagnostic Radiology (Y.K., S.H., S.M., A.U., T.M., S.T.) and Noninvasive Diagnostic Imaging (H.T.), Tohoku University Graduate School of Medicine, Sendai, Japan.

Please address correspondence to Yumiko Kato, MD, Tohoku University Graduate School of Medicine, Diagnostic Radiology, 1–1 Seiryo-machi, Aoba-ku, Sendai, Miyagi-ken, 980-8574, Japan; e-mail: ykato{at}rad.med.tohoku.ac.jp

BACKGROUND AND PURPOSE: Early accurate diagnosis of brain metastases is crucial for a patient's prognosis. This study aimed to compare the conspicuity and detectability of small brain metastases between contrast-enhanced 3D fast spin-echo (sampling perfection with application-optimized contrasts by using different flip angle evolutions [SPACE]) and 3D gradient-echo (GE) T1-weighted (magnetization-prepared rapid acquisition of GE [MPRAGE]) images at 3T.

MATERIALS AND METHODS: Sixty-nine consecutive patients with suspected brain metastases were evaluated prospectively by using SPACE and MPRAGE on a 3T MR imaging system. After careful evaluation by 2 experienced neuroradiologists, 92 lesions from 16 patients were selected as brain metastases. We compared the shorter diameter, contrast rate (CR), and contrast-to-noise ratio (CNR) of each lesion. Diagnostic ability was compared by using receiver operating characteristic (ROC) analysis. Ten radiologists (5 neuroradiologists and 5 residents) participated in the reading.

RESULTS: The mean diameter was significantly larger by using SPACE than MPRAGE (mean, 4.5 ± 3.7 versus 4.3 ± 3.7 mm, P = .0014). The CR and CNR of SPACE (mean, 57.3 ± 47.4%, 3.0 ± 1.9, respectively) were significantly higher than those of MPRAGE (mean, 37.9 ± 41.2%, 2.6 ± 2.2; P < .0001, P = .04). The mean area under the ROC curve was significantly larger with SPACE than with MPRAGE (neuroradiologists, 0.99 versus 0.88, P = .013; residents, 0.99 versus 0.78, P = .0001).

CONCLUSIONS: Lesion detectability was significantly higher on SPACE than on MPRAGE, irrespective of the experience of the reader in neuroradiology. SPACE should be a promising diagnostic technique for assessing brain metastases.