TY - JOUR T1 - 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 JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 923 LP - 929 DO - 10.3174/ajnr.A1506 VL - 30 IS - 5 AU - Y. Kato AU - S. Higano AU - H. Tamura AU - S. Mugikura AU - A. Umetsu AU - T. Murata AU - S. Takahashi Y1 - 2009/05/01 UR - http://www.ajnr.org/content/30/5/923.abstract N2 - 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. ER -