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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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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DOI: https://doi.org/10.1007/s00330-015-3975-x