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The detectability of brain metastases using contrast-enhanced spin-echo or gradient-echo images: a systematic review and meta-analysis

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Abstract

This study aimed to compare the detectability of brain metastases using contrast-enhanced spin-echo (SE) and gradient-echo (GRE) T1-weighted images. The Ovid-MEDLINE and EMBASE databases were searched for studies on the detectability of brain metastases using contrast-enhanced SE or GRE images. The pooled proportions for the detectability of brain metastases were assessed using random-effects modeling. Heterogeneity among studies was determined using χ 2 statistics for the pooled estimates and the inconsistency index, I 2. To overcome heterogeneity, subgroup analyses according to slice thickness and lesion size were performed. A total of eight eligible studies, which included a sample size of 252 patients and 1413 brain metastases, were included. The detectability of brain metastases using SE images (89.2 %) was higher than using GRE images (81.6 %; adjusted 84.0 %), but this difference was not statistically significant (p = 0.2385). In subgroup analysis of studies with 1-mm-thick slices and small metastases (<5 mm in diameter), 3-dimensional (3D) SE images demonstrated a higher detectability in comparison to 3D GRE images (93.7 % vs 73.1 % in 1-mm-thick slices; 89.5 % vs 59.4 % for small metastases) (p < 0.0001). Although both SE or GRE images are acceptable for detecting brain metastases, contrast-enhanced 3D SE images using 1-mm-thick slices are preferred for detecting brain metastases, especially small lesions (<5 mm in diameter).

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Abbreviations

MRI:

Magnetic resonance imaging

2D:

Two-dimensional

SE:

Spin-echo

3D:

Three-dimentional

GRE:

Gradient-echo

CNR:

Contrast-to-noise ratio

SNR:

Signal-to-noise ratio

SPACE:

Sampling perfection with application-optimized contrasts by using different flip angle evolutions

TSE-MSDE:

3D turbo spin-echo sequence with motion-sensitized driven-equilibrium preparation

QUADAS-2:

Quality Assessment of Diagnostic Accuracy Studies-2

BB-ssTSE:

Contrast-enhanced black-blood single-slab 3D turbo-spin echo imaging

MPRAGE:

Magnetization-prepared rapid gradient-echo

FSPGR:

Fast spoiled gradient-echo

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

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Correspondence to Seung Chai Jung.

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Suh, C.H., Jung, S.C., Kim, K.W. et al. The detectability of brain metastases using contrast-enhanced spin-echo or gradient-echo images: a systematic review and meta-analysis. J Neurooncol 129, 363–371 (2016). https://doi.org/10.1007/s11060-016-2185-y

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  • DOI: https://doi.org/10.1007/s11060-016-2185-y

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