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3D MR Sequence Capable of Simultaneous Image Acquisitions with and without Blood Vessel Suppression: Utility in Diagnosing Brain Metastases

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Abstract

Objective

Volume isotropic simultaneous interleaved bright- and black-blood examination (VISIBLE) is a recently developed 3D MR sequence that provides simultaneous acquisitions of images with blood vessel suppression (Black) and images without it (Bright). Our purpose was to evaluate the usefulness of VISIBLE in detecting brain metastases.

Methods

This prospective study included patients with suspected brain metastasis imaged with both VISIBLE and MPRAGE. From a data set, we compared the number of visualized blood vessels and the lesion-to-normal contrast-to-noise ratio (CNR) in 60 patients. We also performed an observer test to compare their diagnostic performance with VISIBLE, MPRAGE and only Black in 34 patients. Diagnostic performance was evaluated using a figure of merit (FOM), sensitivity, false-positive results per case (FPs/case) and reading time.

Results

The number of vessels was significantly fewer in Black compared to MPRAGE and Bright (P < 0.0001). CNR was significantly higher with both Black and Bright than with MPRAGE (P < 0.005). In the observer test, significantly higher sensitivity (P < 0.0001) and FOM (P < 0.0001), significantly shorter reading time (P = 0.0001) and similar FPs/case were achieved with VISIBLE compared to MPRAGE. Compared to only Black, VISIBLE resulted in comparable sensitivity, but significantly fewer FPs/case (P = 0.0008).

Conclusion

VISIBLE can improve radiologists’ diagnostic performance for brain metastasis.

Key Points

• VISIBLE can achieve higher sensitivity and shorter reading time than MPRAGE.

• VISIBLE can achieve lower false-positive rates than blood vessel suppressed images.

• Compared to MPRAGE, VISIBLE can improve diagnostic performance for brain metastasis.

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Abbreviations

3D:

Three dimensional

ANOVA:

Analysis of variance

CNR:

Contrast-to-noise ratio

EPI:

Echo-planar imaging

FA:

Flip angle

FOM:

Figure of merit

FOV:

Field of view

FP:

False positive

FPs/case:

False-positive results per case

GRE:

Fradient-recalled echo

HSD:

Honestly significant difference

iMSDE:

Improved motion-sensitized driven equilibrium

JAFROC:

Jackknife free-response receiver operating characteristic

MPRAGE:

Magnetization-prepared rapid acquisition of gradient echo

MSDE:

Motion-sensitized driven equilibrium

PACS:

Picture archiving and communication system

ROI:

Region of interest

SENSE:

Sensitivity encoding

SRS:

Stereotactic radiosurgery

TE:

Echo time

TFE:

Turbo field-echo

TI:

Inversion time

TR:

Repetition time

TSE:

Turbo spin-echo

TSE-MSDE:

TSE with MSDE preparation

Venc:

Velocity encoding

VISIBLE:

Volume isotropic simultaneous interleaved bright- and black-blood examination

WBRT:

Whole brain radiation therapy

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Acknowledgments

The scientific guarantor of this publication is Hiroshi Honda. The authors of this manuscript declare relationships with the following companies: Philips Electronics Japan. Makoto Obara is an employee of Philips Electronics Japan. He is not involved in data analysis in this study. This work was supported by JSPS KAKENHI Grant Number 26461826. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazufumi Kikuchi, Akio Hiwatashi, Osamu Togao, Koji Yamashita, Takashi Yoshiura & Hiroshi Honda

  2. Yaesu Clinic, C-road Bldg 4F, 2-1-18 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan

    Masami Yoneyama

  3. Philips Electronics Japan, 2-13-37, Konan, Minato-ku, Tokyo, 108-8507, Japan

    Makoto Obara

  4. Department of Research and Development of Next Generation Medicine, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Junji Kishimoto

Authors
  1. Kazufumi Kikuchi
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  2. Akio Hiwatashi
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  3. Osamu Togao
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  4. Koji Yamashita
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  5. Masami Yoneyama
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  6. Makoto Obara
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  7. Junji Kishimoto
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  8. Takashi Yoshiura
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  9. Hiroshi Honda
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Corresponding author

Correspondence to Akio Hiwatashi.

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Kikuchi, K., Hiwatashi, A., Togao, O. et al. 3D MR Sequence Capable of Simultaneous Image Acquisitions with and without Blood Vessel Suppression: Utility in Diagnosing Brain Metastases. Eur Radiol 25, 901–910 (2015). https://doi.org/10.1007/s00330-014-3496-z

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  • DOI: https://doi.org/10.1007/s00330-014-3496-z

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