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. 2016 Jun;26(6):1818-25. doi: 10.1007/s00330-015-3975-x. Epub 2015 Sep 3.

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.

Keywords: 3-D imaging; Brain imaging; Clinical oncology; Magnetic resonance imaging; Neoplastic processes.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / secondary*
  • Child
  • Child, Preschool
  • Contrast Media
  • Female
  • Heterocyclic Compounds
  • Humans
  • Image Interpretation, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Organometallic Compounds
  • Retrospective Studies
  • Young Adult

Substances

  • Contrast Media
  • Heterocyclic Compounds
  • Organometallic Compounds
  • gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate