title: Contrast-enhanced FLAIR imaging in combination with pre- and postcontrast magnetization transfer T1-weighted imaging: usefulness in the evaluation of brain metastases.
abstract: OBJECTIVE
  To assess whether the use of postcontrast fluid-attenuated inversion recovery (FLAIR) imaging in combination with pre- and postcontrast magnetization transfer (MT) T1-weighted imaging (T1WI) can increase diagnostic confidence in the evaluation of brain metastases.
  
  
  METHODS
  Brain MR images from 41 patients with suspected brain metastases were reviewed. Two radiologists viewed pre- and postcontrast MT-T1W images for the presence of metastatic tumors and rated the possible enhanced lesions using a five-point confidence scale (session 1). The postcontrast FLAIR images were then viewed together with pre- and postcontrast MT-T1W images, and the presence of metastasis was rated again (session 2).
  
  
  RESULTS
  A total of 240 possible enhanced lesions were detected in session 1. Judging by follow-up MR examinations, 196 were considered to be nonmetastatic findings and 44 were determined to be metastasis. In session 2 the confidence rating for nonmetastasis increased significantly in the subset of nonmetastatic findings (P < 0.001), and the confidence rating for metastasis increased significantly in the subset of metastases (P < 0.05).
  
  
  CONCLUSIONS
  The addition of postcontrast FLAIR imaging to pre- and postcontrast MT-T1WI improves diagnostic confidence in evaluation of brain metastases.
authors.affiliation: Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. sterae@radi.med.hokudai.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Terae
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoshida
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Khin Khin
authors.initials: KK
authors.lastname: Tha
authors.forename: Masaharu
authors.initials: M
authors.lastname: Fujino
authors.forename: Kazuo
authors.initials: K
authors.lastname: Miyasaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary; D001943:Breast Neoplasms / Q000473:pathology*; D002277:Carcinoma / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage*; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008175:Lung Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012372:ROC Curve
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA