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.
OBJECTIVE
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.


CONCLUSIONS
• 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.
Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Nussbaumstr. 20, 80336, Munich, Germany. nora.kammer@med.lmu.de.
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Kammer
Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Nussbaumstr. 20, 80336, Munich, Germany.
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Coppenrath
Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Nussbaumstr. 20, 80336, Munich, Germany.
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Treitl
Philips Healthcare, Luebeckertordamm 5, 20099, Hamburg, Germany.
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Kooijman
Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Marchioninistr 15, 81377, Munich, Germany.
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Dietrich
Institute for Clinical Radiology, Ludwig-Maximilians-University Hospital Munich, Nussbaumstr. 20, 80336, Munich, Germany.
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Saam
D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000556:secondary*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D006571:Heterocyclic Compounds; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies; D055815:Young Adult
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate
3-D imaging; Brain imaging; Clinical oncology; Magnetic resonance imaging; Neoplastic processes