Sangjoon Lee1, Dong Woo Park1, Ji Young Lee2, Young-Jun Lee2, Taeyoon Kim1. 1. 1 Hanyang University Guri Hospital, College of Medicine, Hanyang University Hospital, Guri, Republic of Korea. 2. 2 Hanyang University Medical Center, College of Medicine, Hanyang University Hospital, Seoul, Republic of Korea.
Abstract
OBJECTIVE: To evaluate the clinical usefulness of an improved motion-sensitized driven-equilibrium (iMSDE) preparation for three-dimensional turbo spin echo (TSE) T1 weighted imaging after gadolinium administration in 3.0-T MRI for the detection of brain metastases compared with conventional gradient echo (C-GRE) T1 weighted imaging with gadolinium. METHODS: 40 patients with suspected brain metastases underwent MR studies, including two contrast-enhanced sequences, iMSDE-TSE and C-GRE. Post-enhancement images of 14 patients with suspected metastatic brain lesions were retrospectively analyzed, and comparisons between iMSDE-TSE and C-GRE were made using the Wilcoxon signed-rank test. RESULTS: C-GRE detected 86 metastatic lesions, whereas iMSDE-TSE detected 97, including one false-positive lesion on both sequences. 11 of 96 metastases were detected on iMSDE-TSE only. On C-GRE, 15 of 85 metastases were equivocal. There was a significant difference between C-GRE and iMSDE-TSE in terms of the number of detected lesions (p = 0.024). Notably, the interobserver agreement for diagnosing metastases and identifying non-metastases was nearly identical. Overall, iMSDE-TSE achieves higher detectability of metastatic brain lesions, especially equivocal lesions. CONCLUSION: Compared with C-GRE, iMSDE-TSE detected more brain metastases. This method is especially helpful in discerning equivocal metastases. ADVANCES IN KNOWLEDGE: Previous studies have offered limited clinically useful information because they have all been preliminary studies such as comparing the contrast-to-noise ratio of each sequence without evaluating iMSDE-TSE. This study, however, is unique because we evaluate the clinical usefulness of iMSDE-TSE for the detection of brain metastases, and we compare these results to C-GRE.
OBJECTIVE: To evaluate the clinical usefulness of an improved motion-sensitized driven-equilibrium (iMSDE) preparation for three-dimensional turbo spin echo (TSE) T1 weighted imaging after gadolinium administration in 3.0-T MRI for the detection of brain metastases compared with conventional gradient echo (C-GRE) T1 weighted imaging with gadolinium. METHODS: 40 patients with suspected brain metastases underwent MR studies, including two contrast-enhanced sequences, iMSDE-TSE and C-GRE. Post-enhancement images of 14 patients with suspected metastatic brain lesions were retrospectively analyzed, and comparisons between iMSDE-TSE and C-GRE were made using the Wilcoxon signed-rank test. RESULTS: C-GRE detected 86 metastatic lesions, whereas iMSDE-TSE detected 97, including one false-positive lesion on both sequences. 11 of 96 metastases were detected on iMSDE-TSE only. On C-GRE, 15 of 85 metastases were equivocal. There was a significant difference between C-GRE and iMSDE-TSE in terms of the number of detected lesions (p = 0.024). Notably, the interobserver agreement for diagnosing metastases and identifying non-metastases was nearly identical. Overall, iMSDE-TSE achieves higher detectability of metastatic brain lesions, especially equivocal lesions. CONCLUSION: Compared with C-GRE, iMSDE-TSE detected more brain metastases. This method is especially helpful in discerning equivocal metastases. ADVANCES IN KNOWLEDGE: Previous studies have offered limited clinically useful information because they have all been preliminary studies such as comparing the contrast-to-noise ratio of each sequence without evaluating iMSDE-TSE. This study, however, is unique because we evaluate the clinical usefulness of iMSDE-TSE for the detection of brain metastases, and we compare these results to C-GRE.
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