Nicolin Hainc1,2, Christian Federau3,4, Anthony Tyndall2,3, Andreas Mittermeier5,6, Andrea Bink2,3, Christoph Stippich2,3, Tilman Schubert2,3. 1. Department of Medical Imaging, Division of Neuroradiology, Toronto Western Hospital, Toronto, Ontario, Canada. 2. Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland. 3. Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, University of Basel, Basel, Switzerland. 4. Institute for Biomedical Engineering, Swiss Federal Institute of Technology, Zurich, Switzerland. 5. Department of Medical Imaging, The Hospital for Sick Children, University of Toronto, Toronto, Canada. 6. Department of Radiology, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
Abstract
BACKGROUND: To visualize and assess brain metastases on magnetic resonance imaging, radiologists face an ever-increasing pressure to perform faster and more efficiently. The usage of maximum intensity projections (MIPs) of contrast-enhanced T1-weighed (T1ce) magnetization-prepared rapid acquisition with gradient echo (MP-RAGE) images proposes to increase reading efficiency by increasing lesion conspicuity while reducing in the number of images to be reviewed. AIM: To assess if MIPs save reading time and achieve the same level of diagnostic accuracy as standard 1 mm T1ce images for the detection of brain metastases. METHODS: Forty-four patients were included in this retrospective study. Axial reformations of T1ce MP-RAGE (TR/TE = 2300/2.25 ms, resolution = 1 mm3 ) images were analyzed and post-processed into 5 and 10 mm MIPs. Two readers evaluated the randomly assorted images and recorded reading time. Reading time differences were analyzed using the Wilcoxon test, and inter-reader statistics were performed using Bland-Altman plots. RESULTS: About 22.5 61.2 s/study and 43.8 ± 159.9 s/study were saved using 5 and 10 mm MIPs, respectively. Combined average sensitivity was 92.0% for 5 mm MIPs and 86.3% for 10 mm MIPs compared to standard 1 mm axial slices, with an average rate of 0.98 and 0.57 false positives per study, respectively CONCLUSION: While 5 mm and 10 mm T1ce MP-RAGE MIPs showed a clinical benefit in reducing reading times for evaluation of brain metastases, they should be used in conjunction with standard 1 mm images for best sensitivity and specificity, a practice which possibly annuls their benefit.
BACKGROUND: To visualize and assess brain metastases on magnetic resonance imaging, radiologists face an ever-increasing pressure to perform faster and more efficiently. The usage of maximum intensity projections (MIPs) of contrast-enhanced T1-weighed (T1ce) magnetization-prepared rapid acquisition with gradient echo (MP-RAGE) images proposes to increase reading efficiency by increasing lesion conspicuity while reducing in the number of images to be reviewed. AIM: To assess if MIPs save reading time and achieve the same level of diagnostic accuracy as standard 1 mm T1ce images for the detection of brain metastases. METHODS: Forty-four patients were included in this retrospective study. Axial reformations of T1ce MP-RAGE (TR/TE = 2300/2.25 ms, resolution = 1 mm3 ) images were analyzed and post-processed into 5 and 10 mm MIPs. Two readers evaluated the randomly assorted images and recorded reading time. Reading time differences were analyzed using the Wilcoxon test, and inter-reader statistics were performed using Bland-Altman plots. RESULTS: About 22.5 61.2 s/study and 43.8 ± 159.9 s/study were saved using 5 and 10 mm MIPs, respectively. Combined average sensitivity was 92.0% for 5 mm MIPs and 86.3% for 10 mm MIPs compared to standard 1 mm axial slices, with an average rate of 0.98 and 0.57 false positives per study, respectively CONCLUSION: While 5 mm and 10 mm T1ce MP-RAGE MIPs showed a clinical benefit in reducing reading times for evaluation of brain metastases, they should be used in conjunction with standard 1 mm images for best sensitivity and specificity, a practice which possibly annuls their benefit.
Authors: Benjamin M Ellingson; Martin Bendszus; Jerrold Boxerman; Daniel Barboriak; Bradley J Erickson; Marion Smits; Sarah J Nelson; Elizabeth Gerstner; Brian Alexander; Gregory Goldmacher; Wolfgang Wick; Michael Vogelbaum; Michael Weller; Evanthia Galanis; Jayashree Kalpathy-Cramer; Lalitha Shankar; Paula Jacobs; Whitney B Pope; Dewen Yang; Caroline Chung; Michael V Knopp; Soonme Cha; Martin J van den Bent; Susan Chang; W K Al Yung; Timothy F Cloughesy; Patrick Y Wen; Mark R Gilbert Journal: Neuro Oncol Date: 2015-08-05 Impact factor: 12.300
Authors: Nicolin Hainc; Christian Federau; Anthony Tyndall; Andreas Mittermeier; Andrea Bink; Christoph Stippich; Tilman Schubert Journal: Cancer Rep (Hoboken) Date: 2020-08-07
Authors: Yun Jung Bae; Byung Se Choi; Kyung Mi Lee; Yeon Hong Yoon; Leonard Sunwoo; Cheolkyu Jung; Jae Hyoung Kim Journal: Korean J Radiol Date: 2017-05-19 Impact factor: 3.500
Authors: Nicolin Hainc; Christian Federau; Anthony Tyndall; Andreas Mittermeier; Andrea Bink; Christoph Stippich; Tilman Schubert Journal: Cancer Rep (Hoboken) Date: 2020-08-07