AIMS: To improve tumor conspicuity and delineation on contrast-enhanced T1-weighted MR images with and without magnetization transfer (MT) contrast as a strategy to improve the macroscopic boost volume definition in the planning process of radiosurgery in patients with high grade gliomas or metastatic brain lesions. PATIENTS AND METHODS: Thirty-two patients (mean age 47 years) with histologically proven or suspected high grade glioma (n = 12) or metastatic brain lesions (n = 20) were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight) the lesions were imaged with a T1-weighted MT-fast low angle shot (FLASH) pulse sequence and with a conventional T1-weighted SE sequence without MT saturation. RESULTS: The mean CNR of enhancing lesions on T1-weighted MT-FLASH was 15 +/- 5 compared to 11 +/- 4 on SE images, representing a significant (p < .01) improvement. The mean tumor diameter of malignant gliomas was significantly (p < .01) larger measured on T1-weighted MT-FLASH images compared to those obtained from T1-weighted SE images and were comparable for metastatic lesions. Lesion conspicuity and delineation were improved in 50% of patients with high grade gliomas and in 35% of patients with brain metastases. Lesion conspicuity was markedly improved in the posterior fossa. Additional contrast enhancing lesions were detected in 10% of patients with metastases on MT-FLASH images. CONCLUSIONS: It is concluded that contrast-enhanced MT-FLASH images may improve lesion detection and delineation in the planning process of radiosurgery in patients with intracranial high grade gliomas or metastases or even alter the treatment approach.
AIMS: To improve tumor conspicuity and delineation on contrast-enhanced T1-weighted MR images with and without magnetization transfer (MT) contrast as a strategy to improve the macroscopic boost volume definition in the planning process of radiosurgery in patients with high grade gliomas or metastatic brain lesions. PATIENTS AND METHODS: Thirty-two patients (mean age 47 years) with histologically proven or suspected high grade glioma (n = 12) or metastatic brain lesions (n = 20) were prospectively examined by MR imaging. After the administration of gadolinium dimeglumine (0.1 mmol/kg body weight) the lesions were imaged with a T1-weighted MT-fast low angle shot (FLASH) pulse sequence and with a conventional T1-weighted SE sequence without MT saturation. RESULTS: The mean CNR of enhancing lesions on T1-weighted MT-FLASH was 15 +/- 5 compared to 11 +/- 4 on SE images, representing a significant (p < .01) improvement. The mean tumor diameter of malignant gliomas was significantly (p < .01) larger measured on T1-weighted MT-FLASH images compared to those obtained from T1-weighted SE images and were comparable for metastatic lesions. Lesion conspicuity and delineation were improved in 50% of patients with high grade gliomas and in 35% of patients with brain metastases. Lesion conspicuity was markedly improved in the posterior fossa. Additional contrast enhancing lesions were detected in 10% of patients with metastases on MT-FLASH images. CONCLUSIONS: It is concluded that contrast-enhanced MT-FLASH images may improve lesion detection and delineation in the planning process of radiosurgery in patients with intracranial high grade gliomas or metastases or even alter the treatment approach.
Authors: L R Schad; H H Ehricke; B Wowra; G Layer; R Engenhart; H U Kauczor; H J Zabel; G Brix; W J Lorenz Journal: Magn Reson Imaging Date: 1992 Impact factor: 2.546
Authors: W T Yuh; D J Fisher; J D Engelken; G M Greene; Y Sato; T J Ryals; M R Crain; J C Ehrhardt Journal: Radiology Date: 1991-08 Impact factor: 11.105
Authors: V M Runge; J E Kirsch; V J Burke; A C Price; K L Nelson; G S Thomas; B L Dean; C Lee Journal: J Magn Reson Imaging Date: 1992 Jan-Feb Impact factor: 4.813
Authors: L R Schad; R Boesecke; W Schlegel; G H Hartmann; V Sturm; L G Strauss; W J Lorenz Journal: J Comput Assist Tomogr Date: 1987 Nov-Dec Impact factor: 1.826
Authors: J S Loeffler; H M Kooy; P Y Wen; H A Fine; C W Cheng; E G Mannarino; J S Tsai; E Alexander Journal: J Clin Oncol Date: 1990-04 Impact factor: 44.544