Detection of brain metastasis: comparison of Turbo-FLAIR imaging, T2-weighted imaging and double-dose gadolinium-enhanced MR imaging.

The purpose of this study was to compare Turbo-FLAIR imaging, T2-weighted imaging, and double-dose gadolinium-enhanced MR imaging in the detection of brain metastasis. Using the three sequences, 20 consecutive patients with brain metastases were prospectively studied with a 1.5-Tesla system. Three independent, blinded readers assessed the images for the presence, size, number, and location of metastatic lesions. In the detection of large lesions (> 0.5 cm), Turbo-FLAIR imaging (38/48, 79%) was not significantly different from gadolinium-enhanced imaging (42/48, 88%) (p = 0.273). T2-weighted imaging (31/48, 65%), however, was inferior to gadolinium-enhanced imaging (p < 0.05). There was no difference between Turbo-FLAIR imaging and gadolinium-enhanced imaging in the accuracy of detecting solitary brain metastasis (4/4, 100%). In conclusion, Turbo-FLAIR imaging is a useful, noninvasive screening modality for brain metastasis. Its use may lead to cost savings in the diagnosis of brain metastases and may impact positively the cost-effectiveness of treatment.