4 582

Cited 0 times in

Detection of small metastatic brain tumors: comparison of 3D contrast-enhanced whole-brain black-blood imaging and MP-RAGE imaging

Authors
 Eun Young Lee  ;  Tae Sung Park  ;  Min Jin Kim  ;  Myung Hee Chang  ;  Eun Hae Cho  ;  Seo-Jin Park  ;  Jong Rak Choi  ;  Jong-Ha Yoo 
Citation
 INVESTIGATIVE RADIOLOGY, Vol.47(2) : 136-141, 2012 
Journal Title
INVESTIGATIVE RADIOLOGY
ISSN
 0020-9996 
Issue Date
2012
MeSH
Aged ; Algorithms ; Brain/pathology* ; Brain Neoplasms/pathology* ; Brain Neoplasms/secondary* ; Contrast Media ; Female ; Gadolinium DTPA* ; Humans ; Image Enhancement/methods ; Image Interpretation, Computer-Assisted/methods* ; Imaging, Three-Dimensional/methods* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity
Keywords
MRI ; contrast-enhanced ; black-blood ; brain metastases ; spin echo ; variable flip angle
Abstract
OBJECTIVE: Early and accurate diagnosis of small metastatic brain tumors may affect outcomes and treatment strategies. For this reason, 3-dimensional (3D) thin-section imaging is preferred. However, with conventional contrast-enhanced (CE) 3D imaging, such as magnetization-prepared rapid gradient echo (MP-RAGE), many visually enhanced vessels may mimic small metastatic tumors, hindering tumor detection. CE black-blood single-slab 3D turbo-spin echo imaging (BB-ssTSE) was recently developed, which uses variable refocusing flip angles and flow-sensitizing gradient schemes, to enhance metastatic brain tumors while selectively suppressing blood vessels. The purpose of this work was to investigate the efficiency of the proposed CE BB-ssTSE in detecting small metastatic brain tumors as compared with conventional MP-RAGE.

MATERIALS AND METHODS: Numerical comparisons of MP-RAGE and BB-ssTSE were performed by simulation studies to investigate the signal/contrast behaviors of flowing blood and stationary CE tumors. For in vivo studies, we enrolled 35 patients (18 women; mean age, 58.1 years) with breast or lung cancer who underwent brain magnetic resonance imaging. After administering a double dose of contrast medium, whole-brain 2-dimensional T1-weighted imaging followed by high-resolution isotropic 3D BB-ssTSE and MP-RAGE was performed at 3.0 T. Two reviewers independently evaluated the presence of metastatic brain tumors using: (1) MP-RAGE; (2) BB-ssTSE; and (3) MP-RAGE + BB-ssTSE sequentially in 3 review sessions, 2 weeks apart. The lesions were classified by size into 2 groups: large (≥5 mm) and small (<5 mm). Both reviewers marked all tumors detected at each session. Another reviewer combined the results of the 2 reviewers and compared the detection rates of metastatic brain tumors between BB-ssTSE and MP-RAGE by using follow-up imaging. Intraclass correlation coefficients between the 2 reviewers were measured.

RESULTS: Numerical simulations showed that the proposed BB-ssTSE effectively attenuated the signal intensity of flowing blood over the entire echo train, resulting in CE tumor-to-white matter contrast comparable with conventional MP-RAGE. The combined evaluation of MP-RAGE + BB-ssTSE showed 242 tumors in 28 patients. Of these, 153 lesions were <5 mm. MP-RAGE found 111 small metastatic brain tumors, BB-ssTSE found 150, and MP-RAGE + BB-ssTSE found 153. Significantly, more small tumors were detected by BB-ssTSE than MP-RAGE (P = 0.001, Wilcoxon signed-rank test). All large tumors were detected similarly by both MP-RAGE and BB-ssTSE. By combined results for MP-RAGE + BB-ssTSE, sensitivities for detection of small metastatic tumors were 72.5% for MP-RAGE and 98.0% for BB-ssTSE (P < 0.0001, McNemar test). Intraclass correlation coefficients between the 2 reviewers were 0.826 for MP-RAGE and 0.954 for BB-ssTSE.

CONCLUSION: Compared with conventional MP-RAGE, the proposed CE BB-ssTSE imaging, which enhances tumors while selectively suppressing blood vessels, leads to significantly better detection of small metastatic brain tumors <5 mm.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004424-201202000-00006&LSLINK=80&D=ovft
DOI
22104961
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Yeop(김응엽)
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Yoo, Eun Hye(유은혜)
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90581
사서에게 알리기
  feedback

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse

Links