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  • Title: Improved motion-sensitized driven-equilibrium preparation for 3D turbo spin echo T1 weighted imaging after gadolinium administration for the detection of brain metastases on 3T MRI.
    Author: Lee S, Park DW, Lee JY, Lee YJ, Kim T.
    Journal: Br J Radiol; 2016 Jul; 89(1063):20150176. PubMed ID: 27187597.
    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.
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