Comparison of contrast-enhanced modified T1-weighted 3D TSE black-blood and 3D MP-RAGE sequences for the detection of cerebral metastases and brain tumours

Kammer, Nora N.; Coppenrath, Eva; Treitl, M; Kooijman, Hendrik; Dietrich, Olaf; Saam, Tobias

doi:10.1007/s00330-015-3975-x

Cited by 33 publications

(47 citation statements)

References 21 publications

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“…Our findings are in line with recent studies, that obtained higher detection rates for brain lesions using T1-DB sequences compared to the routinely used T1w-SE or T1w-GRE sequences. [ 14 , 15 ] However, we did not compare between T1-DB and T1w-SE but T1w-MPRAGE, which is a 3D gradient echo sequence with an initial 180 degree inversion pulse and routinely used in our institution as standard sequence for CEL detection in MS patients. While it is reported that T1w-SE shows better sensitivity of contrast enhancement than T1w-GRE at 1.5 T, it is also prone to flow related artefacts and is usually acquired in thicker slices, since covering the whole brain in thin slices would take too much time in clinical routine.…”

Section: Discussionmentioning

confidence: 99%

“…[ 10 – 13 ] Furthermore, in recent studies it was demonstrated that at 1.5 Tesla, T1-DB sequences were superior to T1w-SE detecting brain lesions such as primary central nervous system malignant neoplasia and metastases. [ 14 , 15 ] However, these former studies included a small heterogeneous group of potential contrast enhancing lesions and, so far, no study exists examining the potential of T1-DB sequences for CEL detection in a larger homogeneous population or MS. We therefore chose a population of MS patients, where the detection, number and volume of contrast-enhancing lesions is relevant in the diagnostic work-up and is used as endpoint in therapy studies. With the promising results of the recently published studies we hypothesized, that post-contrast T1-DB sequences detect more enhancing MS lesions than the routinely used T1w-GRE with superior inter-observer agreement.…”

Section: Introductionmentioning

confidence: 99%

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T1w dark blood imaging improves detection of contrast enhancing lesions in multiple sclerosis

et al. 2017

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PurposeIn multiple sclerosis (MS) the sensitivity for detection of contrast enhancing lesions (CEL) in T1-weighted scans is essential for diagnostics and therapy decisions. The purpose of our study was to evaluate the sensitivity of T1w MPRAGE scans in comparison to T1w dark blood technique (T1-DB) for CEL in MS.Materials and methods3T MR imaging was performed in 37 MS patients, including T2-weighted imaging, T1w MPRAGE before and after gadolinium injection (unenhanced-T1 and T1-CE) and T1-DB imaging. After gadolinium application, the T1-DB scan was performed prior to T1-CE. From unenhanced-T1 and T1-CE scans, subtraction images (T1-SUB) were calculated. The number of CEL was determined separately on T1-CE and T1-DB by two raters independently. Lesions only detected on T1-DB scans then were verified on T1-SUB. Only lesions detected by both raters were included in further analysis.ResultsIn 16 patients, at least one CEL was detected by both rater, either on T1-CE or T1-DB. All lesions that were detected on T1-CE were also detected on T1-DB images. The total number of contrast enhancing lesions detected on T1-DB images (n = 54) by both raters was significantly higher than the corresponding number of lesions identified on T1-CE (n = 27) (p = 0.01); all of these lesions could be verified on SUB images. In 21 patients, no CEL was detected in any of the sequences.ConclusionsThe application of T1-DB technique increases the sensitivity for CEL in MS, especially for those lesions that show only subtle increase in intensity after Gadolinium application but remain hypo- or iso-intense to surrounding tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

T1w dark blood imaging improves detection of contrast enhancing lesions in multiple sclerosis

et al. 2017

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“…24 We recently developed a novel 3D T1w TSE BB sequence with variable refocusing flip angles sweeps (T1-weighted modified volumetric isotropic TSE acquisition [T1-mVISTA]). 25 This sequence provides a submillimeter isotropic resolution, coverage of the whole brain, reconstruction in all planes, and scan times under 5 minutes. In an initial study in patients with cerebral metastases, detection rates with T1-mVISTA were nearly doubled, especially in small lesions under 5 mm.…”

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confidence: 99%

Multiple Sclerosis

Sommer¹,

Saam²,

Coppenrath³

et al. 2018

Invest Radiol

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“…While conventional turbo field echo (TFE) imaging before and after contrast administration has been long established to assess tumor-related contrast enhancement and spread, recent studies have hinted at the value of advanced T1-weighted sequences for the depiction of intracranial contrastenhancing pathology [19,20]. Although initially developed for vessel wall imaging, T1-weighted black blood (BB) sequences in particular have gained attention for depicting intracranial malignancies.…”

Section: Introductionmentioning

confidence: 99%

“…Although initially developed for vessel wall imaging, T1-weighted black blood (BB) sequences in particular have gained attention for depicting intracranial malignancies. Recently, MRI protocols making use of contrast-enhanced (CE) BB sequences were able to detect significantly more cerebral metastases and had a higher sensitivity to identify leptomeningeosis carcinomatosa compared with more established T1-weighted sequences for this purpose (e.g., gradient echo and spin echo sequences) [19,21].…”

Section: Introductionmentioning

confidence: 99%

MR imaging by 3D T1-weighted black blood sequences may improve delineation of therapy-naive high-grade gliomas

et al. 2020

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Objectives To investigate the value of contrast-enhanced (CE) turbo spin echo black blood (BB) sequences for imaging of therapy-naive high-grade gliomas (HGGs). Methods Consecutive patients with histopathologically confirmed World Health Organization (WHO) grade III or IV gliomas and no oncological treatment prior to index imaging (March 2019 to January 2020) were retrospectively included. Magnetic resonance imaging (MRI) at 3 Tesla comprised CE BB and CE turbo field echo (TFE) sequences. The lack/presence of tumor-related contrast enhancement and satellite lesions were evaluated by two readers. Sharper delineation of tumor boundaries (1, bad; 2, intermediate; 3, good delineation) and vaster expansion of HGGs into the adjacent brain parenchyma on CE BB imaging were the endpoints. Furthermore, contrast-to-noise ratios (CNRs) were calculated and compared between sequences. Results Fifty-four patients were included (mean age: 61.2 ± 15.9 years, 64% male). The vast majority of HGGs (51/54) showed contrast enhancement in both sequences, while two HGGs as well as one of six detected satellite lesions were depicted in CE BB imaging only. Tumor boundaries were significantly sharper (R1: 2.43 ± 0.71 vs. 2.73 ± 0.62, p < 0.001; R2: 2.44 ± 0.74 vs. 2.77 ± 0.60, p = 0.001), while the spread of HGGs into the adjacent parenchyma was larger when considering CE BB sequences according to both readers (larger spread in CE BB sequences: R1: 23 patients; R2: 20 patients). The CNR for CE BB sequences significantly exceeded that of CE TFE sequences (43.4 ± 27.1 vs. 32.5 ± 25.0, p = 0.0028). Conclusions Our findings suggest that BB imaging may considerably improve delineation of therapy-naive HGGs when compared with established TFE imaging. Thus, CE BB sequences might supplement MRI protocols for brain tumors. Key Points • This study investigated contrast-enhanced (CE) T1-weighted black blood (BB) sequences for improved MRI in patients with therapy-naive high-grade gliomas (HGGs). • Compared with conventionally used turbo field echo (TFE) sequences, CE BB sequences depicted tumor boundaries and spread of HGGs into adjacent parenchyma considerably better, which also showed higher CNRs. • Two enhancing tumor masses and one satellite lesion were exclusively identified in CE BB sequences, but remained undetected in conventionally used CE TFE sequences.

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Comparison of contrast-enhanced modified T1-weighted 3D TSE black-blood and 3D MP-RAGE sequences for the detection of cerebral metastases and brain tumours

Cited by 33 publications

References 21 publications

T1w dark blood imaging improves detection of contrast enhancing lesions in multiple sclerosis

T1w dark blood imaging improves detection of contrast enhancing lesions in multiple sclerosis

Multiple Sclerosis

MR imaging by 3D T1-weighted black blood sequences may improve delineation of therapy-naive high-grade gliomas

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