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.

objectiveTo 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.

methods40 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.

resultsC-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.

conclusionCompared 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.