ArticleFrontiers in neuroimaging2026
Gadolinium-based contrast agent-free (GBCA-free) versus gadolinium-based contrast agent-enhanced (GBCA-enhanced) magnetic resonance imaging as a screening tool for intracranial tumors.
Article in Frontiers in neuroimaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: GBCA-enhanced MRI is considered the gold standard for diagnosing intracranial tumors. However, concerns regarding gadolinium-based contrast agents (GBCAs) and workflow limitations have led to increasing interest in GBCA-free MRI techniques. Objective: To compare the diagnostic performance of GBCA-free MRI with GBCA-enhanced MRI for detecting intracranial tumors within a neurological diagnostic pathway. Methods: In this retrospective cohort study, 191 patients with 195 tumors (124 intra-axial and 71 extra-axial) and 410 controls were included from a regional brain tumor diagnostic pathway between 2013 and 2022. Three senior neuroradiologists independently assessed anonymized MRI scans. Each scan was first evaluated using GBCA-free sequences and subsequently reassessed using the full GBCA-enhanced protocol. Sensitivity, specificity, and inter-method agreement were calculated. Results: GBCA-free MRI demonstrated a sensitivity of 79.6% and a specificity of 96.1%, whereas GBCA-enhanced MRI showed a sensitivity of 73.3% and a specificity of 92.9% ( Conclusion: GBCA-free MRI demonstrated diagnostic performance comparable to that of GBCA-enhanced MRI for detecting intracranial tumors. These findings suggest that GBCA-free MRI may serve as a reliable first-line screening tool within the neurological diagnostic pathway, reserving GBCA administration for cases requiring further lesion characterization.
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