Kazufumi Kikuchi MD, Presenter: Nothing to Disclose

Takashi Yoshiura MD, PhD, Abstract Co-Author: Nothing to Disclose

Akio Hiwatashi MD, Abstract Co-Author: Nothing to Disclose

Osamu Togao MD, PhD, Abstract Co-Author: Nothing to Disclose

Masami Yoneyama, Abstract Co-Author: Nothing to Disclose

Hiroshi Honda MD, Abstract Co-Author: Nothing to Disclose

Koji Yamashita MD, Abstract Co-Author: Nothing to Disclose

Makoto Obara, Abstract Co-Author: Employee, Koninklijke Philips Electronics NV

Post-contrast 3D T1-weighted images are widely used to detect brain metastases. In those images, signals from enhancing blood vessels can simulate metastases. Suppression of blood vessels would help detect metastases more efficiently. Our purpose was to develop and evaluate a new MR sequence named volume isotropic simultaneous interleaved bright- and black-blood examination (VISIBLE), which allows for simultaneous acquisitions with and without blood vessel suppression.

In VISIBLE, two sequential phases of turbo filed-echo acquisition were implemented following a motion-sensitized driven-equilibrium preparation for black-blood imaging. The first and second acquisition phases were for imaging with blood vessel suppression (Black image) and imaging without it (Bright image), respectively. Post-contrast images of patients with suspected brain metastases were obtained on a 3T scanner using both conventional 3D MPRAGE and VISIBLE. The number of visualized blood vessels counted in a single centrum semioval section was compared among 3 types of images (MPRAGE, Black and Bright) in 20 patients with no enhancing lesions. Moreover, the lesion-to-normal contrast-to-noise ratios (CNRs) were compared in 20 metastatic lesions. Statistical comparisons were performed using 2-way ANOVA and least square means Student t test.

With VISIBLE, Bright and Black images could be obtained simultaneously with a similar imaging time (308s) to MPRAGE (320s). Strong blood vessel suppression was achieved in Black images: the numbers of vessels (mean±SD) were 35.4±9.2 for MPRAGE, 29.5±8.3 for Bright image, and 1.4±1.1 for Black image (P<.05 for all comparisons). The lesion-to-normal CNR was significantly greater with Black (14.3±5.6) and Bright (13.7±5.8) images than with MPRAGE (8.0±3.4) (P<.05).

With strong blood vessel suppression and greater CNR, Black images of VISIBLE should allow for easier detection of metastases than MPRAGE. Bright images may be useful to recognize relationships between lesions and blood vessels and to avoid false detection of lesions created by partially suppressed blood vessels. VISIBLE may improve radiologists’ diagnostic performance in detecting brain metastases.

VISIBLE is capable of simultaneous acquisitions with and without blood vessel suppression, and should improve radiologists’ diagnostic performance in detecting brain metastases.

Kikuchi, K, Yoshiura, T, Hiwatashi, A, Togao, O, Yoneyama, M, Honda, H, Yamashita, K, Obara, M, Volume Isotropic Simultaneous Interleaved Bright- and Black-Blood Examination (VISIBLE): Development of a New 3D MR Sequence for Easier Brain Metastasis Detection.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12023885.html