Nora Navina Kammer MD, Presenter: Nothing to Disclose

Eva Maria Coppenrath MD, Abstract Co-Author: Nothing to Disclose

Karla Maria Treitl MD, Abstract Co-Author: Nothing to Disclose

Hendrik Kooijman, Abstract Co-Author: Employee, Koninklijke Philips NV

Maximilian F. Reiser MD, Abstract Co-Author: Nothing to Disclose

Tobias Saam MD, Abstract Co-Author: Research Grant, Diamed Medizintechnik GmbH Research Grant, Bayer AG

To evaluate a commercially not available gadolinium-enhanced isotropic 3D-whole-brain-black-blood T1w-TSE sequence with variable flip angles (T1w-VISTA) for the diagnosis of brain metastases in comparison with a conventional gadolinium-enhanced T1w-MP-RAGE sequence.

We prospectively included 48 patients with known or suspected intracranial tumors and 15 controls without any evidence of intracranial tumors. All patients underwent both standard contrast-enhanced MP-RAGE and a T1w-VISTA (resolution=0.8 mm3 isotropic, scan time 4:43 minutes) at 3-Tesla (Philips Ingenia). For each patient the number of metastases was determined by two experienced radiologists. For each individual lesion, the maximum diameter, the diagnostic confidence (5-point Likert scale), the visual assessment of contrast enhancement (3-point Likert scale) as well as the contrast-to-noise ratio (CNR) was assessed.

14 patients presented with metastases, in 6 cases contrast enhanced VISTA was acquired before MP-RAGE. Significantly more metastases were found in the T1w-VISTA sequence compared to the conventional MP-RAGE sequence (63 metastases vs. 37 metastases; p<0.05). Metastases which were only detected in T1w-VISTA (N=26) were significantly smaller than those detected in both sequences (4.3±3.7mm vs. 11.3±10.7mm; p=0.0022). Further, diagnostic confidence in T1w-VISTA was significantly higher compared to MP-RAGE (p=0.0387). Mean CNR of metastases was 24.2±17.5 for VISTA and 12.7±11.5 for MP-RAGE (p=0.0003) and visual assessment of contrast enhancement was rated significantly higher in the VISTA sequence (p<0.0001).

Black-blood 3D-T1w-VISTA provides significant advantages for the detection of cerebral tumors by nearly doubling the contrast-to-noise ratio of metastases compared to a conventional MP-RAGE sequence. This leads to a higher number of detected metastases and a higher diagnostic confidence.

3D-T1w-VISTA black-blood imaging is superior for tumor detection compared to the conventional “white-blood” MP-RAGE sequence.

Kammer, N, Coppenrath, E, Treitl, K, Kooijman, H, Reiser, M, Saam, T, Comparison of Contrast-Enhanced MP-RAGE Imaging and Whole Brain T1w 3D-Black-Blood 3T-MRI for the Diagnosis of Brain Metastases.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011412.html