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Use of half-dose gadolinium-enhanced MRI and magnetization transfer saturation in brain tumors
D Haba1, A Pasco Papon, J Y Tanguy
1Department of Radiology, University Hospital of Angers, France.
Abstract:
The aim of this study was to search if half-dose gadolinium (Gd)-enhanced MR imaging with magnetization transfer saturation (MT) can replace standard-dose T1-weighted spin echo (SE) without MT saturation in brain tumors. Thirty patients with a total of 33 brain tumors (14 gliomas, 13 meningiomas, 6 metastases) were prospectively studied using T1-weighted SE half-dose of Gd with MT, and T1-weighted SE standard-dose Gd without MT. The contrast-to-noise ratio (CNR) of the two sequences was calculated and four radiologists reviewed qualitatively the images of the two sequences. There was no significant difference between both techniques for quantitative analysis (Wilcoxon test). However, there was a good agreement between sequences to evidence an intraclass correlation coefficient (r = 0.70) of all lesions. In cases of meningioma, the agreement was better (r = 0.84). The results show a difference in the qualitative data between the two sequences, suggesting the use of the T1-weighted MR images with MT and half-dose of Gd with good results in the whole tested parameters except the lesional edema and the presence of artifacts. Half-dose T1-weighted SE with MT can replace standard-dose T1-weighted SE without MT with no loss of contrast enhancement in investigation of meningiomas and saving 50% of the contrast material.
Insights
Half-dose gadolinium (Gd)-enhanced MRI with magnetization transfer saturation (MT) shows promise for brain tumor imaging. This technique can replace standard-dose T1-weighted spin echo (SE) without MT, reducing contrast agent usage.
Area of Science:
- Radiology
- Medical Imaging
- Neuro-oncology
Background:
- Gadolinium-enhanced MRI is crucial for brain tumor diagnosis.
- Reducing gadolinium dosage is desirable to minimize potential risks.
- Magnetization transfer saturation (MT) may enhance contrast.
Purpose of the Study:
- To evaluate if half-dose gadolinium-enhanced T1-weighted spin echo (SE) MRI with MT saturation can replace standard-dose T1-weighted SE without MT for brain tumor imaging.
- To compare quantitative and qualitative image analysis between the two techniques.
Main Methods:
- Prospective study of 30 patients with 33 brain tumors (gliomas, meningiomas, metastases).
- Comparison of T1-weighted SE with half-dose Gd and MT vs. standard-dose Gd without MT.
- Quantitative analysis of contrast-to-noise ratio (CNR) and qualitative review by four radiologists.
Main Results:
- No significant quantitative difference in CNR between half-dose Gd with MT and standard-dose Gd without MT.
- Good agreement (intraclass correlation coefficient r = 0.70) between sequences for lesion detection, with better agreement for meningiomas (r = 0.84).
- Qualitative differences noted, with half-dose Gd with MT performing well except for lesional edema and artifacts.
Conclusions:
- Half-dose Gd-enhanced T1-weighted SE with MT can effectively replace standard-dose T1-weighted SE without MT for meningioma investigation.
- This approach offers comparable contrast enhancement while saving 50% of the contrast material.
- Further evaluation is needed for other tumor types and to address artifacts.