Multicontrast single-slab 3D MRI to detect cerebral metastasis

Area of Science:

• Radiology
• Neuroimaging
• Oncology

Background:

• Cranial metastases pose a significant challenge in cancer management.
• Accurate detection of brain metastases is crucial for effective treatment planning and patient prognosis.
• Various MRI sequences are employed, each with potential limitations in sensitivity and specificity.

Purpose of the Study:

• To compare the diagnostic performance of four single-slab 3D MRI sequences for detecting cranial metastases.
• To evaluate the sensitivities and specificities of double inversion recovery (IR), T2 FLAIR, contrast-enhanced T2 FLAIR, and contrast-enhanced IR-prepared fast spoiled gradient-echo (FSPGR) sequences.

Main Methods:

• Eighty-four patients with suspected cranial metastases underwent 3-T MRI.
• Imaging included double IR and T2 FLAIR sequences.
• A subset of patients received contrast-enhanced IR-prepared FSPGR and contrast-enhanced T2 FLAIR sequences in a randomized order.
• Two neuroradiologists assessed images for the presence, location, and size of metastases.

Main Results:

• Contrast-enhanced T2 FLAIR demonstrated the highest sensitivity (99%) and specificity (82.4%) for detecting cranial metastases.
• This sequence was particularly effective for lesions in the meninges and gray matter.
• Contrast-enhanced IR-prepared FSPGR showed good sensitivity (80.5%), while double IR (66.2%) and T2 FLAIR (56.7%) were less sensitive.
• Delayed enhancement did not impact the sensitivity of contrast-enhanced sequences.

Conclusions:

• Contrast-enhanced T2 FLAIR is the most sensitive MRI sequence for detecting cranial metastases among the evaluated methods.
• Despite a delay in contrast enhancement, this sequence provides superior diagnostic accuracy.
• Findings support the use of contrast-enhanced T2 FLAIR in the routine evaluation of patients with suspected brain metastases.