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Sensitivity of different MRI sequences in the early detection of melanoma brain metastases

Katerina Deike-Hofmann1, Daniel Thünemann1, Michael O Breckwoldt1,2

  • 1Department of Radiology, German Cancer Research Center, DKFZ, Heidelberg, Germany.

Plos One
|March 30, 2018
PubMed
Abstract

Insights

Contrast-enhanced T1-weighted MRI is the most sensitive sequence for detecting melanoma brain metastases (MBM). This technique identifies MBM earlier than other MRI sequences, including SWI and DWI, by highlighting blood-brain barrier disruption.

Area of Science:

  • Radiology
  • Oncology
  • Neuroimaging

Background:

  • Melanoma brain metastases (MBM) detection is challenging with new MRI techniques.
  • Specific imaging characteristics of MBM necessitate evaluating MRI sequence sensitivity.

Purpose of the Study:

  • To investigate the sensitivity of six clinical MRI sequences for early detection of MBM.
  • To compare the effectiveness of various MRI sequences in identifying MBM.

Main Methods:

  • Retrospective analysis of melanoma patients with MBM from November 2005 to December 2016.
  • Evaluation of six MRI sequences: T1w, contrast-enhanced T1w (ceT1w), T2w, T2w-FLAIR, SWI, and DWI.
  • Lesion conspicuity rated on a scale of 0-3 for each sequence.

Main Results:

  • Contrast-enhanced T1w (ceT1w) demonstrated the highest sensitivity (99.7%) for MBM detection.
  • ceT1w identified 7.3% of lesions exclusively, which were not detectable by other sequences.
  • Other sequences showed varying sensitivities: FLAIR (77.0%), SWI (64.7%), T2w (61.0%), T1w (56.7%), and DWI (48.4%).

Conclusions:

  • Contrast-enhanced T1-weighting is the most sensitive MRI sequence for detecting MBM.
  • Blood-brain barrier disruption is an earlier indicator of MBM than edema or diffusion restriction.
  • ceT1w MRI is crucial for the early and comprehensive detection of melanoma brain metastases.

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