Volumetric Postcontrast T1 Turbo Spin-Echo versus Gradient-Recalled Echo MR sequences for Detecting Brain Metastases:...

Area of Science:

• Neuroimaging
• Oncology
• Radiology

Background:

• Contrast-enhanced 3D T1-weighted MRI is standard for brain metastases detection.
• GRE-based sequences (e.g., MPRAGE) have limitations in lesion conspicuity.
• 3D black-blood TSE-based sequences (e.g., SPACE) are increasingly used for improved lesion detection.

Purpose of the Study:

• To compare the diagnostic performance of 3D T1 TSE versus GRE sequences for brain metastases detection.
• To evaluate sensitivity, lesion conspicuity, and accuracy of different MRI sequences.

Main Methods:

• Systematic literature search on MEDLINE, EMBASE, Cochrane Central, Google Scholar, and PROSPERO.
• Meta-analysis of 15 studies including 544 patients and 4338 metastases.
• Assessment of diagnostic accuracy, image quality, and inter-rater agreement using random-effects models.

Main Results:

• TSE sequences demonstrated significantly higher pooled sensitivity (97.4%) compared to GRE sequences (76.1%).
• TSE was superior for detecting small metastases (<5 mm), with 96.1% sensitivity vs. 58.4% for GRE.
• Both techniques performed comparably for larger lesions (≥5 mm).

Conclusions:

• Postcontrast 3D T1 TSE sequences offer superior sensitivity and lesion conspicuity for brain metastases compared to GRE sequences.
• TSE is particularly beneficial for detecting small metastases.
• Slightly higher false positives with TSE require consideration, often related to vessel suppression.