DOI QR코드

DOI QR Code

Efficacy of Maximum Intensity Projection of Contrast-Enhanced 3D Turbo-Spin Echo Imaging with Improved Motion-Sensitized Driven-Equilibrium Preparation in the Detection of Brain Metastases

  • Bae, Yun Jung (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Choi, Byung Se (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Kyung Mi (Department of Radiology, Kyung Hee University College of Medicine, Kyung Hee University Hospital) ;
  • Yoon, Yeon Hong (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Sunwoo, Leonard (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Jung, Cheolkyu (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Jae Hyoung (Department of Radiology, Seoul National University College of Medicine, Seoul National University Bundang Hospital)
  • Received : 2016.09.30
  • Accepted : 2017.01.16
  • Published : 2017.08.01

Abstract

Objective: To evaluate the diagnostic benefits of 5-mm maximum intensity projection of improved motion-sensitized driven-equilibrium prepared contrast-enhanced 3D T1-weighted turbo-spin echo imaging (MIP iMSDE-TSE) in the detection of brain metastases. The imaging technique was compared with 1-mm images of iMSDE-TSE (non-MIP iMSDE-TSE), 1-mm contrast-enhanced 3D T1-weighted gradient-echo imaging (non-MIP 3D-GRE), and 5-mm MIP 3D-GRE. Materials and Methods: From October 2014 to July 2015, 30 patients with 460 enhancing brain metastases (size > 3 mm, n = 150; size ${\leq}3mm$, n = 310) were scanned with non-MIP iMSDE-TSE and non-MIP 3D-GRE. We then performed 5-mm MIP reconstruction of these images. Two independent neuroradiologists reviewed these four sequences. Their diagnostic performance was compared using the following parameters: sensitivity, reading time, and figure of merit (FOM) derived by jackknife alternative free-response receiver operating characteristic analysis. Interobserver agreement was also tested. Results: The mean FOM (all lesions, 0.984; lesions ${\leq}3mm$, 0.980) and sensitivity ([reader 1: all lesions, 97.3%; lesions ${\leq}3mm$, 96.2%], [reader 2: all lesions, 97.0%; lesions ${\leq}3mm$, 95.8%]) of MIP iMSDE-TSE was comparable to the mean FOM (0.985, 0.977) and sensitivity ([reader 1: 96.7, 99.0%], [reader 2: 97, 95.3%]) of non-MIP iMSDE-TSE, but they were superior to those of non-MIP and MIP 3D-GREs (all, p < 0.001). The reading time of MIP iMSDE-TSE (reader 1: $47.7{\pm}35.9$ seconds; reader 2: $44.7{\pm}23.6$ seconds) was significantly shorter than that of non-MIP iMSDE-TSE (reader 1: $78.8{\pm}43.7$ seconds, p = 0.01; reader 2: $82.9{\pm}39.9$ seconds, p < 0.001). Interobserver agreement was excellent (${\kappa}$ > 0.75) for all lesions in both sequences. Conclusion: MIP iMSDE-TSE showed high detectability of brain metastases. Its detectability was comparable to that of non-MIP iMSDE-TSE, but it was superior to the detectability of non-MIP/MIP 3D-GREs. With a shorter reading time, the false-positive results of MIP iMSDE-TSE were greater. We suggest that MIP iMSDE-TSE can provide high diagnostic performance and low false-positive rates when combined with 1-mm sequences.

Keywords

Acknowledgement

Supported by : SNUBH

References

  1. Posner JB, Chernik NL. Intracranial metastases from systemic cancer. Adv Neurol 1978;19:579-592
  2. Nagao E, Yoshiura T, Hiwatashi A, Obara M, Yamashita K, Kamano H, et al. 3D turbo spin-echo sequence with motionsensitized driven-equilibrium preparation for detection of brain metastases on 3T MR imaging. AJNR Am J Neuroradiol 2011;32:664-670 https://doi.org/10.3174/ajnr.A2343
  3. Kwak HS, Hwang S, Chung GH, Song JS, Choi EJ. Detection of small brain metastases at 3 T: comparing the diagnostic performances of contrast-enhanced T1-weighted SPACE, MPRAGE, and 2D FLASH imaging. Clin Imaging 2015;39:571-575 https://doi.org/10.1016/j.clinimag.2015.02.010
  4. Nussbaum ES, Djalilian HR, Cho KH, Hall WA. Brain metastases. Histology, multiplicity, surgery, and survival. Cancer 1996;78:1781-1788 https://doi.org/10.1002/(SICI)1097-0142(19961015)78:8<1781::AID-CNCR19>3.0.CO;2-U
  5. Chang WS, Kim HY, Chang JW, Park YG, Chang JH. Analysis of radiosurgical results in patients with brain metastases according to the number of brain lesions: is stereotactic radiosurgery effective for multiple brain metastases? J Neurosurg 2010;113 Suppl:73-78
  6. Yoshida A, Tha KK, Fujima N, Zaitsu Y, Yoshida D, Tsukahara A, et al. Detection of brain metastases by 3-dimensional magnetic resonance imaging at 3 T: comparison between T1-weighted volume isotropic turbo spin echo acquisition and 3-dimensional T1-weighted fluid-attenuated inversion recovery imaging. J Comput Assist Tomogr 2013;37:84-90 https://doi.org/10.1097/RCT.0b013e318271f216
  7. Sills AK. Current treatment approaches to surgery for brain metastases. Neurosurgery 2005;57(5 Suppl):S24-S32; discusssion S1-S4 https://doi.org/10.1227/01.NEU.0000168185.29659.C5
  8. Linskey ME, Andrews DW, Asher AL, Burri SH, Kondziolka D, Robinson PD, et al. The role of stereotactic radiosurgery in the management of patients with newly diagnosed brain metastases: a systematic review and evidence-based clinical practice guideline. J Neurooncol 2010;96:45-68 https://doi.org/10.1007/s11060-009-0073-4
  9. Suh CH, Jung SC, Kim KW, Pyo J. The detectability of brain metastases using contrast-enhanced spin-echo or gradientecho images: a systematic review and meta-analysis. J Neurooncol 2016;129:363-371 https://doi.org/10.1007/s11060-016-2185-y
  10. Kakeda S, Korogi Y, Hiai Y, Ohnari N, Moriya J, Kamada K, et al. Detection of brain metastasis at 3T: comparison among SE, IR-FSE and 3D-GRE sequences. Eur Radiol 2007;17:2345-2351 https://doi.org/10.1007/s00330-007-0599-9
  11. Furutani K, Harada M, Mawlan M, Nishitani H. Difference in enhancement between spin echo and 3-dimensional fast spoiled gradient recalled acquisition in steady state magnetic resonance imaging of brain metastasis at 3-T magnetic resonance imaging. J Comput Assist Tomogr 2008;32:313-319 https://doi.org/10.1097/RCT.0b013e318074fd9d
  12. Komada T, Naganawa S, Ogawa H, Matsushima M, Kubota S, Kawai H, et al. Contrast-enhanced MR imaging of metastatic brain tumor at 3 tesla: utility of T(1)-weighted SPACE compared with 2D spin echo and 3D gradient echo sequence. Magn Reson Med Sci 2008;7:13-21 https://doi.org/10.2463/mrms.7.13
  13. Park J, Kim J, Yoo E, Lee H, Chang JH, Kim EY. Detection of small metastatic brain tumors: comparison of 3D contrastenhanced whole-brain black-blood imaging and MP-RAGE imaging. Invest Radiol 2012;47:136-141 https://doi.org/10.1097/RLI.0b013e3182319704
  14. Yoneyama M, Nakamura M, Tabuchi T, Takemura A, Obara M, Tatsuno S, et al. Whole-brain black-blood imaging with magnetization-transfer prepared spin echo-like contrast: a novel sequence for contrast-enhanced brain metastasis screening at 3T. Radiol Phys Technol 2013;6:431-436 https://doi.org/10.1007/s12194-013-0216-3
  15. Yoneyama M, Nakamura M, Takahara T, Takemura A, Obara M, Tabuchi T, et al. Improvement of T1 contrast in wholebrain black-blood imaging using motion-sensitized drivenequilibrium prepared 3D turbo spin echo (3D MSDE-TSE). Magn Reson Med Sci 2014;13:61-65 https://doi.org/10.2463/mrms.2013-0047
  16. Lee S, Park DW, Lee JY, Lee YJ, Kim T. Improved motionsensitized driven-equilibrium preparation for 3D turbo spin echo T1 weighted imaging after gadolinium administration for the detection of brain metastases on 3T MRI. Br J Radiol 2016;89:20150176 https://doi.org/10.1259/bjr.20150176
  17. Obara M, Van Cauteren M, Honda M, Imai Y, Kuroda K. Assessment of improved motion-sensitized driven equilibrium (iMSDE) for multi-contrast vessel wall screening. Magn Reson Med Sci 2014;13:139-144 https://doi.org/10.2463/mrms.2013-0036
  18. Wang J, Yarnykh VL, Yuan C. Enhanced image quality in black-blood MRI using the improved motion-sensitized driven-equilibrium (iMSDE) sequence. J Magn Reson Imaging 2010;31:1256-1263 https://doi.org/10.1002/jmri.22149
  19. Jankowski A, Martinelli T, Timsit JF, Brambilla C, Thony F, Coulomb M, et al. Pulmonary nodule detection on MDCT images: evaluation of diagnostic performance using thin axial images, maximum intensity projections, and computerassisted detection. Eur Radiol 2007;17:3148-3156 https://doi.org/10.1007/s00330-007-0727-6
  20. Jensen CT, Vicens-Rodriguez RA, Wagner-Bartak NA, Fox PS, Faria SC, Carrion I, et al. Multidetector CT detection of peritoneal metastases: evaluation of sensitivity between standard 2.5 mm axial imaging and maximumintensity-projection (MIP) reconstructions. Abdom Imaging 2015;40:2167-2172 https://doi.org/10.1007/s00261-015-0370-7
  21. Park EA, Goo JM, Lee JW, Kang CH, Lee HJ, Lee CH, et al. Efficacy of computer-aided detection system and thin-slab maximum intensity projection technique in the detection of pulmonary nodules in patients with resected metastases. Invest Radiol 2009;44:105-113 https://doi.org/10.1097/RLI.0b013e318190fcfc
  22. Yoneda K, Ueno J, Nishihara S, Tsujikawa T, Morita N, Otsuka H, et al. Postprocessing technique with MDCT data improves the accuracy of the detection of lung nodules. Radiat Med 2007;25:511-515 https://doi.org/10.1007/s11604-007-0176-9
  23. Chakraborty DP, Berbaum KS. Observer studies involving detection and localization: modeling, analysis, and validation. Med Phys 2004;31:2313-2330 https://doi.org/10.1118/1.1769352
  24. Chakraborty DP. Analysis of location specific observer performance data: validated extensions of the jackknife freeresponse (JAFROC) method. Acad Radiol 2006;13:1187-1193 https://doi.org/10.1016/j.acra.2006.06.016
  25. Kim M, Kim HS. Emerging techniques in brain tumor imaging: what radiologists need to know. Korean J Radiol 2016;17:598-619 https://doi.org/10.3348/kjr.2016.17.5.598
  26. Gruden JF, Ouanounou S, Tigges S, Norris SD, Klausner TS. Incremental benefit of maximum-intensity-projection images on observer detection of small pulmonary nodules revealed by multidetector CT. AJR Am J Roentgenol 2002;179:149-157 https://doi.org/10.2214/ajr.179.1.1790149
  27. Valencia R, Denecke T, Lehmkuhl L, Fischbach F, Felix R, Knollmann F. Value of axial and coronal maximum intensity projection (MIP) images in the detection of pulmonary nodules by multislice spiral CT: comparison with axial 1-mm and 5-mm slices. Eur Radiol 2006;16:325-332 https://doi.org/10.1007/s00330-005-2871-1
  28. Kilburn-Toppin F, Arthurs OJ, Tasker AD, Set PA. Detection of pulmonary nodules at paediatric CT: maximum intensity projections and axial source images are complementary. Pediatr Radiol 2013;43:820-826 https://doi.org/10.1007/s00247-012-2597-6
  29. Sepulveda F, Yanez P, Carnevale MD, Romero C, Castillo M. MIP improves detection of brain metastases. J Comput Assist Tomogr 2016;40:997-1000 https://doi.org/10.1097/RCT.0000000000000466

Cited by

  1. Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals vol.19, pp.6, 2018, https://doi.org/10.3348/kjr.2018.19.6.1172
  2. Evaluation of Thick-Slab Overlapping MIP Images of Contrast-Enhanced 3D T1-Weighted CUBE for Detection of Intracranial Metastases: A Pilot Study for Comparison of Lesion Detection, Interpretation Time vol.39, pp.9, 2018, https://doi.org/10.3174/ajnr.a5747
  3. Advanced Imaging of Brain Metastases: From Augmenting Visualization and Improving Diagnosis to Evaluating Treatment Response vol.11, pp.None, 2020, https://doi.org/10.3389/fneur.2020.00270
  4. Evaluation of the clinical utility of maximum intensity projections of 3D CONTRAST‐ENHANCED , T1 ‐weighted imaging for the detection of brain metastases vol.3, pp.5, 2017, https://doi.org/10.1002/cnr2.1277
  5. MRI pulse sequence integration for deep‐learning‐based brain metastases segmentation vol.48, pp.10, 2017, https://doi.org/10.1002/mp.15136