Prospective Comparison of T1-SPACE and MPRAGE for the Identification of Intrinsic T1 Hyperintensity in Patients with Intracranial Melanoma Metastases

Lasocki, A; Stuckey, SL; Caspersz, L; Xie, J; McArthur, GA

Author(s): Lasocki, A; Stuckey, SL; Caspersz, L; Xie, J; McArthur, GA;
Details: Publication Year 2023-09,Volume 44,Issue #9,Page 1039-1044
Journal Title: American Journal of Neuroradiology
Publication Type: Research article
Abstract: BACKGROUND AND PURPOSE: Volumetric TSE (3D-TSE) techniques are increasingly replacing volumetric magnetization-prepared gradient recalled-echo (3D-GRE) sequences due to improved metastasis detection. In addition to providing a baseline for assessing postcontrast enhancement, precontrast T1WI also identifies intrinsic T1 hyperintensity, for example, reflecting melanin or blood products. The ability of precontrast 3D-TSE to demonstrate intrinsic T1 hyperintensity is not clear from the literature; thus, this study compares precontrast 3D-TSE and 3D-GRE sequences for identifying intrinsic T1 hyperintensity in patients with metastatic melanoma. MATERIALS AND METHODS: Patients with metastatic melanoma and previously reported intrinsic T1 hyperintensity were identified. MRIs were performed at 3T including both 3D-GRE (MPRAGE) and 3D-TSE T1 sampling perfection with application-optimized contrasts by using different flip angle evolution (T1-SPACE) sequences precontrast. Axial 1-mm slices of both T1WI sequences were independently reviewed by 2 neuroradiologists, comparing the conspicuity of each lesion between the 2 sequences according to a 5-point scale and assessing whether the intrinsic T1 hyperintensity was attributable to melanin, blood products, or both. RESULTS: Twenty examinations were performed, with a total of 214 lesions demonstrating intrinsic T1 hyperintensity. Both readers found that intrinsic T1 hyperintensity was less conspicuous with T1-SPACE compared with MPRAGE for most lesions assessed (81.8%, averaged across both readers), including for lesions with intrinsic T1 hyperintensity attributable to melanin and blood products. Intrinsic T1 hyperintensity was rarely more conspicuous on T1-SPACE (1.4%). CONCLUSIONS: Precontrast intrinsic T1 hyperintensity is more conspicuous with MPRAGE than T1-SPACE. In patients with metastatic melanoma, 3D-GRE should be preferred as the precontrast T1WI sequence when both 3D-TSE and 3D-GRE are performed postcontrast and when not administering IV contrast.
Publisher: American Society of Neuroradiology
Keywords: Humans; Melanins; *Melanoma/diagnostic imaging; *Brain Neoplasms/diagnostic imaging; *Neoplasms, Second Primary; Magnetic Resonance Imaging
Department(s): Cancer Imaging; Biostatistics and Clinical Trials; Medical Oncology
PubMed ID: 37620155
Publisher's Version: https://doi.org/10.3174/ajnr.A7975
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-11-02 06:14:32

Last Modified: 2024-07-09 05:46:37