Teng Jin1, Jing Wang1, and Zhenwei Yao2
1Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, 2Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
Synopsis
For reducing the gadolinium dose of patients
with metastasis, we seek
a valuable tool to lower contrast agent doses but keep MR image quality, which is
important for patients’ healthcare. We analyzed the optimum scanning time
for 1/2 dose CE-T2FLAIR, and compared the CR value of metastases and enhancement
degree among the 1/2
dose CE-T2 FLAIR, 1/2 dose CE-T1WI and full dose CE-BRAVO sequence. Our team
further analyzed the relationship between enhancement pattern, lesion size and
image quality. Our study not only reduced the harm from GBCA administrations but
also improved detection rate of brain metastases.
Objective
To explore the clinical value
of half-dose contrast-enhanced T2-fluid-attenuated inversion recovery sequence
(1/2-dose CE-T2 FLAIR) in intracranial
metastases.Materials and Methods
Forty-six patients with known
cancers and brain metastasis were
prospectively enrolled, they underwent 3.0 T MR examinations which mainly
including: 1/2-dose CE-T2 FLAIR (continuous
scanning for three phases: phase1, phase2 and phase3), 1/2-dose
CE-T1WI and routine-dose CE-3D-BRAVO. All
lesions were divided into three groups according to the diameter and enhancement
pattern: Group A, solid-enhanced with a diameter ≥5mm;
Group B, ring-enhanced with a diameter ≥5mm;
Group C, lesion diameter <5mm.
The lesion
enhancement degree was scored in 1/2-dose CE-T2 FLAIR (phase3), 1/2-dose
CE-T1WI and routine-dose CE-BRAVO respectively. The scoring criteria was as
follows: 3 point, enhancement degree was good; 2 point, enhancement degree was moderate;
1 point, enhancement degree was poor (Lesions that were initially misdiagnosed
were also scored 1 point). I)
The CR values of lesions in three consecutive phases of 1/2-dose
CE-T2 FLAIR were compared; (II) The percentage increase (PI) of 1/2-dose CE-T2
FLAIR in groups A, B, and C were measured respectively for comparisons; (III)
Statistical analysis was performed to compare the enhancement degree on three
enhanced-sequences in each group.Results:
A
total of 89 metastases were
confirmed, including 27 in
group A, 23 in group B, and 39 in group C. (I) The mean values of CR in 1/2-dose
CE-T2 FLAIR for the three consecutive phases were CRphase1=63.64±32.19,
CRphase2=77.34±40.19, and CRphase3=83.05±46.65, wherein CRphase1<CRphase2<CRphase3
(P=0.001). (II) The PI values of 1/2-dose
CE-T2 FLAIR in groups A, B, and C were PIA=31.42±11.65, PIB=
58.60±27.79, and PIC=61.05±29.55, respectively. PIA<PIB
(P=0.001) and PIA<PIc (P<0.001). (III) Group A: the enhancement degree of metastases on 1/2-dose CE-T2 FLAIR was lower than that on 1/2-dose
CE-T1WI (P=0.001) and routine dose CE-BRAVO (P<0.001); Group B: there was
no significant difference between 1/2-dose CE-T2 FLAIR and routine-dose
CE-BRAVO (P=0.122); Group C:
the enhancement degree on 1/2-dose CE-T2 FLAIR was obviously higher than that on
1/2-dose CE-T1WI (P<0.001) and routine-dose
CE-BRAVO (P<0.001)Conclusion
Compared with routine-dose
CE-BRAVO, half dose CE-T2 FLAIR has unique advantages in detecting
ring-enhanced metastases and small metastases at early phase.Acknowledgements
Funding: This work was
supported by Bracco international B.V. as an investigator initiated trial. The
funders had no roles in study design, data collection and analysis, decision to
publish, or preparation of the manuscript.References
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