Application of 3D Fast Spin-Echo T1 Black-Blood Imaging in the Diagnosis and Prognostic Prediction of Patients with Leptomeningeal Carcinomatosis

Oh, Jiyong; Choi, Seung Hong; Lee, E; Shin, Dong Jae; Jo, Sang-Won; Yoo, Roh‐Eul; Kang, Koung Mi; Tie, Yun; Kim, Ji-Hoon; Sohn, Chul‐Ho

doi:10.3174/ajnr.a5721

Cited by 20 publications

(23 citation statements)

References 29 publications

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“…W e appreciate Dr. Nabavizadeh's interest and comments on our article, "Application of 3D Fast Spin-Echo T1 Black-Blood Imaging in the Diagnosis and Prognostic Prediction of Patients with Leptomeningeal Carcinomatosis." 1 We agree that poorly suppressed blood vessels often mimic leptomeningeal enhancement on the black-blood imaging; in particular, slow-flowing blood in leptomeningeal veins, dilated arteries, or leptomeningeal collaterals can be incompletely suppressed using a variable flip angle refocusing pulse sequence. 2 However, we evaluated the consecutive sections of the images rather than the 1 image section, allowing anatomic differentiation between leptomeningeal vessels and leptomeningeal enhancement because the floating curvilinear enhancement pattern of leptomeningeal vessels is somewhat different from that in leptomeningeal carcinomatosis.…”

supporting

confidence: 58%

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Choi

2018

AJNR Am J Neuroradiol

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supporting

confidence: 58%

Reply:

Choi

2018

AJNR Am J Neuroradiol

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“…Highest sensitivity was achieved on post-contrast CUBE (97.43%), followed by postcontrast 2D T1-weighted spin-echo (66.67%), and post-contrast T1 FSPGR (64.1%). There were no significant differences in specificities among the three imaging techniques (16).…”

Section: Detection Of Brain Metastasesmentioning

confidence: 76%

Advanced Imaging of Brain Metastases: From Augmenting Visualization and Improving Diagnosis to Evaluating Treatment Response

2020

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Early detection of brain metastases and differentiation from other neuropathologies is crucial. Although biopsy is often required for definitive diagnosis, imaging can provide useful information. After treatment commences, imaging is also performed to assess the efficacy of treatment. Contrast-enhanced magnetic resonance imaging (MRI) is the traditional imaging method for the evaluation of brain metastases, as it provides information about lesion size, morphology, and macroscopic properties. Newer MRI sequences have been developed to increase the conspicuity of detecting enhancing metastases. Other advanced MRI techniques, that have the capability to probe beyond the anatomic structure, are available to characterize microstructures, cellularity, physiology, perfusion, and metabolism. Artificial intelligence provides powerful computational tools for detection, segmentation, classification, prediction, and prognosis. We highlight and review a few advanced MRI techniques for the assessment of brain metastases-specifically for (1) diagnosis, including differentiating between malignancy types and (2) evaluation of treatment response, including the differentiation between radiation necrosis and disease progression.

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“…This is particularly relevant during tumor resection since blood leakage, clotting, or perioperative anatomical derangement can hamper timely and accurate discrimination of residual tumor tissue. Recent advances in neuroradiological imaging hint at the superiority of Black Blood (BB) sequences compared to more established T1-weighted sequences (e.g., MP-RAGE) in depicting various types of contrast-enhancing pathologies [20,21]. Specifically, in a heterogeneous pool of intracranial malignomas comprising primary brain tumors and metastases, CE BB sequences allowed to detect smaller lesions and metastases that would otherwise have been missed with T1-weighted gradient-echo imaging [20].…”

Section: Introductionmentioning

confidence: 99%

Assessment of the Extent of Resection in Surgery of High-Grade Glioma—Evaluation of Black Blood Sequences for Intraoperative Magnetic Resonance Imaging at 3 Tesla

Finck

Gempt

Krieg

et al. 2020

Cancers

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Achieving an optimal extent of resection (EOR) whilst keeping lasting neurological decline to a minimum is paramount for modern neurosurgery in patients with high-grade glioma (HGG). To improve EOR assessment, this study introduces Black Blood (BB) imaging, which uses a selective saturation pulse to suppress the blood signal, to 3-Tesla intraoperative magnetic resonance imaging (iMRI). Seventy-three patients (56.4 ± 13.9 years, 64.4% male) with contrast-enhancing HGGs underwent iMRI, including contrast-enhanced (CE) and non-CE 3D turbo field-echo imaging (TFE; acquisition time: 4:20 min per sequence) and CE and non-CE 3D BB imaging (acquisition time: 1:36 min per sequence). Two readers (R1 and R2) retrospectively evaluated the EOR and diagnostic confidence (1—very inconfident to 5—very confident) as well as the delineation of tumor boarders and spread of contrast-enhancing tumor components (in case of contrast-enhancing tumor residuals). Furthermore, the contrast-to-noise ratio (CNR) was measured for contrast-enhancing tumor residuals. Both BB and conventional TFE imaging allowed for the correct detection of all contrast-enhancing tumor residuals intraoperatively (considering postsurgical MRI and histopathological evaluation as the ground truth for determination of the lack/presence of contrast-enhancing tumor residuals), but BB imaging showed significantly higher diagnostic confidence (R1: 4.65 ± 0.53 vs. 3.88 ± 1.02, p < 0.0001; R2: 4.75 ± 0.50 vs. 4.25 ± 0.81, p < 0.0001). Delineation of contrast-enhancing tumor residuals and detection of their spread into adjacent brain parenchyma was better for BB imaging. Accordingly, significantly higher CNRs were noted for BB imaging (48.1 ± 32.1 vs. 24.4 ± 15.3, p < 0.0001). In conclusion, BB imaging is not inferior to conventional TFE imaging for EOR assessment, but may significantly reduce scanning time for iMRI whilst increasing diagnostic confidence. Furthermore, given the better depiction of contrast-enhancing tumor residual spread and borders, BB imaging could support achieving complete macroscopic resection in patients suffering from HGG, which is clinically relevant as an optimal EOR is correlated to prolonged survival.

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Application of 3D Fast Spin-Echo T1 Black-Blood Imaging in the Diagnosis and Prognostic Prediction of Patients with Leptomeningeal Carcinomatosis

Abstract: Black-blood imaging can improve the diagnostic accuracy and predict progression-free survival in patients with leptomeningeal carcinomatosis.

Cited by 20 publications

References 29 publications

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Advanced Imaging of Brain Metastases: From Augmenting Visualization and Improving Diagnosis to Evaluating Treatment Response

Assessment of the Extent of Resection in Surgery of High-Grade Glioma—Evaluation of Black Blood Sequences for Intraoperative Magnetic Resonance Imaging at 3 Tesla

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