Brain Tumor-Enhancement Visualization and Morphometric Assessment: A Comparison of MPRAGE, SPACE, and VIBE MRI Techniques

Abstract

BACKGROUND AND PURPOSE: Postgadolinium MR imaging is crucial for brain tumor diagnosis and morphometric assessment. We compared brain tumor enhancement visualization and the "target" object morphometry obtained with the most commonly used 3D MR imaging technique, MPRAGE, with 2 other routinely available techniques: sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) and volumetric interpolated brain examination (VIBE). MATERIALS AND METHODS: Fifty-four contrast-enhancing tumors (38 gliomas and 16 metastases) were assessed using MPRAGE, VIBE, and SPACE techniques randomly acquired after gadolinium-based contrast agent administration on a 3T scanner. Enhancement conspicuity was assessed quantitatively by calculating the contrast rate and contrast-to-noise ratio, and qualitatively, by consensus visual comparative ratings. The total enhancing tumor volume and between-sequence discrepancy in the margin delineation were assessed on the corresponding 3D target objects contoured with a computer-assisted software for neuronavigation. The Wilcoxon signed rank and Pearson 2 nonparametric tests were used to investigate between-sequence discrepancies in the contrast rate, contrast-to-noise ratio, visual conspicuity ratings, tumor volume, and margin delineation estimates. Differences were also tested for 1D (Response Evaluation Criteria in Solid Tumors) and 2D (Response Assessment in Neuro-Oncology) measurements. RESULTS: Compared with MPRAGE, both SPACE and VIBE obtained higher contrast rate, contrast-to-noise ratio, and visual conspicuity ratings in both gliomas and metastases (P range, Ͻ.001-.001). The between-sequence 3D target object margin discrepancy ranged between 3% and 19.9% of lesion tumor volume. Larger tumor volumes, 1D and 2D measurements were obtained with SPACE (P range, Ͻ.01-.007). CONCLUSIONS: Superior conspicuity for brain tumor enhancement can be achieved using SPACE and VIBE techniques, compared with MPRAGE. Discrepancies were also detected when assessing target object size and morphology, with SPACE providing more accurate estimates. ABBREVIATIONS: CEL ϭ contrast-enhancing lesion; GBCA ϭ gadolinium-based contrast agent; RANO ϭ Response Assessment in Neuro-Oncology; RECIST ϭ Response Evaluation Criteria in Solid Tumors; SPACE ϭ sampling perfection with application-optimized contrasts using different flip angle evolution; TV ϭ tumor volume; VIBE ϭ volumetric interpolated brain examination

Optimizing 3D EPI for rapid T1‐weighted imaging

“…There is also the fact that inversion prepared T 1 ‐weighted imaging, despite its superior dynamic range, may miss the gadolinium enhancement because of an unfavorable zero‐crossing of the signal relaxation . In this case, 3D EPI could be used as a non‐IR backup scan to resolve potential doubts.…”

Magnetic resonance imaging for brain stereotactic radiotherapy

“…Inversion-recovery gradient echo sequences (IR-GRE) like the T1-MPRAGE [55] have been the most commonly used 3D MR imaging technique for brain tumors and have been included in the standardized brain tumor imaging protocol (BTIP) [56,57]. However, multiple sources suggest that a 3D-turbo-spin-echo (TSE) T1-SPACE could be superior to the frequently used T1-MPRAGE gradient-echo sequence for intracranial radiotherapy target volume delineation [56,[58][59][60].…”

“…Inversion-recovery gradient echo sequences (IR-GRE) like the T1-MPRAGE [55] have been the most commonly used 3D MR imaging technique for brain tumors and have been included in the standardized brain tumor imaging protocol (BTIP) [56,57]. However, multiple sources suggest that a 3D-turbo-spin-echo (TSE) T1-SPACE could be superior to the frequently used T1-MPRAGE gradient-echo sequence for intracranial radiotherapy target volume delineation [56,[58][59][60]. While T1-SPACE provides less contrast between grey and white matter [56], this is negligible in most cases for radiotherapy treatment planning and may in fact even help with the delineation of intracranial metastases, as does the suppression of vessels in the T1-SPACE [60].…”

“…However, multiple sources suggest that a 3D-turbo-spin-echo (TSE) T1-SPACE could be superior to the frequently used T1-MPRAGE gradient-echo sequence for intracranial radiotherapy target volume delineation [56,[58][59][60]. While T1-SPACE provides less contrast between grey and white matter [56], this is negligible in most cases for radiotherapy treatment planning and may in fact even help with the delineation of intracranial metastases, as does the suppression of vessels in the T1-SPACE [60]. Conversely, T1-MPRAGE suffers from a known reduced enhancement if low contrast agent uptake is present, which could lead to underestimation of lesion boundaries ( Fig.…”

“…Conversely, T1-MPRAGE suffers from a known reduced enhancement if low contrast agent uptake is present, which could lead to underestimation of lesion boundaries ( Fig. 6; [56,61]). In a very recent paper by Danieli et al published in the American Journal of Neuroradiology, the authors system-K atically compared T1-MPRAGE, T1-SPACE and T1-VIBE in 16 brain metastases and 38 gliomas [56].…”