Multiple cerebral metastases: detectability with Gd-DTPA-enhanced MR imaging.

Russell, Eric J.; Geremia, Glen; Johnson, Carl E.; Huckman, Michael S.; Ramsey, Ruth G.; Washburn-Bleck, J.; Turner, Dennis A.; Norusis, M.

doi:10.1148/radiology.165.3.3317495

Cited by 112 publications

(26 citation statements)

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“…In agreement with these findings, several authors continue to support the use of MRI contrast media in the detection of cerebral metastasis in humans 28, 29. However, lack of contrast enhancement does not exclude the presence of metastatic disease, as recently reported in a dog with metastatic cerebral adenocarcinoma 30.…”

Section: Discussionsupporting

confidence: 65%

Exclusion of a Brain Lesion: Is Intravenous Contrast Administration Required after Normal Precontrast Magnetic Resonance Imaging?

Ives

Rousset

Heliczer

et al. 2014

Veterinary Internal Medicne

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BackgroundNo evidence‐based guidelines are available for the administration of gadolinium‐based contrast media to veterinary patients.ObjectiveTo investigate whether administration of intravenous (IV) contrast media alters the likelihood of identifying a brain lesion in dogs and cats.AnimalsFour hundred and eighty‐seven client‐owned animals referred for investigation of intracranial disease.MethodsTwo reviewers retrospectively analyzed precontrast transverse and sagittal T1‐weighted (T1W), T2‐weighted, and fluid‐attenuated inversion recovery low‐field MRI sequences from each patient for the presence of a clinically relevant brain lesion. All sequences subsequently were reviewed in the same manner with additional access to postcontrast T1W images.ResultsOf the 487 precontrast MRI studies, 312 were judged to be normal by 1 or both reviewers. Of these 312 studies, a previously undetected lesion was identified in only 6 cases (1.9%) based on changes observed on postcontrast sequences. Final diagnoses included meningoencephalitis of unknown origin (n = 1), feline infectious peritonitis (n = 1), and neoplasia (n = 2). All 4 of these cases had persistent neurological deficits suggestive of an underlying brain lesion. Contrast enhancement observed in the 2 other cases was considered falsely positive based on the results of further investigations.Conclusions and Clinical ImportanceIn patients with normal neurological examination and normal precontrast MRI, the subsequent administration of IV gadolinium‐based contrast media is highly unlikely to disclose a previously unidentified lesion, calling into question the routine administration of contrast media to these patients. However, administration still should be considered in animals with persistent neurological deficits suggestive of an underlying inflammatory or neoplastic brain lesion.

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Section: Discussionsupporting

confidence: 65%

Exclusion of a Brain Lesion: Is Intravenous Contrast Administration Required after Normal Precontrast Magnetic Resonance Imaging?

Ives

Rousset

Heliczer

et al. 2014

Veterinary Internal Medicne

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“…There are some reports of cases in which smaller metastases were only detected with PCA because of absence of edema or masking due to high signal lesions in the vicinity. Plain standard technique did not detect or underestimate a number of lesions [16,17,48,55,59].…”

Section: Sensitivity and Specificitymentioning

confidence: 82%

MR imaging of cerebral tumors: State of the art and work in progress

Hp¹,

Pedrosa²,

Schuth³

1989

Neurosurg. Rev.

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MR imaging of the brain has made tremendous progress during the last years. This technique is generally superior to computed tomography (CT) in brain tumors, due to its capability for direct imagining in various planes and its high tissue contrast. Moreover, the detectability and differentiation of extraaxial tumors, previously the domain of CT, has been improved with paramagnetic contrast agents (PCA). Although, the sensitivity of MRI for intracranial tumors is unchallenged, the specificity for such tumors is not remarcably greater than that of CT. Differentiation between high grade glioma, abscess and metastasis still requires biopsy for definitive diagnosis. Methods for improvement of specificity--tissue characterization--are currently being evaluated in a clinical setting. Further development in this field is necessary before such methods can be applied on a routine basis.

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“…Contrast-enhanced MRI has become indispensable for evaluating brain metastases in patients with cancer (7)(8)(9)(10)(11)(12). Lesion detection on contrast-enhanced MRI is affected by several factors, including lesion contrast (lesion-to-background ratio), size, and location (6).…”

Section: Discussionmentioning

confidence: 99%

Contrast‐enhanced FLAIR imaging in combination with pre‐ and postcontrast magnetization transfer T1‐weighted imaging: Usefulness in the evaluation of brain metastases

Terae

Yoshida

Kudo

et al. 2007

Magnetic Resonance Imaging

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Purpose:To assess whether the use of postcontrast fluidattenuated inversion recovery (FLAIR) imaging in combination with pre-and postcontrast magnetization transfer (MT) T1-weighted imaging (T1WI) can increase diagnostic confidence in the evaluation of brain metastases. Materials and Methods:Brain MR images from 41 patients with suspected brain metastases were reviewed. Two radiologists viewed pre-and postcontrast MT-T1W images for the presence of metastatic tumors and rated the possible enhanced lesions using a five-point confidence scale (session 1). The postcontrast FLAIR images were then viewed together with pre-and postcontrast MT-T1W images, and the presence of metastasis was rated again (session 2).Results: A total of 240 possible enhanced lesions were detected in session 1. Judging by follow-up MR examinations, 196 were considered to be nonmetastatic findings and 44 were determined to be metastasis. In session 2 the confidence rating for nonmetastasis increased significantly in the subset of nonmetastatic findings (P Ͻ 0.001), and the confidence rating for metastasis increased significantly in the subset of metastases (P Ͻ 0.05). Conclusion:The addition of postcontrast FLAIR imaging to pre-and postcontrast MT-T1WI improves diagnostic confidence in evaluation of brain metastases.

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Multiple cerebral metastases: detectability with Gd-DTPA-enhanced MR imaging.

Cited by 112 publications

References 0 publications

Exclusion of a Brain Lesion: Is Intravenous Contrast Administration Required after Normal Precontrast Magnetic Resonance Imaging?

Exclusion of a Brain Lesion: Is Intravenous Contrast Administration Required after Normal Precontrast Magnetic Resonance Imaging?

MR imaging of cerebral tumors: State of the art and work in progress

Contrast‐enhanced FLAIR imaging in combination with pre‐ and postcontrast magnetization transfer T1‐weighted imaging: Usefulness in the evaluation of brain metastases

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