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Contrast-Enhanced 3-Dimensional SPACE Versus MP-RAGE for the Detection of Brain Metastases: Considerations With a 32-Channel Head Coil

Reichert, Miriam MD*; Morelli, John N. MD; Runge, Val M. MD; Tao, Ai MD§; von Ritschl, Ruediger MD; von Ritschl, Andreas MD; Padua, Abraham RT, BS; Dix, James E. MD; Marra, Michael J. RT, BS; Schoenberg, Stefan O. MD*; Attenberger, Ulrike I. MD*

doi: 10.1097/RLI.0b013e318277b1aa
Original Articles

Purpose The aim of this study was to compare the detection of brain metastases at 3 T using a 32-channel head coil with 2 different 3-dimensional (3D) contrast-enhanced sequences, a T1-weighted fast spin-echo–based (SPACE; sampling perfection with application-optimized contrasts using different flip angle evolutions) sequence and a conventional magnetization-prepared rapid gradient-echo (MP-RAGE) sequence.

Materials and Methods Seventeen patients with 161 brain metastases were examined prospectively using both SPACE and MP-RAGE sequences on a 3-T magnetic resonance system. Eight healthy volunteers were similarly examined for determination of signal-to-noise ratio (SNR) values. Parameters were adjusted to equalize acquisition times between the sequences (3 minutes and 30 seconds). The order in which sequences were performed was randomized. Two blinded board-certified neuroradiologists evaluated the number of detectable metastatic lesions with each sequence relative to a criterion standard reading conducted at the Gamma Knife facility by a neuroradiologist with access to all clinical and imaging data.

Results In the volunteer assessment with SPACE and MP-RAGE, SNR (10.3 ± 0.8 vs 7.7 ± 0.7) and contrast-to-noise ratio (0.8 ± 0.2 vs 0.5 ± 0.1) were statistically significantly greater with the SPACE sequence (P < 0.05). Overall, lesion detection was markedly improved with the SPACE sequence (99.1% of lesions for reader 1 and 96.3% of lesions for reader 2) compared with the MP-RAGE sequence (73.6% of lesions for reader 1 and 68.5% of lesions for reader 2; P < 0.01).

Conclusions A 3D T1-weighted fast spin echo sequence (SPACE) improves detection of metastatic lesions relative to 3D T1-weighted gradient-echo–based scan (MP-RAGE) imaging when implemented with a 32-channel head coil at identical scan acquisition times (3 minutes and 30 seconds).

From the *Department of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Manheim, Germany; †Department of Radiology, Scott and White Hospital, Texas A&M Health Sciences Center, Temple; ‡Department of Radiology, University of Texas Medical Branch, Galveston, TX; §Department of Radiology, Tongji Hospital, Tonji Medical College, Huazhong University of Science and Technology, Wuhan, China; ∥Siemens Medical Solutions, Malvern, PA; and ¶Gamma Knife Center, Methodist Hospital, San Antonio, TX.

Received for publication May 9, 2012; and accepted for publication, after revision, September 15, 2012.

Conflicts of interest and sources of funding: The remaining authors have no conflicts of interest to report.

Abraham Padua is an employee of Siemens Medical Solutions.

John N. Morelli and Miriam Reichert contributed equally to the preparation of this manuscript.

Reprints: Miriam Reichert, MD, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, D-68167 Mannheim, Germany. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.