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Research ArticleAdult Brain

Evaluation of Thick-Slab Overlapping MIP Images of Contrast-Enhanced 3D T1-Weighted CUBE for Detection of Intracranial Metastases: A Pilot Study for Comparison of Lesion Detection, Interpretation Time, and Sensitivity with Nonoverlapping CUBE MIP, CUBE, and Inversion-Recovery-Prepared Fast-Spoiled Gradient Recalled Brain Volume

B.C. Yoon, A.F. Saad, P. Rezaii, M. Wintermark, G. Zaharchuk and M. Iv
American Journal of Neuroradiology September 2018, 39 (9) 1635-1642; DOI: https://doi.org/10.3174/ajnr.A5747
B.C. Yoon
aFrom the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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A.F. Saad
aFrom the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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P. Rezaii
aFrom the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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M. Wintermark
aFrom the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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G. Zaharchuk
aFrom the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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M. Iv
aFrom the Department of Radiology, Division of Neuroimaging and Neurointervention, Stanford University, Stanford, California.
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Abstract

BACKGROUND AND PURPOSE: Early and accurate identification of cerebral metastases is important for prognostication and treatment planning although this process is often time consuming and labor intensive, especially with the hundreds of images associated with 3D volumetric imaging. This study aimed to evaluate the benefits of thick-slab overlapping MIPs constructed from contrast-enhanced T1-weighted CUBE (overlapping CUBE MIP) for the detection of brain metastases in comparison with traditional CUBE and inversion-recovery prepared fast-spoiled gradient recalled brain volume (IR-FSPGR-BRAVO) and nonoverlapping CUBE MIP.

MATERIALS AND METHODS: A retrospective review of 48 patients with cerebral metastases was performed at our institution from June 2016 to October 2017. Brain MRIs, which were acquired on multiple 3T scanners, included gadolinium-enhanced T1-weighted IR-FSPGR-BRAVO and CUBE, with subsequent generation of nonoverlapping CUBE MIP and overlapping CUBE MIP. Two blinded radiologists identified the total number and location of metastases on each image type. The Cohen κ was used to determine interrater agreement. Sensitivity, interpretation time, and lesion contrast-to-noise ratio were assessed.

RESULTS: Interrater agreement for identification of metastases was fair-to-moderate for all image types (κ = 0.222–0.598). The total number of metastases identified was not significantly different across the image types. Interpretation time for CUBE MIPs was significantly shorter than for CUBE and IR-FSPGR-BRAVO, saving at least 50 seconds per case on average (P < .001). The mean lesion contrast-to-noise ratio for both CUBE MIPs was higher than for IR-FSPGR-BRAVO. The mean contrast-to-noise ratio for small lesions (<4 mm) was lower for nonoverlapping CUBE MIP (1.55) than for overlapping CUBE MIP (2.35). For both readers, the sensitivity for lesion detection was high for all image types but highest for overlapping CUBE MIP and CUBE (0.93–0.97).

CONCLUSIONS: This study suggests that the use of overlapping CUBE MIP or nonoverlapping CUBE MIP for the detection of brain metastases can reduce interpretation time without sacrificing sensitivity, though the contrast-to-noise ratio of lesions is highest for overlapping CUBE MIP.

ABBREVIATIONS:

CNR
contrast-to-noise ratio
IR-FSPGR-BRAVO
inversion-recovery-prepared fast-spoiled gradient recalled brain volume
nC-MIP
nonoverlapping CUBE MIP
oC-MIP
overlapping CUBE MIP
SRS
stereotactic radiosurgery
XR
cross-reference
  • © 2018 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 39 (9)
American Journal of Neuroradiology
Vol. 39, Issue 9
1 Sep 2018
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Evaluation of Thick-Slab Overlapping MIP Images of Contrast-Enhanced 3D T1-Weighted CUBE for Detection of Intracranial Metastases: A Pilot Study for Comparison of Lesion Detection, Interpretation Time, and Sensitivity with Nonoverlapping CUBE MIP, CUBE, …
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B.C. Yoon, A.F. Saad, P. Rezaii, M. Wintermark, G. Zaharchuk, M. Iv
Evaluation of Thick-Slab Overlapping MIP Images of Contrast-Enhanced 3D T1-Weighted CUBE for Detection of Intracranial Metastases: A Pilot Study for Comparison of Lesion Detection, Interpretation Time, and Sensitivity with Nonoverlapping CUBE MIP, CUBE, and Inversion-Recovery-Prepared Fast-Spoiled Gradient Recalled Brain Volume
American Journal of Neuroradiology Sep 2018, 39 (9) 1635-1642; DOI: 10.3174/ajnr.A5747

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Evaluation of Thick-Slab Overlapping MIP Images of Contrast-Enhanced 3D T1-Weighted CUBE for Detection of Intracranial Metastases: A Pilot Study for Comparison of Lesion Detection, Interpretation Time, and Sensitivity with Nonoverlapping CUBE MIP, CUBE, and Inversion-Recovery-Prepared Fast-Spoiled Gradient Recalled Brain Volume
B.C. Yoon, A.F. Saad, P. Rezaii, M. Wintermark, G. Zaharchuk, M. Iv
American Journal of Neuroradiology Sep 2018, 39 (9) 1635-1642; DOI: 10.3174/ajnr.A5747
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