PT  - JOURNAL ARTICLE
AU  - Oh, J.
AU  - Choi, S.H.
AU  - Lee, E.
AU  - Shin, D.J.
AU  - Jo, S.W.
AU  - Yoo, R.-E.
AU  - Kang, K.M.
AU  - Yun, T.J.
AU  - Kim, J.-h.
AU  - Sohn, C.-H.
TI  - Application of 3D Fast Spin-Echo T1 Black-Blood Imaging in the Diagnosis and Prognostic Prediction of Patients with Leptomeningeal Carcinomatosis
AID  - 10.3174/ajnr.A5721
DP  - 2018 Aug 01
TA  - American Journal of Neuroradiology
PG  - 1453--1459
VI  - 39
IP  - 8
4099  - http://www.ajnr.org/content/39/8/1453.short
4100  - http://www.ajnr.org/content/39/8/1453.full
SO  - Am. J. Neuroradiol.2018 Aug 01; 39
AB  - BACKGROUND AND PURPOSE: Contrast-enhanced 3D fast spin-echo T1 black-blood imaging selectively suppresses the signal of blood flow and could provide a higher contrast-to-noise ratio compared with contrast-enhanced 3D ultrafast gradient recalled echo (contrast-enhanced gradient recalled echo) and 2D spin-echo T1WI (contrast-enhanced spin-echo). The purpose of our study was to evaluate whether black-blood imaging can improve the diagnostic accuracy for leptomeningeal carcinomatosis compared with contrast-enhanced gradient recalled-echo and contrast-enhanced spin-echo and, furthermore, to determine whether the grade of leptomeningeal carcinomatosis evaluated on black-blood imaging is a significant predictor of progression-free survival.MATERIALS AND METHODS: Leptomeningeal carcinomatosis (n = 78) and healthy (n = 31) groups were enrolled. Contrast-enhanced gradient recalled-echo, contrast-enhanced spin-echo, and black-blood imaging were separately reviewed, and a diagnostic rating (positive, indeterminate, or negative) and grading of leptomeningeal carcinomatosis were assigned. The diagnostic accuracies of the 3 imaging sequences were compared in terms of leptomeningeal carcinomatosis detection. The Kaplan-Meier and the Cox proportional hazards model analyses were performed to determine the relationship between the leptomeningeal carcinomatosis grade evaluated on black-blood imaging and progression-free survival.RESULTS: Black-blood imaging showed a significantly higher sensitivity (97.43%) than contrast-enhanced gradient recalled-echo (64.1%) and contrast-enhanced spin-echo (66.67%) (P < .05). In terms of specificities, we did not find any significant differences among contrast-enhanced gradient recalled-echo (90.32%), contrast-enhanced spin-echo (90.32%), and black-blood imaging (96.77%) (P > .05). A Cox proportional hazards model identified the time to metastasis, Karnofsky Performance Scale status, and a combination of the leptomeningeal carcinomatosis grade with a linear pattern as independent predictors of progression-free survival (P < .05).CONCLUSIONS: Black-blood imaging can improve the diagnostic accuracy and predict progression-free survival in patients with leptomeningeal carcinomatosis.CEcontrast-enhancedGREgradient recalled-echoICCintraclass correlation coefficientKPSKarnofsky Performance ScaleLCleptomeningeal carcinomatosisPFSprogression-free survivalSEspin-echo