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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Combination of Contrast-enhanced FlAIR and Contrast-enhanced T1WI: A Quick and Efficient Method in Detecting Brain Metastases of Lung Cancers

Author(s): Linlin Sun, Shihai Luan, Xiaodan Ye, Jing Chen, Jueqian Shi, Huiyuan Zhu, Haiyang Dong, Guangyu Tao, Xuemei Liu, Li Zhu* and Hong Yu*

Volume 20, 2024

Published on: 28 February, 2024

Article ID: e15734056288838 Pages: 10

DOI: 10.2174/0115734056288838240201040400

open_access

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Abstract

Background: Some patients with suspected brain metastases (BM) could not tolerate longer scanning examinations according to the standardized MRI protocol.

Objective: The purpose of this study was to evaluate the clinical value of contrast-enhanced fast fluid-attenuated inversion recovery (CE FLAIR) imaging in combination with contrast-enhanced T1 weighted imaging (CE T1WI) in detecting BM of lung cancer and explore a quick and effective MRI protocol.

Material and Methods: In 201 patients with lung cancers and suspected BM, T1WI and FLAIR were performed before and after administration of gadopentetate dimeglumine. Two radiologists reviewed pre- and post-contrast images to determine the presence of abnormal contrast enhancement or signal intensity and decided whether it was metastatic or not on CE T1WI (Group 1) and CE FLAIR (Group 2). The number, locations and features of abnormal findings in two groups were recorded. Receiver Operating Characteristic (ROC) analyses were conducted in three groups: Group 1, 2 and 3(combination of CE FLAIR and CE T1WI).

Results: A total of 714 abnormal findings were revealed, of which 672 were considered as BM and 42 nonmetastatic. Superficial and small metastases(≤10mm) in parenchyma and ependyma, leptomeningeal and non-expansive skull metastases were typically better seen on CE FLAIR. The areas under ROC in the three groups were 0.720,0.887 and 0.973, respectively. Group 3 was significantly better in diagnostic efficiency of BMs than Group 1 (p<0.0001) or Group 2 (p=0.0006).

Conclusion: The combination of CE T1WI and CE FLAIR promotes diagnostic performance and results in better observation and characterization of BM in patients with lung cancers. It provides a quick and efficient way of detecting BM.

Keywords: Fluid-attenuated inversion recovery imaging, T1 weighted imaging, Contrast enhancement, Brain metastases, Lung cancer, Screening.


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