Mungunkhuyag Majigsuren1, Takashi Abe1, Masafumi Harada1

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Mungunkhuyag Majigsuren1, Takashi Abe1, Masafumi Harada1 ASNR 2015 E-Poster #56 Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups Mungunkhuyag Majigsuren1, Takashi Abe1, Masafumi Harada1 Department of 1-Radiology, Institute of Health Biosciences, The University of Tokushima Graduate School

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 ☑ The author has no conflict of interest to disclose with respect to this presentation.

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 BACKGROUND: T1-CUBE image is one of the 3D fast spin echo MRI sequence with variable flip angle. In our institution, we used 3D-T1 gradient echo and 2D T1 spin-echo sequence for detecting metastatic brain tumors. Recently some investigators1-3 reported that about 3D FSE (SPACE) imaging compared to 3D T1-weighted gradient-echo based imaging (MPRAGE). 1.Komada T et al. Magn Reson Med Sci 2008;7:13-21 2.Reichert M et al. Invest Radiol 2013;48:55-60 3.Kato Y et al. AJNR Am J Neuroradiol 2009;30:923-29

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 PURPOSE: The aim of this study is to clarify the difference of enhancement extent of brain tumors between T1-CUBE and 3-dimensional fast spoiled gradient recall acquisition in steady state (3DFSPGR) at 3T MRI depending on the tumor size and histological type.

MATERIALS AND METHODS (1/3): Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 MATERIALS AND METHODS (1/3): MR imaging: 3T MR scanner (Discovery 750, GE Healthcare) pre SPGR post CUBE post SPGR scan time: (3min 9sec) (2min 41sec) contrast agent (Gd-DTPA, 0.1 mmol/kg, Magnevist, Bayer) T1-CUBE TR/TE 500 /15.1, bandwidth 50 kHz, ST 1.2 mm, matrix 384x256, ETL18, FA 15, number of excitation 1, FOV 24x24 cm, acceleration factor 2x2 3DFSPGR TR/TE 10.4 /4.4, bandwidth 31.25 kHz, ST 1.2 mm, matrix 384x256, FA 15, number of excitation 1, FOV 24x24 cm, acceleration factor 2x2

MATERIALS AND METHODS (2/3): Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 MATERIALS AND METHODS (2/3): Patients: from December 2012 to October 2013 consecutive 53 examinations in 61 lesions from 32 patients (17 men, 15 women; mean age, 63.1 years; age range, 34−84 years) Metastasis=9 patients 34 lesions High grade glioma (HGG)=11 patients 13 lesions Lymphoma=4 patients 6 lesion Meningioma=7 patients 7 lesions Hemangiopericytoma=1 patient 1 lesion 8 lesions

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 MATERIALS AND METHODS (3/3): ROIs settings 2 measurements (same slices and anatomic levels) 1st Measurement PostT1-CUBE>>preSPGR>>postSPGR 2nd Measurement Post SPGR>>preSPGR>>PostT1-CUBE ROI measurements: The ROI measurements was conducted twice on the different days and the consistency was confirmed by intra-class correlation coefficients.

CNR and tumor size was evaluated for both post-contrast images. Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 STATISTICAL ANALYSIS CNR= (SIlesion - SIwhite matter)/Sdlesion SIlesion =mean SI values of the lesion SIwhite matter =mean SI values of the normal appearing WM SDlesion =standard deviation of the signal intensity within the lesion Spearman’s rank correlation: CNR and tumor size was evaluated for both post-contrast images. Wilcoxon rank sum test: CNR and subgroups analyses All statistical analysis was performed: -Excel Statistics 2012 (Social Survey Research Information Co., Ltd., Tokyo, Japan) -Excel 2010 (Microsoft Co., Redmond, WA) P<0.05 was considered statistically significant.

DATA ANALYSIS Subgroup analysis Workstation AW 4.6 Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 Subgroup analysis Metastatic tumor size group (small and large metastatic tumor group) Histopathological group (Metastasis, High grade glioma , Meningioma and Lymphoma) DATA ANALYSIS Workstation AW 4.6 (GE Healthcare, Milwaukee, WI) -Pre and post-contrast 3DFSPGR, and post-contrast T1-CUBE images

Fig 1. Brain metastases from lung cancer, 77 y/o, male. Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 Fig 1. Brain metastases from lung cancer, 77 y/o, male. A B A. T1-CUBE Sag B. T1-CUBE Axial C. 3DFSPGR Sag D. 3DFSPGR Axial Numerous small well-enhancing lesions clearly show on the T1-CUBE (A,B) image compared to 3DFSPGR (C,D) image. An enhancing small nodular lesion clearly shows on T1-CUBE (arrow, B) whereas fairly faint enhancement on the contrast-enhanced 3DFSPGR (arrow, D) and it’s scarcely visible. D C

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 RESULTS (1/3): ICC >= 0.8 The reliability of the measurement was confirmed. Comparison of tumor CNR: T1-CUBE or 3DFSPGR T1-CUBE 1.85 ± 0.97, 3DFSPGR 1.12 ± 1.05; P<0.01

RESULTS (2/3): Large metastatic Small metastatic P<0.01** P=0.06 Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 RESULTS (2/3): P<0.01** P=0.06 Large metastatic Median size of metastasis= 24.2mm2 Small metastatic

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 RESULTS (3/3):

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 DISCUSSION 1/2 In present study, we demonstrate differences in contrast enhancement characteristics between T1-CUBE and 3DFSPGR imaging using 3T MRI for the same heterogeneous group of tumors, including brain metastasis, high grade glioma, meningioma, and lymphoma. In analyses by tumor subtype, T1-CUBE images exhibited greater Gd enhancement for metastatic brain tumors and lymphoma than 3DFSPGR images.

DISCUSSION 2/2 There were no significant differences in mean CNR values for HGG and meningiomas. The intrinsic reasons for these differences in CNR values among specific histological tumor types are not clear, but may stem from differences in vascular permeability and/or extracellular space characteristics. Further study is needed to clarify this study.

Comparison of contrast enhancement of brain tumors with T1-CUBE and 3DFSPGR imaging in difference of histopathological groups ASNR E-poster # 56 CONCLUSIONS: Gadolinium enhancement of brain tumors was generally higher using T1-CUBE than DFSPGR, especially for smaller lesions. We suggest that T1-CUBE is superior to 3DFSPGR for the detection of small metastatic brain lesions.

Thank you very much for your attention