Post-gadolinium evaluation of intracranial tumours: a comparative study of Spin Echo, Fast Spin Echo, Gradient Echo T1-weighted sequences, with and without Magnetization Transfer

This study compares the use of six different post-gadolinium T1-weighted sequences on intracranial tumours with the aim of evaluating their efficacy in terms of lesion and edema contrast resolution and cortex visualization. Forty-eight intracranial neoplastic lesions were evaluated after contrast media administration by means of the following Tl-weighted sequences: Fast Spin-Echo (FSE), Spin-Echo (SE) and Gradient-Echo (GE) with and without Magnetization Transfer (MT) pulse. For each technique tumour/background contrast resolution (T/B CR), oedema/background contrast resolution (E/B CR) and white matter/grey matter contrast resolution (WM/GM CR) were calculated. GE sequences, with and without MT, showed the lowest contrast resolution values for all parameters. FSE MT sequences showed the highest T/B CR values. SE sequences, instead, showed the best E/B and WM/GM CR values. FSE and SE MT values were intermediate between FSE MT and SE sequences. No sequence had high values for all contrast resolution parameters. The sequence with the best T/B CR was the FSE MT, but that with the best anatomic peritumoural edema and cortex definition was SE. Both FSE MT and SE T1-weighted sequences may be acquired to obtain accurate post-gadolinium tumour evaluation.