Clinical feasibility of post-contrast accelerated 3D T1-Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions (SPACE) with iterative denoising for intracranial enhancing lesions: a retrospective study

Abstract

Background: Post-contrast T1-Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions (SPACE) is the preferred 3D T1 spin-echo sequence for evaluating brain metastases, regardless of the prolonged scan time.

Purpose: To evaluate the application of accelerated post-contrast T1-SPACE with iterative denoising (ID) for intracranial enhancing lesions in oncologic patients.

Material and methods: For evaluation of intracranial lesions, 108 patients underwent standard and accelerated T1-SPACE during the same imaging session. Two neuroradiologists evaluated the overall image quality, artifacts, degree of enhancement, mean contrast-to-noise ratio_{lesion/parenchyma}, and number of enhancing lesions for standard and accelerated T1-SPACE without ID.

Results: Although there was a significant difference in the overall image quality and mean contrast-to-noise ratio_{lesion/parenchyma} between standard and accelerated T1-SPACE without ID and accelerated SPACE with and without ID, there was no significant difference between standard and accelerated T1-SPACE with ID. Accelerated T1-SPACE showed more artifacts than standard T1-SPACE; however, accelerated T1-SPACE with ID showed significantly fewer artifacts than accelerated T1-SPACE without ID. Accelerated T1-SPACE without ID showed a significantly lower number of enhancing lesions than standard- and accelerated T1-SPACE with ID; however, there was no significant difference between standard and accelerated T1-SPACE with ID, regardless of lesion size.

Conclusion: Although accelerated T1-SPACE markedly decreased the scan time, it showed lower overall image quality and lesion detectability than the standard T1-SPACE. Application of ID to accelerated T1-SPACE resulted in comparable overall image quality and detection of enhancing lesions in brain parenchyma as standard T1-SPACE. Accelerated T1-SPACE with ID may be a promising replacement for standard T1-SPACE.

Keywords: Iterative denoising; SPACE; Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions; accelerated; brain; metastases.