AUTHOR=Ceballos-Ceballos Joel , Loza-Gallardo Diego A. , Barajas-Romero Marco A. , Cantú-Brito Carlos , Valdés-Ferrer Sergio Iván 

TITLE=Recognition of Brain Metastases Using Gadolinium-Enhanced SWI MRI: Proof-of-Concept Study

JOURNAL=Frontiers in Neurology

VOLUME=11

YEAR=2020

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2020.00005

DOI=10.3389/fneur.2020.00005

ISSN=1664-2295

ABSTRACT=<p><bold>Background and purpose:</bold> SWI MRI, a T2<sup>*</sup>-dominant MRI sequence with T1 <italic>shine-through</italic> effect, uses intrinsic structural susceptibility to create enhancement among brain structures. We evaluated whether gadolinium-enhanced SWI (SWI-Gd) improves brain metastasis detection in combination with other MRI sequences.</p><p><bold>Materials and methods:</bold> MRI images of 24 patients (46 studies) were prospectively acquired using a 1.5-T scanner. T1-weighted, unenhanced SWI (SWI-U) and SWI-Gd were evaluated blindly to clinical features by two board-certified radiologists.</p><p><bold>Results:</bold> SWI-Gd revealed more significant metastatic lesions than either T1-Gd or SWI-U (<italic>p</italic> = 0.0004 for either comparator sequence). Moreover, SWI-Gd revealed more lesions only for those patients with ≤5 lesions on T1-Gd (<italic>n</italic> = 30 studies from 16 patients; <italic>p</italic> = 0.046). Performing SWI-Gd added &lt;5 min of scanning time with no further additional risk.</p><p><bold>Conclusions:</bold> Our findings suggest that, when added to T1-Gd and other common sequences, SWI-Gd may improve the diagnostic yield of brain metastases with only a few extra minutes of scanning time and no further risk than that of a regular gadolinium-enhanced MRI.</p>