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

• Main Authors: Joel Ceballos-Ceballos, Diego A. Loza-Gallardo, Marco A. Barajas-Romero, Carlos Cantú-Brito, Sergio Iván Valdés-Ferrer
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2020-02-01
• Series: Frontiers in Neurology
• Subjects: brain metastasis; MRI; SWI; susceptibility-weighted image; gadolinium; metastasis diagnosis
• Online Access: https://www.frontiersin.org/article/10.3389/fneur.2020.00005/full

Background and purpose: SWI MRI, a T2*-dominant MRI sequence with T1 shine-through 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.Materials and methods: 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.Results: SWI-Gd revealed more significant metastatic lesions than either T1-Gd or SWI-U (p = 0.0004 for either comparator sequence). Moreover, SWI-Gd revealed more lesions only for those patients with ≤5 lesions on T1-Gd (n = 30 studies from 16 patients; p = 0.046). Performing SWI-Gd added <5 min of scanning time with no further additional risk.Conclusions: 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.