The value of DTI: achieving high diagnostic performance for brain metastasis

• Published in: Radiologia medica Vol. 126; no. 2; pp. 291 - 298
• Main Authors: Liheng, Ma, Guofan, Xu, Balzano, Rosario Francesco, Yuying, Liang, Weifeng, Hong, Ning, Yang, Yayun, Ji, Mouyuan, Liu, Guglielmi, Giuseppe
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.02.2021; Springer Nature B.V
• Subjects: Brain; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - secondary; Contrast Media; Diagnostic Radiology; Diagnostic systems; Diffusion Tensor Imaging - methods; Edema; Female; Hemorrhage; Humans; Image contrast; Image enhancement; Imaging; Imaging, Three-Dimensional; Interventional Radiology; Lesions; Magnetic Resonance Imaging; Male; Medical imaging; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neuroradiology; Radiology; Retrospective Studies; Sequences; Tensors; Ultrasound; Magnetic resonance imaging (MRI); Brain metastases; Diffusion tensor imaging (DTI); Post-contrast Imaging
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-020-01243-6

Background The evaluation of brain metastases generally requires post-contrast MRI exam, but some patients have contraindication to contrast medium administration. Purpose To investigate the value of the MRI diffusion tensor imaging (DTI) for detection of metastatic brain tumor. Materials and methods We retrospectively analyzed the MRI data from 23 patients (13 males and 10 females) with brain metastases. The MRI protocol consisted in T1WI, T2WI, post-contrast 3DT1WI and DTI images ( b  = 1000) sequences. The brain metastatic lesions were counted in each of these sequences. We compared the advantages and limitations of different sequences in the brain metastases detection. The number of metastatic lesions identified on the contrast-enhanced 3DT1WI image is used as the reference. FA values were measured in the intratumoral, adjacent peritumoral and distant peritumoral edema area (PTEA) of brain metastasis, and the differences were statistically analyzed. Results DTI can detect more brain metastatic lesions rather than T1WI and T2WI. The number of brain metastases on DTI is similar to post-contrast 3D T1WI. There is no statistical difference in the FA value change between the adjacent and distant PTEA. Conclusion The DTI original image can be used as an alternative examination for patients with contraindications to contrast-enhanced MRI. It has high sensitivity to intratumoral hemorrhage, which has advantage to detect brain metastatic lesions as compared with T1WI or T2WI images.