• Satoshi Terae, Daisuke Yoshida, Kohsuke Kudo, Khin Khin Tha, Masaharu Fujino, and Kazuo Miyasaka.
• Department of Radiology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. sterae@radi.med.hokudai.ac.jp
• J Magn Reson Imaging. 2007 Mar 1; 25 (3): 479-87.

PurposeTo assess whether the use of postcontrast fluid-attenuated inversion recovery (FLAIR) imaging in combination with pre- and postcontrast magnetization transfer (MT) T1-weighted imaging (T1WI) can increase diagnostic confidence in the evaluation of brain metastases.Materials And MethodsBrain MR images from 41 patients with suspected brain metastases were reviewed. Two radiologists viewed pre- and postcontrast MT-T1W images for the presence of metastatic tumors and rated the possible enhanced lesions using a five-point confidence scale (session 1). The postcontrast FLAIR images were then viewed together with pre- and postcontrast MT-T1W images, and the presence of metastasis was rated again (session 2).ResultsA total of 240 possible enhanced lesions were detected in session 1. Judging by follow-up MR examinations, 196 were considered to be nonmetastatic findings and 44 were determined to be metastasis. In session 2 the confidence rating for nonmetastasis increased significantly in the subset of nonmetastatic findings (P < 0.001), and the confidence rating for metastasis increased significantly in the subset of metastases (P < 0.05).ConclusionThe addition of postcontrast FLAIR imaging to pre- and postcontrast MT-T1WI improves diagnostic confidence in evaluation of brain metastases.

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