Contrast enhanced IR-SSFP examination compared with T1-weighted turbo spin-echo imaging of cardiac tumors and tumorlike lesions

Abstract

Purpose To show that the use of an early and delayed contrast enhanced multislice inversion recovery steady state free precession (SS-IR-SSFP) is a valuable substitute for conventional post-contrast fat saturated turbo spin-echo (TSE) T1-weighted images in the assessment of cardiac tumors. Materials and methods 34 consecutive patients referred for MRI in order to assess cardiac tumors were examined. Shortly after administration of gadopenetate dimeglumine (Gd-DTPA) images were obtained using a SS-IR-SSFP sequence. The inversion time (TI) was set at 350 ms to achieve a good demarcation of intracavitary tumor spread. Hereafter 9 slices of a T1w TSE sequence were obtained. Finally a SS-IR-SSFP sequence with an optimized TI to null normal myocardium was employed. Quantitative comparisons were performed by calculating contrast to noise ratios of tumor/myocardium (CNR tumor/myo) and CNR of tumor/left ventricular cavity (CNR tumor/LVC). Image quality was assessed regarding overall image quality, artifacts and tumor conspicuity. Results Neither calculation of CNR tumor/LVC when comparing the early IR-SSFP and T1w TSE, nor calculation of CNR tumor/myo when comparing the late IR-SSFP and T1w TSE sequence resulted in statistically significant differences. However, qualitative assessments revealed significant superior results for the early and the late IR-SSFP images compared to the T1-weighted TSE images ( p < 0.001). Conclusions Image quality and tumor conspicuity were superior and image degradation by artifacts was less on IR-SSFP images compared to TSE images without loss of CNR. Thus the use of IR-SSFP sequences is an attractive alternative imaging method compared to post-contrast T1w TSE imaging in the assessment of cardiac tumors.