Abstract
Spiral MR imaging has several advantages compared with Cartesian MR imaging that can be leveraged for added clinical value. A multicenter multireader study was designed to compare spiral with standard-of-care Cartesian postcontrast structural brain MR imaging on the basis of relative performance in 10 metrics of image quality, artifact prevalence, and diagnostic benefit. Seven clinical sites acquired 88 total subjects. For each subject, sites acquired 2 postcontrast MR imaging scans: a spiral 2D T1 spin-echo, and 1 of 4 routine Cartesian 2D T1 spin-echo/TSE scans (fully sampled spin-echo at 3T, 1.5T, partial Fourier, TSE). The spiral acquisition matched the Cartesian scan for scan time, geometry, and contrast. Nine neuroradiologists independently reviewed each subject, with the matching pair of spiral and Cartesian scans compared side-by-side, and scored on 10 image-quality metrics (5-point Likert scale) focused on intracranial assessment. The Wilcoxon signed rank test evaluated relative performance of spiral versus Cartesian, while the Kruskal-Wallis test assessed interprotocol differences. Spiral was superior to Cartesian in 7 of 10 metrics (flow artifact mitigation, SNR, GM/WM contrast, image sharpness, lesion conspicuity, preference for diagnosing abnormal enhancement, and overall intracranial image quality), comparable in 1 of 10 metrics (motion artifacts), and inferior in 2 of 10 metrics (susceptibility artifacts, overall extracranial image quality) related to magnetic susceptibility (P < .05). Interprotocol comparison confirmed relatively higher SNR and GM/WM contrast for partial Fourier and TSE protocol groups, respectively (P < .05). Spiral 2D T1 spin-echo for routine structural brain MR imaging is feasible in the clinic with conventional scanners and was preferred by neuroradiologists for overall postcontrast intracranial evaluation.
Highlights
BACKGROUND AND PURPOSESpiral MR imaging has several advantages compared with Cartesian MR imaging that can be leveraged for added clinical value
Spiral was superior to Cartesian in 7 of 10 metrics, comparable in 1 of 10 metrics, and inferior in 2 of 10 metrics related to magnetic susceptibility (P, .05)
Spiral 2D T1 spin-echo for routine structural brain MR imaging is feasible in the clinic with conventional scanners and was preferred by neuroradiologists for overall postcontrast intracranial evaluation
Summary
Sites acquired 2 postcontrast MR imaging scans: a spiral 2D T1 spin-echo, and 1 of 4 routine Cartesian 2D T1 spin-echo/TSE scans (fully sampled spin-echo at 3T, 1.5T, partial Fourier, TSE). Subjects were scanned at 7 clinical sites from April 2018 to November 2018, and informed consent was obtained from each subject (4 sites) or waived (3 sites) as a minimum-risk study to add the proposed sequence at the end of a routine brain MR imaging examination. Crusher gradients around the 180° refocusing radiofrequency pulse provided additional flow signal suppression and black-blood contrast.[11] The spiral implementation is Dixon-based by design, with samples acquired at 2 or 3 unique TEs to encode chemical-shift information, in order to account for the different blurring properties of water/fat. A B0 prescan (30 seconds) was acquired before the spiral scan for use in reconstruction
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