Department of Radiology, Institut Jules Bordet, 90 Rue Meylemeersch, 1070, Brussels, Belgium.
Neuroradiology. 2023 Jul;65(7):1133-1141. doi: 10.1007/s00234-023-03143-8. Epub 2023 Mar 30.
Sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) is a black-blood 3D T1-weighted (T1w) magnetic resonance imaging (MRI) sequence that has shown robust performance for brain metastases detection. However, this could generate false positive results due to suboptimal blood signal suppression. For that reason, SPACE is used in our institution alongside a non-black-blood T1w sequence: volumetric interpolated breath-hold examination (VIBE). Our study aims to (i) evaluate the diagnostic accuracy of SPACE compared to its use in combination with VIBE, (ii) investigate the effect of radiologist's experience in the sequence's performance, and (iii) analyze causes of discordants results.
Four hundred seventy-three 3T MRI scans were retrospectively analyzed following a monocentric study design. Two studies were formed: one including SPACE alone and one combining both sequences (SPACE + VIBE, the reference). An experienced neuroradiologist and a radiology trainee independently reviewed the images of each study and reported the number of brain metastases. The sensitivity (Se) and specificity (Sp) of SPACE compared to SPACE + VIBE in metastases detection were reported. Diagnostic accuracy of SPACE compared to SPACE + VIBE was assessed by using McNemar's test. Significance was set at p < 0.05. Cohen's kappa was used for inter-method and inter-observer variability.
No significant difference was found between the two methods, with SPACE having a Se > 93% and a Sp > 87%. No effect of readers' experience was disclosed.
Independently of radiologist's experience, SPACE alone is robust enough to replace SPACE + VIBE for brain metastases detection.
应用优化对比的采样完美（SPACE）是一种黑血 3D T1 加权（T1w）磁共振成像（MRI）序列，它在脑转移瘤检测方面表现出了强大的性能。然而，由于血液信号抑制不理想，这可能会产生假阳性结果。出于这个原因，SPACE 在我们机构中与非黑血 T1w 序列：容积内插屏气检查（VIBE）一起使用。我们的研究旨在：（i）评估 SPACE 与联合使用 VIBE 的诊断准确性，（ii）研究放射科医生经验对序列性能的影响，以及（iii）分析不一致结果的原因。
采用中心研究设计回顾性分析了 473 例 3T MRI 扫描。形成了两项研究：一项包括单独的 SPACE，另一项则包括联合使用两种序列（SPACE+VIBE，作为参考）。一位经验丰富的神经放射科医生和一位放射科住院医师分别独立地查看了每个研究的图像，并报告了脑转移瘤的数量。报告了 SPACE 检测转移瘤的灵敏度（Se）和特异性（Sp）与 SPACE+VIBE 的比较。使用 McNemar 检验评估 SPACE 与 SPACE+VIBE 比较的诊断准确性。显著性设置为 p<0.05。使用 Cohen's kappa 评估方法间和观察者间的可变性。
两种方法之间没有发现显著差异，SPACE 的 Se>93%，Sp>87%。没有发现读者经验的影响。
无论放射科医生的经验如何，单独使用 SPACE 足以替代 SPACE+VIBE 进行脑转移瘤检测。
