Radiological diagnosis of drop metastases from paediatric brain tumours using combination of 2D and 3D MRI sequences

• Published in: Clinical radiology Vol. 72; no. 10; pp. 902.e13 - 902.e19
• Main Authors: Kralik, S.F., O'Neill, D.P., Kamer, A.P., Rodriguez, E., Ho, C.Y.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-10-2017
• Subjects: Adolescent; Brain Neoplasms - pathology; Child; Child, Preschool; Female; Humans; Imaging, Three-Dimensional - methods; Infant; Magnetic Resonance Imaging - methods; Male; Meningeal Neoplasms - diagnostic imaging; Meningeal Neoplasms - secondary; Retrospective Studies
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2017.04.016

To evaluate spinal magnetic resonance imaging (MRI) examinations using a combination of two-dimensional (2D) and three-dimensional (3D) MRI sequences for diagnosis of drop metastases.
Fifty-five paediatric patients with primary brain tumours were evaluated for drop metastases at initial presentation using spinal MRI including sagittal 2D T1-weighted (W) contrast-enhanced (+C), axial 3D T1W+C volumetric interpolated breath-hold (VIBE), and sagittal 3D T2W SPACE (Sampling Perfection with Application optimised Contrasts using different flip angle Evolutions).
The MRI false-negative rate was 4%, and cerebrospinal fluid (CSF) false-negative rate was 16% (p=0.07). The 3D T1W+C VIBE increased the number of drop metastases detected in 42% of patients. Drop metastases were more conspicuous in 25% of patients on 3D T2W SPACE.
Spinal MRI examinations including 2D and 3D sequences demonstrate characteristics that may improve radiological diagnosis of drop metastases.
•The combination of 2D and 3D MRI sequences outperformed CSF cytology.•The 3D T1W+C VIBE sequence improved interobserver agreement.•The 3D T1W+C VIBE sequence increased the number of drop metastases detected.•The 3D T2W SPACE sequence increased conspicuity of drop metastases in some patients.