Prospective Comparison of Brain Tumor Detection and Characterization Using Post-contrast Dixon uT1RESS and MPRAGE at 3 Tesla

Motivation: Existing MRI sequences like magnetization-prepared rapid gradient echo (MPRAGE) may not adequately detect small metastatic lesions, hindering accurate diagnosis and treatment planning. Goal(s): Our goal was to compare the diagnostic performance of Dixon unbalanced T1 relaxation-enhanced steady-state (uT1RESS) with MPRAGE in patients with primary brain tumors and metastases at 3 Tesla. Approach: A prospective, single-center study evaluated image quality and lesion characterization using both techniques. Results: Dixon uT1RESS showed improved tumor-to-brain contrast and enhanced lesion visibility, particularly for small metastatic lesions, while maintaining high overall image quality. However, MPRAGE outperformed uT1RESS in assessing internal lesion structure. Impact: Dixon uT1RESS significantly improved the detection of small metastatic lesions and evaluation of vascular and dural involvement compared to MPRAGE. It may enhance tumor management in brain metastasis patients, though additional sequences might be needed to fully characterize enhancing lesions.