Improved Brain Tumor Visualization with 3T Stack-of-Stars Echo Unbalanced T1 Relaxation-Enhanced Steady-State MRI – A Two Center Clinical Study

Motivation: The echo unbalanced T1 relaxation-enhanced steady-state (echo-uT1RESS) technique offers strong dark-blood effect; however, its effectiveness is compromised by sensitivity to head motion, motivating the development of a motion-resistant version using radial stack-of-stars (SOS) k-space trajectory. Goal(s): To assess the diagnostic performance of the SOS echo-uT1RESS technique in comparison to magnetization-prepared rapid gradient echo (MPRAGE). Approach: A two-center prospective study was conducted involving 25 patients, utilizing both quantitative and qualitative analyses of post-contrast acquisitions. Results: The SOS echo-uT1RESS technique improved tumor-to-brain contrast and lesion conspicuity while maintaining high image quality and comparable artifact levels. Impact: This study highlights the SOS echo-uT1RESS technique's potential to significantly improve visualization and characterization of brain lesions. It offers consistent dark-blood effect and improved lesion conspicuity, while maintaining high image quality and motion robustness, with promising implications for clinical practice.