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Background Accurate identification of brain metastases is crucial for cancer treatment. Objectives To compare the ability to detect brain metastases of two alternative types of contrast-enhanced three-dimensional (3D) T1-weighted sequences called SPACE (Sampling Perfection with Application optimized Contrasts using different flip angle Evolutions) and VIBE (Volumetric Interpolated Brain Sequence) on magnetic resonance imaging (MRI) at 3 tesla. Methods Between April 2017 and February 2018, 27 consecutive adult Thai patients with a total number of 424 brain metastases were retrospectively included. The patients underwent both contrast-enhanced 3D T1-weighted SPACE and 3D T1-weighted VIBE MRI sequences at 3 tesla. Two neuroradiology experts independently reviewed the images to determine the number of enhancing lesions on each sequence. Wilcoxon signed rank test was used to compare the difference between the numbers of detectable parenchymal enhancing lesions. Interobserver reliability was calculated using intraclass correlation. Results 3D T1-weighted SPACE detected more parenchymal enhancing lesions than 3D T1-weighted VIBE (424 vs. 378 lesions, median 6 vs. 5,  P  = 0.008). Fifteen patients (55.6%) had equal number of parenchymal enhancing lesions between two sequences. 3D T1-weighted SPACE detected more parenchymal enhancing lesions (up to 9 more lesions) in 10 patients (37%), while 3D T1-weighted VIBE detected more enhancing lesions (up to 2 more lesions) in 2 patients (7.4%). Interobserver reliability between the readers was excellent. Conclusion Contrast-enhanced 3D T1-weighted SPACE sequence demonstrates a higher ability to detect brain metastases than contrast-enhanced 3D T1-weighted VIBE sequence at 3 tesla.

Detection of brain metastases using alternative magnetic resonance imaging sequences: a comparison between SPACE and VIBE sequences