Improved visibility of brain tumors in synthetic MP‐RAGE anatomies with pure T1 weighting

Conventional MRI for brain tumor diagnosis employs T2‐weighted and contrast‐enhanced T1‐weighted sequences. Non‐enhanced T1‐weighted images provide improved anatomical details for precise tumor location, but reduced tumor‐to‐background contrast as elevated T1 and proton density (PD) values in tumor tissue affect the signal inversely. Radiofrequency (RF) coil inhomogeneities may further mask tumor and edema outlines. To overcome this problem, the aims of this work were to employ quantitative MRI techniques to create purely T1‐weighted synthetic anatomies which can be expected to yield improved tissue and tumor‐to‐background contrasts, to compare the quality of conventional and synthetic anatomies, and to investigate optical contrast and visibility of brain tumors and edema in synthetic anatomies. Conventional magnetization‐prepared rapid acquisition of gradient echoes (MP‐RAGE) anatomies and maps of T1, PD and RF coil profiles were acquired in comparable and clinically feasible times. Three synthetic MP‐RAGE anatomies (PD T1 weighting both with and without RF bias; pure T1 weighting) were calculated for healthy subjects and 32 patients with brain tumors. In healthy subjects, the PD T1‐weighted synthetic anatomies with RF bias precisely matched the conventional anatomies, yielding high signal‐to‐noise (SNR) and contrast‐to‐noise (CNR) ratios. Pure T1 weighting yielded lower SNR, but high CNR, because of increased optical contrasts. In patients with brain tumors, synthetic anatomies with pure T1 weighting yielded significant increases in optical contrast and improved visibility of tumor and edema in comparison with anatomies reflecting conventional T1 contrasts. In summary, the optimized purely T1‐weighted synthetic anatomy with an isotropic resolution of 1 mm, as proposed in this work, considerably enhances optical contrast and visibility of brain tumors and edema. Copyright © 2015 John Wiley & Sons, Ltd.