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Published online before print February 28, 2006, 10.1148/radiol.2383050211
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(Radiology 2006;239:238-245.)
© RSNA, 2006

Technical Developments

Artificial Multiple Sclerosis Lesions on Simulated FLAIR Brain MR Images: Echo Time and Observer Performance in Detection1

Lana Pikus, MS, John H. Woo, MD, Ronald L. Wolf, MD, PhD, Edward H. Herskovits, MD, PhD, Gul Moonis, MD, Abbas F. Jawad, PhD, Jaroslaw Krejza, MD, PhD and Elias R. Melhem, MD

1 From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Dulles 2, Philadelphia, PA 19104 (L.P., J.H.W., R.L.W., E.H.H., G.M., A.F.J., J.K., E.R.M.); Division of Neuroradiology, the Johns Hopkins Medical Institutions, Baltimore, Md (E.H.H., E.R.M.); Division of Biostatistics and Epidemiology, the Children's Hospital of Philadelphia, Philadelphia, Pa (A.F.J.); and Department of Radiology, Medical University of Gdansk, Gdansk, Poland (J.K.). Received February 10, 2005; revision requested April 20; revision received May 3; final version accepted June 3. Address correspondence to: E.R.M. (e-mail: emelhem{at}rad.upenn.edu).

The institutional review board approved the described HIPAA-compliant study, which was performed to prospectively evaluate observer performance in the detection of artificial multiple sclerosis (MS) lesions that were randomly distributed supra- and infratentorially on simulated fluid-attenuated inversion-recovery (FLAIR) magnetic resonance (MR) images obtained at different echo times (TEs). MR parametric maps were derived from mixed multi-echo inversion-recovery images obtained in a 40-year-old healthy male volunteer and in a patient with MS, both of whom gave informed consent. Pseudorandomly distributed artificial MS lesions of varying size, number, and location were equally represented on the FLAIR images (11 000/100–200/2600 [repetition time msec/TE msec/inversion time msec]). Twelve images obtained in both regions at each of 11 TEs spaced 10 msec apart were rated by seven neuroradiologists by using a four-point scale. Observer performance in the detection of MS lesions on the FLAIR images, as estimated by using areas under the alternative free-response receiver operating characteristic curve, was highest and most consistent at the 100-msec TE, both supratentorially (93.0% ± 8.6 [standard error of the mean]) and infratentorially (87.4% ± 10.0).

© RSNA, 2006






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