MRI Highly Accelerated Wave‐CAIPI T1‐SPACE versus Standard T1‐SPACE to detect brain gadolinium‐enhancing lesions at 3T

Background and Purpose High‐resolution three‐dimensional (3D) post‐contrast imaging of the brain is essential for comprehensive evaluation of inflammatory, neoplastic, and neurovascular diseases of the brain. 3D T1‐weighted spin‐echo‐based sequences offer increased sensitivity for the detection of enhancing lesions but are relatively prolonged examinations. We evaluated whether a highly accelerated Wave‐controlled aliasing in parallel imaging (Wave‐CAIPI) post‐contrast 3D T1‐sampling perfection with application‐optimized contrasts using different flip angle evolutions (T1‐SPACE) sequence (Wave‐T1‐SPACE) was noninferior to the standard high‐resolution 3D T1‐SPACE sequence for visualizing enhancing lesions with comparable diagnostic quality. Methods One hundred and three consecutive patients were prospectively evaluated with a standard post‐contrast 3D T1‐SPACE sequence (acquisition time [TA] = 4 min 19 s) and an optimized Wave‐CAIPI 3D T1‐SPACE sequence (TA = 1 min 40 s) that was nearly three times faster than the standard sequence. Two blinded neuroradiologists performed a head‐to‐head comparison to evaluate the visualization of enhancing pathology, perception of artifacts, and overall diagnostic quality. A 15% margin was used to test whether post‐contrast Wave‐T1‐SPACE was noninferior to standard T1‐SPACE. Results Wave‐T1‐SPACE was noninferior to standard T1‐SPACE for delineating parenchymal and meningeal enhancing pathology (p