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Contrast-Enhanced Volumetric Interpolated Breath-Hold Examination Compared with Spin-Echo T1-Weighted Imaging of Head and Neck Tumors

¹ Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Kyoto University, 54 Shogoinkawaharacho, Sakyo, Kyoto 606-8507, Japan.
² Department of Radiology, Kyoto City Hospital, Kyoto, Japan.
³ Department of Radiology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
⁴ Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

View larger version (157K): [in a new window]   Fig. 1A. —Postcontrast fat-saturated axial images of 75-year-old man with nasopharyngeal cancer. Volumetric interpolated breath-hold examination image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spin-echo T1-weighted image (502/17.0) (B) of nasopharynx show tumor involving both sides of nasopharynx (arrows). Both images were scored as excellent quality with minimum degradation by artifacts. Tumor is well delineated on both; these images were scored as 5 for all items.

View larger version (138K): [in a new window]   Fig. 1B. —Postcontrast fat-saturated axial images of 75-year-old man with nasopharyngeal cancer. Volumetric interpolated breath-hold examination image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spin-echo T1-weighted image (502/17.0) (B) of nasopharynx show tumor involving both sides of nasopharynx (arrows). Both images were scored as excellent quality with minimum degradation by artifacts. Tumor is well delineated on both; these images were scored as 5 for all items.

View larger version (139K): [in a new window]   Fig. 2A. —Postcontrast fat-saturated axial images of 78-year-old man with hypopharyngeal cancer. Volumetric interpolated breath-hold examination image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spin-echo T1-weighted image (497/17.0) (B) of hypopharynx show tumor located at left pyriform sinus (arrows). Both images were scored as excellent quality with minimum degradation by artifacts. Extension of tumor is well delineated in both; these images were scored as 5 for all items.

View larger version (149K): [in a new window]   Fig. 2B. —Postcontrast fat-saturated axial images of 78-year-old man with hypopharyngeal cancer. Volumetric interpolated breath-hold examination image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spin-echo T1-weighted image (497/17.0) (B) of hypopharynx show tumor located at left pyriform sinus (arrows). Both images were scored as excellent quality with minimum degradation by artifacts. Extension of tumor is well delineated in both; these images were scored as 5 for all items.

View larger version (152K): [in a new window]   Fig. 3A. —Postcontrast fat-saturated axial images of 74-year-old man with lymphoma. Volumetric interpolated breath-hold examination (VIBE) image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spinecho T1-weighted image (502/17.0) (B) of hypopharynx show tumor involving epiglottic area (arrows). Lesion was relatively unclear on spin-echo T1-weighted image because of motion. In this case, overall image quality and artifact were evaluated as being better on VIBE image than on spin-echo T1-weighted image. Tumor conspicuity is scored superior on VIBE as well. VIBE image was scored as 5, whereas spin-echo T1-weighted image was scored as 4 for all three items.

View larger version (149K): [in a new window]   Fig. 3B. —Postcontrast fat-saturated axial images of 74-year-old man with lymphoma. Volumetric interpolated breath-hold examination (VIBE) image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spinecho T1-weighted image (502/17.0) (B) of hypopharynx show tumor involving epiglottic area (arrows). Lesion was relatively unclear on spin-echo T1-weighted image because of motion. In this case, overall image quality and artifact were evaluated as being better on VIBE image than on spin-echo T1-weighted image. Tumor conspicuity is scored superior on VIBE as well. VIBE image was scored as 5, whereas spin-echo T1-weighted image was scored as 4 for all three items.

View larger version (119K): [in a new window]   Fig. 4A. —Postcontrast fat-saturated axial images of 56-year-old man with hypopharyngeal cancer. Volumetric interpolated breath-hold examination (VIBE) image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spinecho T1-weighted image (497/17.0) (B) of hypopharynx show tumor located at left pyriform sinus (arrows). Lesion is relatively unclear on VIBE image. In this case, overall image quality and tumor conspicuity were evaluated as being better on spin-echo T1-weighted image than on VIBE image. VIBE image was scored as 4, whereas spin-echo T1-weighted image was scored as 5. Artifacts were scored as 4 on both VIBE and spin-echo T1-weighted images.

View larger version (123K): [in a new window]   Fig. 4B. —Postcontrast fat-saturated axial images of 56-year-old man with hypopharyngeal cancer. Volumetric interpolated breath-hold examination (VIBE) image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spinecho T1-weighted image (497/17.0) (B) of hypopharynx show tumor located at left pyriform sinus (arrows). Lesion is relatively unclear on VIBE image. In this case, overall image quality and tumor conspicuity were evaluated as being better on spin-echo T1-weighted image than on VIBE image. VIBE image was scored as 4, whereas spin-echo T1-weighted image was scored as 5. Artifacts were scored as 4 on both VIBE and spin-echo T1-weighted images.

View larger version (162K): [in a new window]   Fig. 5A. —Postcontrast fat-saturated axial images of 72-year-old man with hypopharyngeal cancer. Volumetric interpolated breath-hold examination (VIBE) image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spinecho T1-weighted image (497/17.0) (B) of upper part of hypopharynx show tumor located at right aryepiglottic fold to pyriform sinus (arrows). Spin-echo T1-weighted image is deteriorated because of flow-related artifact. Artifact from right internal jugular vein (arrowheads, B) mimics enhanced lesions on spin-echo T1-weighted image. In this case, overall image quality and artifacts were evaluated as being better on VIBE image than on spin-echo T1-weighted image, whereas tumor conspicuity was evaluated as being the same on both images. Overall image quality, artifacts, and tumor conspicuity were scored as 5, 4, and 5, respectively, on VIBE image and as 4, 3, and 5 on spin-echo T1-weighted image.

View larger version (159K): [in a new window]   Fig. 5B. —Postcontrast fat-saturated axial images of 72-year-old man with hypopharyngeal cancer. Volumetric interpolated breath-hold examination (VIBE) image (TR/TE, 4.3/2.0; flip angle, 15°) (A) and spinecho T1-weighted image (497/17.0) (B) of upper part of hypopharynx show tumor located at right aryepiglottic fold to pyriform sinus (arrows). Spin-echo T1-weighted image is deteriorated because of flow-related artifact. Artifact from right internal jugular vein (arrowheads, B) mimics enhanced lesions on spin-echo T1-weighted image. In this case, overall image quality and artifacts were evaluated as being better on VIBE image than on spin-echo T1-weighted image, whereas tumor conspicuity was evaluated as being the same on both images. Overall image quality, artifacts, and tumor conspicuity were scored as 5, 4, and 5, respectively, on VIBE image and as 4, 3, and 5 on spin-echo T1-weighted image.

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