MR imaging of uterine cervical carcinoma: comparison between fast spin-echo MRI and GRASE

Abstract.

The aim of our study was to compare the image quality of T2-weighted gradient-echo-and-spin-echo (GRASE) MRI and fast spin-echo (FSE) MRI for imaging of cervical carcinoma. In 40 patients FSE₈ (TR/TE = 3400/90 ms) MRI with echo train length (ETL) of 8, GRASE (3400/90) MRI with ETL of 18, turbo factor of 6 and 3 gradient reversals, and FSE₁₈ (2500/120) MRI with ETL of 18 were performed. Tissue contrast, subjectively rated image quality, and accuracy of tumor delineation were compared. Surgical correlation was obtained in 27 subjects. Contrast-to-noise ratios of the tumor–cervix stroma, tumor–parametrium and tumor–rectum wall interfaces were better in FSE₁₈ than in FSE₈ and GRASE (P < 0.001) but not different between FSE₈ and GRASE. Subjective image quality was better in FSE₁₈ and FSE₈ than in GRASE (P < 0.02). The accuracy of tumor delineation was similar for the three different sequences. The accuracy of FSE and GRASE MRI for the delineation of cervical carcinoma is similar. Based on measurement of image quality and CNRs, however, high turbo factor FSE provides better image quality in MRI of cervical carcinoma.Whether the superior characteristics may result in better staging has to be explored in larger clinical trials.