MRI of Soft-Tissue Tumors: Fast STIR Sequence as Substitute for T1-Weighted Fat-Suppressed Contrast-Enhanced Spin-Echo Sequence

OBJECTIVE. The purpose of this study was to assess the value of the fast STIR sequence in comparison with the T1-weighted fat-suppressed contrast-enhanced sequence in the evaluation of soft-tissue tumors. MATERIALS AND METHODS. Sixty-seven soft-tissue tumors imaged with both STIR and T1-weighted fat-suppressed contrast-enhanced sequences were evaluated. The signal-to-noise and contrast-to-noise ratios of the tumors in comparison with normal muscle, bone marrow, and fat were measured. Subjective image contrast between soft-tissue tumors and the nearest normal tissue was evaluated by two observers. The observers classified the soft-tissue tumors as benign or malignant using a 5-point scale, and sensitivity, specificity, and accuracy were calculated. The results of the two readings were assessed with receiver operating characteristic analysis. RESULTS. The contrast-to-noise ratios of all tumors in comparison with muscle (p < 0.01), bone marrow (p < 0.05), and fat (p < 0.05) were significantly higher on the fast STIR images than on the T1-weighted fat-suppressed contrast-enhanced images. Both observers' mean ratings of benign, malignant, and all tumors in comparison with muscle on fast STIR images were significantly higher than those on T1-weighted fat-suppressed contrast-enhanced images. For both observers, the mean sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve in evaluation of the fast STIR images did not differ significantly from those in evaluation of the T1-weighted fat-suppressed contrast-enhanced images. CONCLUSION. The fast STIR sequence is excellent for evaluation of soft-tissue tumors, and contrast-enhancement is not always needed.