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Two blinded readers independently assessed enhancing lesions per sequence. A consensus review, incorporating longitudinal imaging and additional sequences, served as the reference standard.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The consensus identified 70 enhancing lesions in 31 patients. All 70 were visible on 3DT1TSE, while 64 (91%) were detectable on 3DT1TFE. Reader sensitivity was higher for 3DT1TSE (84% and 90%) than 3DT1TFE (45% and 40%) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Inter-reader agreement was excellent for 3DT1TSE (ICC\u2009=\u20090.90) and moderate for 3DT1TFE (intraclass correlation coefficient\u2009=\u20090.69). Although false positives were more common with 3DT1TSE, they were readily excluded during consensus reading. In six patients, enhancing lesions were detected only on 3DT1TSE, with treatment escalation in two.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>3DT1TSE outperformed 3DT1TFE in sensitivity and reader agreement for enhancing lesion detection in MS. Incorporating 3DT1TSE into standard MRI protocols may improve disease activity assessment and clinical decision-making.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Critical relevance statement<\/jats:title>\n            <jats:p>Replacing 3D gradient-echo with post-contrast 3D T1 turbo spin-echo brain MRI greatly improves the detection of gadolinium-enhancing multiple-sclerosis lesions, boosting diagnostic sensitivity and reader agreement and directly influencing treatment-escalation decisions in routine practice.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Key Points<\/jats:title>\n            <jats:p>\n              <jats:list list-type=\"bullet\">\n                <jats:list-item>\n                  <jats:p>Detecting and enhancing MS lesions is limited by standard 3D T1 turbo field echo (3DT1TFE) MRI.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>3D T1 turbo spin echo detects significantly more gadolinium-enhancing MS lesions than conventional 3DT1TFE.<\/jats:p>\n                <\/jats:list-item>\n                <jats:list-item>\n                  <jats:p>Greater lesion detection allows more precise activity assessment and optimal treatment management.<\/jats:p>\n                <\/jats:list-item>\n              <\/jats:list>\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s13244-025-02093-4","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T15:04:18Z","timestamp":1759503858000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["3D T1 turbo spin echo improves detection of gadolinium-enhancing multiple-sclerosis 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S.M.Y. and A.M.Y. report that their institution (Hospital Universitari de Bellvitge\/IDIBELL) has received research-dedicated support during the past 3 years from Almirall, Bayer, Biogen, Bristol Myers Squibb, Celgene, Genzyme, Horizon\/Amgen, Janssen, Kern Pharma, Lilly, Merck, Neuraxpharm, Novartis, Roche, Sandoz and Sanofi, and that they have received congress-travel support from Biogen, Bristol Myers Squibb, Janssen, Merck, Novartis, Roche and Sandoz. All remaining authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"212"}}