Peritumoral edema -> FLAIR

Enhancing tumor -> T1 CE

Presumably non enhancing tumor core would also come from T1 Contrast enhanced.

I'd gently suggest you get the help of a radiologist.

Yueh Z Lee Thank you so much, Professor Lee. Could you please tell me if there is any difference between T1_CE and T1_GD modalities? Also, what is the justification for using FLAIR in Peritumoral edema and T1_CE for GD-Enhancing tumor?

Not sure exactly what the difference is in T1 contrast enhanced vs. T1 gadolinium - they should be the same.

As for justification, I'd strongly suggest you just pick up a basic neuroradiology textbook, but here is a website to start you off:

https://case.edu/med/neurology/NR/MRI%20Basics.htm

T1 non contrast should be looked at first. It will give you a gross approach to the characteristic of the Tumor. If the tumor takes up contrast in T1 weighted it will show enhancement in gadolinium uptake. Then T2 weighted image should be seen to differentiate the appearance and Tumor heterogeneity. It will give you an idea of Tumor consistency, whether it is solid, cystic fluid filled or mixed. Best modality would be a MRI followed with MRS which gives one an idea about different peaks of choline, NAA, lactate and inositol peaks and their ratios via radiofrequency spatial pulses which gives more tissue interrogation and grading information. For example, a high grade glioma will show choline, lipid and lactate increase and NAA and creatine decrease.

Ischemia would switch brain to anaerobic metabolism showing lipid peak. In infection, due to disturbance of brain tissue a lactate, cytosolic acid, alanine and acetate peak would appear. FLAIR images helps to see the extent of perilesional edema and surrounding mass effect. All this added on with clinical findings will help you with your line of management. A holistic picture of the patient and clinical scenario of presentation should never be missed and these diagnostic modalities help to differentiate your clinical diagnosis but can never replace it. I hope this helps

The choice of MRI modality for the detection of brain tumors depends on the specific characteristics of the tumor and the clinical question being addressed. MRI is a versatile imaging modality that offers different sequences, each providing unique information about the brain and its pathologies. In the context of brain tumor detection, the following MRI sequences are commonly used:

In clinical practice, a combination of these MRI sequences is often used to improve the accuracy of brain tumor detection and characterization. The initial evaluation usually includes T1W, T2W, and FLAIR sequences, which provide essential information about the tumor's location and extent. The addition of contrast-enhanced T1-weighted imaging (T1-Gd) can enhance the visibility of tumors and provide additional information about tumor vascularity.