MR Adult Brain Tumor Follow Up W/WO plus DCE/DSC Perfusion & Spectroscopy (aka The Big Enchilada)

Revised - 5/30/2012
Charge as Brain W/WO and Spectroscopy
Head Coil 1.5T or 3T
Localizer
(REF scan)
Mode Slice Gap FAT SAT FOV Scan Range
SAG T1 TSE 4mm 1mm None 23cm Scalp to Scalp
AXIAL T2 TSE 4mm 1mm None 23cm Angle to Corpus- Skull Base to Vertex
AXIAL T1 TSE 4mm 1mm None 23cm Angle to Corpus- Skull Base to Vertex
AXIAL T2* GRE GRE 4mm 1mm None 23cm Angle to Corpus- Skull Base to Vertex
AXIAL DWI 2mm Voxel SE EPI 3mm 0.3mm SPIR 23cm Angle to Corpus- Skull Base to Vertex
CONTRAST INJECTION
  1. PATIENT NEEDS A 20G OR BIGGER PERIPHERAL IV
  2. Prep Power injector to split contrast injection for 2 injections:
    • 1st Scan would be the DCE: Use 1/3 of the total contrast amount for th DCE sequence
    • 2nd Scan would be the DSC: Use 2/3 of the total contrast amount for the DSC sequence
  3. 15 ml Saline Chaser after DCE and DSC
DCE
(Dynamic Contrast Enhanced Perfusion)
Localizer
(REF scan)
Mode # of Dynamics FAT SAT FOV Coverage
AX 3D T1 FFE TSE 80 None 22cm Center through lesion of interest. Do not add slices!
Notes:
  • Exam is set up with a manual start
  • Start injection @ 4-5 ml/second AT THE SAME TIME YOU BEGIN Dynamic 8
  • 15ml Saline chaser
DSC
(Dynamic Susceptibility Contrast Perfusion)
Localizer
(REF scan)
Mode # of Dynamics FAT SAT FOV Coverage
AX 3D T1 FFE   EPI 60   None 20cm                                                                              
Notes:
  • Scan for 8-10 Seconds then begin contrast injection @ 5ml/s
  • 15ml Saline chaser
Localizer
(REF scan)
Mode Slice Gap FAT SAT FOV Scan Range
COR FLAIR TSE 4mm 1mm None 23cm Frontal through Occipital Bone
AXIAL T1 TSE 4mm 1mm None 23cm Angle to Corpus- Skull Base to Vertex               
COR T1 FAT SAT TSE 4mm 1mm SPIR 23cm Frontal through Occipital Bone
SAG T1 TSE 4mm 1mm None 23cm Optional if lesion seen: Scalp to Scalp
Spectroscopy
Single Voxel Spectroscopy 1cm3 Center on lesion.  Avoid bone with placement in all 3 planes. Don't see a mass, call radiologist. multiple masses. Pick biggest one remote from bone/fat/blood. If mass has rim enhancement, include some of rim that enhance in voxel.
Single Voxel Spectroscopy 1cm3 Center on contralateral side in same general location as mass. Avoid bone.
PERFUSION POST PROCESSING
You Must perform the post processing for the perfusion.
Follow these instructions to complete the processing.