MR Brain Tumor WWO + Spectroscopy Neuro Protocol

Scan Notes

  • Rad to assist with placing Spectroscopy voxels whenever possible.

Note for scanners MR3 and MR4 with compressed sense and 3D imaging:
3D imaging and compressed sense are much more susceptible to motion. If you have a patient that is unable to hold still for an exam after trying all of our other interventions (padding, medication, etc.), then you will need to revert to the old 2D protocols for optimal imaging results.

Last updated: 10/16/2020
Charge as: Brain WWO
Scanner preference: MR3, MR4, DMR2, BEAVERTON. MR2 if patient has implant not safe for 3T.
Coil: Head

Plane Weighting Mode SL/G CS FS FOV MPR Notes
AXIAL DWI SE EPI 3mm/0.3mm - SPIR 23cm - Angle to Corpus- Skull Base to Vertex
AXIAL T1 3D - MR3 and MR4 - 23cm YES NO ANGLE. Cover at least 1cm above vertex through skull base. Cover entire nose.
AX Label as T1 ax. Angle to corpus. 1 skip 0.
SAG Label as T1 sag. Angle to midline. 2 skip 0. Cover ears.
COR Label as T1 cor. Angle to corpus. 2 skip 0. Cover nose.
AXIAL T2 3D - - - 23cm - NO ANGLE. Cover at least 1cm above vertex through skull base. Cover entire nose.
AX Label as T2 ax. Angle to corpus. 1 skip 0.
SAG Label as T2 sag. Angle to midline. 2 skip 0. Cover ears.
COR Label as T2 cor. Angle to corpus. 2 skip 0. Cover nose.
AXIAL SWI 2D 2mm/-1mm MR3 and MR4 - 20cm - Angle to Corpus. Cover skull base to vertex. Ok to add slices. Run Ven Bold on MR1 and MR2 instead of this sequence.
POWER INJECT CONTRAST
+DSC Cover tumor. Do not add slices. Injection Rate: 4-5mL/sec. Start injection 8-10 seconds after beginning the sequence. For peds patients with smaller IVs, consult with Rad and peds RN or Anesthesiologist to determine a safe injection rate.
+SAG FLAIR 3D - MR3 and MR4 - 23cm YES NO ANGLE. Cover ears.
AX Label as +FLAIR ax. Angle to corpus. 1 skip 0.
SAG Label as +FLAIR sag. Angle to midline. 2 skip 0. Cover ears.
COR Label as +FLAIR cor. Angle to corpus. 2 skip 0. Cover nose.
+AXIAL T1 3D - MR3 and MR4 - 23cm YES NO ANGLE. Cover at least 1cm above vertex through skull base. Cover entire nose.
AX Label as +T1 ax. Angle to corpus. 1 skip 0.
SAG Label as +T1 sag. Angle to midline. 2 skip 0. Cover ears.
COR Label as +T1 cor. Angle to corpus. 2 skip 0. Cover nose.
+SAG T1 fs 3D - MR3 and MR4 YES 23cm YES NO ANGLE. Cover ears.
AX Label as +T1 FS ax. Angle to corpus. 1 skip 0.
SAG Label as +T1 FS sag. Angle to midline. 2 skip 0. Cover ears.
COR Label as +T1 FS cor. Angle to corpus. 2 skip 0. Cover nose.
Single Voxel Spectroscopy Rad to place. 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 Center on contralateral side in same general location as mass. Avoid bone.