MR Brain Tumor WWO + Spectroscopy Neuro Protocol

Scan Notes

Rad to assist with placing Spectroscopy voxels whenever possible.

Last updated: 4/29/2020
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.
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 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.
COR Label as +FLAIR cor. Angle to corpus. 2 skip 0. Cover nose.
+AXIAL T2 3D - MR3 and MR4 - 23cm YES NO ANGLE. Cover at least 1cm above vertex through skull base. Cover entire nose.
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 T1 3D - MR3 and MR4 - 23cm YES NO ANGLE. Cover at least 1cm above vertex through skull base. Cover entire nose.
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.
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.