Standard protocol for brain tumor imaging based on expert panel discussion following the framework of the ACRIN 6686 component of the RTOG 0825 protocol73
| Standardized MR imaging protocol |
| 3-Plane localizer/scout (in order of acquisition) |
| T1-weighted precontrast (spin-echo) |
| T2-weighted axial |
| FLAIR (optional to perform after contrast) |
| T1 map (quantitation) for DCE MR imaging—3D gradient-echo T1 or 2D TSE/FSE T1a |
| DWI and/or DTI (can extract DWI data trace/ADC from DTI)a |
| T2* DSC MR imaging (after presaturation DCE MR imaging sequence)a |
| T1-weighted postcontrast (spin-echo) |
| Functional language, auditory, visual, motor testing, and MRSa |
| Can do FLAIR before DSC MR imaging |
| SWI, gradient-echo, additional optional sequencesa |
| General parameter recommendations |
| Section thickness not greater than 5 mm |
| Delay is recommended, which can be built in by performing DWI and/or DTI before acquiring T1 sequences. Another option is to perform FLAIR (or even T2) before T1 sequences, which may give additional sensitivity for leptomeningeal disease74 |
| Target duration ≤30 minutes (maximum, 1.5–2.0 hr) |
Note:—ACRIN indicates American College of Radiology Imaging Network; SWI, susceptibility-weighted imaging; RTOG = Radiation Therapy Oncology Group.
↵a Part of the ACRIN 6686 protocol but can be used as an adjunct in the clinical brain tumor protocol.