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Consensus Recommendations for a Dynamic Susceptibility Contrast MRI Protocol for Use in High-Grade Gliomas.
Neuro-Oncology ( IF 16.4 ) Pub Date : 2020-06-09 , DOI: 10.1093/neuonc/noaa141
Jerrold L Boxerman 1, 2, 3, 4 , Chad C Quarles 5 , Leland S Hu 3, 6, 7 , Bradley J Erickson 3, 7, 8, 9 , Elizabeth R Gerstner 10, 11 , Marion Smits 12, 13 , Timothy J Kaufmann 7, 8 , Daniel P Barboriak 2, 3, 9, 14 , Raymond H Huang 15, 16 , Wolfgang Wick 13, 17 , Michael Weller 13, 18 , Evanthia Galanis 7, 19 , Jayashree Kalpathy-Cramer 20 , Lalitha Shankar 21 , Paula Jacobs 21 , Caroline Chung 7, 22 , Martin J van den Bent 13, 23 , Susan Chang 24 , W K Al Yung 25 , Timothy F Cloughesy 26, 27 , Patrick Y Wen 11, 16 , Mark R Gilbert 28, 29 , Bruce R Rosen 20 , Benjamin M Ellingson 2, 3, 9, 11, 26, 30, 31 , Kathleen M Schmainda 2, 32 ,
Affiliation  

Despite the widespread clinical use of dynamic susceptibility contrast (DSC) MRI, DSC-MRI methodology has not been standardized, hindering its utilization for response assessment in multicenter trials. Recently, the DSC-MRI Standardization Subcommittee of the Jumpstarting Brain Tumor Drug Development Coalition issued an updated consensus DSC-MRI protocol compatible with the standardized brain tumor imaging protocol (BTIP) for high-grade gliomas that is increasingly used in the clinical setting and is the default MRI protocol for the National Clinical Trials Network. After reviewing the basis for controversy over DSC-MRI protocols, this paper provides evidence-based best practices for clinical DSC-MRI as determined by the Committee, including pulse sequence (gradient echo vs spin echo), BTIP-compliant contrast agent dosing (preload and bolus), flip angle (FA), echo time (TE), and post-processing leakage correction. In summary, full-dose preload, full-dose bolus dosing using intermediate (60°) FA and field strength-dependent TE (40–50 ms at 1.5 T, 20–35 ms at 3 T) provides overall best accuracy and precision for cerebral blood volume estimates. When single-dose contrast agent usage is desired, no-preload, full-dose bolus dosing using low FA (30°) and field strength-dependent TE provides excellent performance, with reduced contrast agent usage and elimination of potential systematic errors introduced by variations in preload dose and incubation time.

中文翻译:


用于高级别胶质瘤的动态磁敏感对比 MRI 协议的共识建议。



尽管动态磁敏感对比 (DSC) MRI 广泛应用于临床,但 DSC-MRI 方法尚未标准化,阻碍了其在多中心试验中用于疗效评估。最近,快速启动脑肿瘤药物开发联盟的 DSC-MRI 标准化小组委员会发布了更新的 DSC-MRI 共识协议,该协议与高级别神经胶质瘤的标准化脑肿瘤成像协议 (BTIP) 兼容,该协议越来越多地在临床环境中使用,并且国家临床试验网络的默认 MRI 协议。在回顾了 DSC-MRI 协议争议的基础后,本文提供了委员会确定的临床 DSC-MRI 循证最佳实践,包括脉冲序列(梯度回波与旋转回波)、符合 BTIP 的造影剂剂量(预载)和推注)、翻转角 (FA)、回波时间 (TE) 和后处理泄漏校正。总之,使用中间 (60°) FA 和场强相关 TE(1.5 T 时 40–50 ms,3 T 时 20–35 ms)的全剂量预载、全剂量推注给药为脑血容量估计。当需要使用单剂量造影剂时,使用低 FA (30°) 和场强相关 TE 的无预载、全剂量推注给药可提供出色的性能,同时减少造影剂的使用并消除由变化引入的潜在系统误差预载剂量和孵育时间。
更新日期:2020-06-09
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