Consensus recommendations for a dynamic susceptibility contrast MRI protocol for use in high-grade gliomas.

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Boxerman, JL; Quarles, CC; Hu, LS; Erickson, BJ; Gerstner, ER; Smits, M; Kaufmann, TJ; Barboriak, DP; Huang, RH; Wick, W; Weller, M; Galanis, E; Kalpathy-Cramer, J; Shankar, L; Jacobs, P; Chung, C; van den Bent, MJ; Chang, S; Al Yung, WK; Cloughesy, TF; Wen, PY; Gilbert, MR; Rosen, BR; Ellingson, BM; Schmainda, KM; Jumpstarting Brain Tumor Drug Development Coalition Imaging Standardization Steering Committee,

Published Date

  • September 29, 2020

Published In

Volume / Issue

  • 22 / 9

Start / End Page

  • 1262 - 1275

PubMed ID

  • 32516388

Pubmed Central ID

  • 32516388

Electronic International Standard Serial Number (EISSN)

  • 1523-5866

Digital Object Identifier (DOI)

  • 10.1093/neuonc/noaa141

Language

  • eng

Conference Location

  • England