TY - JOUR
T1 - Consensus recommendations for a dynamic susceptibility contrast MRI protocol for use in high-grade gliomas
AU - Boxerman, JL
AU - Quarles, CC
AU - Hu, LS
AU - Erickson, BJ
AU - Gerstner, ER
AU - Smits, Marion
AU - Kaufmann, TJ
AU - Barboriak, DP
AU - Huang, RH
AU - Wick, W
AU - Weller, M
AU - Galanis, E
AU - Kalpathy-Cramer, J
AU - Shankar, L
AU - Jacobs, P
AU - Chung, C
AU - van den Bent, Martin
AU - Chang, Simeng
AU - Al Yung, WK
AU - Cloughesy, TF
AU - Wen, PY
AU - Gilbert, MR
AU - Rosen, BR
AU - Ellingson, BM
AU - Schmainda, KM
PY - 2020/9
Y1 - 2020/9
N2 - 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.
AB - 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.
U2 - 10.1093/neuonc/noaa141
DO - 10.1093/neuonc/noaa141
M3 - Article
C2 - 32516388
SN - 1522-8517
VL - 22
SP - 1262
EP - 1275
JO - Neuro-Oncology
JF - Neuro-Oncology
IS - 9
ER -