Skip to main content
eScholarship
Open Access Publications from the University of California

Consensus Recommendations for a Dynamic Susceptibility Contrast MRI Protocol for Use in High-Grade Gliomas.

  • Author(s): Boxerman, Jerrold L
  • Quarles, Chad C
  • Hu, Leland S
  • Erickson, Bradley J
  • Gerstner, Elizabeth R
  • Smits, Marion
  • Kaufmann, Timothy J
  • Barboriak, Daniel P
  • Huang, Raymond H
  • Wick, Wolfgang
  • Weller, Michael
  • Galanis, Evanthia
  • Kalpathy-Cramer, Jayashree
  • Shankar, Lalitha
  • Jacobs, Paula
  • Chung, Caroline
  • van den Bent, Martin J
  • Chang, Susan
  • Al Yung, WK
  • Cloughesy, Timothy F
  • Wen, Patrick Y
  • Gilbert, Mark R
  • Rosen, Bruce R
  • Ellingson, Benjamin M
  • Schmainda, Kathleen M
  • Jumpstarting Brain Tumor Drug Development Coalition Imaging Standardization Steering Committee
  • et al.
Abstract

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 multi-center trials. Recently, the DSC-MRI Standardization Subcommittee of the Jumpstarting Brain Tumor Drug Development Coalition issued an updated consensus DSC-MRI protocol compatible with BTIP, the standardized brain tumor imaging protocol 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 manuscript 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 (40-50ms at 1.5T, 20-35ms at 3T) 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.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
Current View