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

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 Developmen...

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Main Authors: Boxerman, Jerrold L (Author) , Quarles, Chad C (Author) , Hu, Leland S (Author) , Erickson, Bradley J (Author) , Gerstner, Elizabeth R (Author) , Smits, Marion (Author) , Kaufmann, Timothy J (Author) , Barboriak, Daniel P (Author) , Huang, Raymond H (Author) , Wick, Wolfgang (Author) , Weller, Michael (Author) , Galanis, Evanthia (Author) , Kalpathy-Cramer, Jayashree (Author) , Shankar, Lalitha (Author) , Jacobs, Paula (Author) , Chung, Caroline (Author) , van den Bent, Martin J (Author) , Chang, Susan (Author) , Al Yung, W K (Author) , Cloughesy, Timothy F (Author) , Wen, Patrick Y (Author) , Gilbert, Mark R (Author) , Rosen, Bruce R (Author) , Ellingson, Benjamin M (Author) , Schmainda, Kathleen M (Author)
Format: Article (Journal)
Language:English
Published: 09 June 2020
In: Neuro-Oncology
Year: 2020, Volume: 22, Issue: 9, Pages: 1262-1275
ISSN:1523-5866
DOI:10.1093/neuonc/noaa141
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/neuonc/noaa141
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Author Notes:Jerrold L Boxerman, Chad C Quarles, Leland S Hu, Bradley J Erickson, Elizabeth R Gerstner, Marion Smits, Timothy J Kaufmann, Daniel P Barboriak, Raymond H Huang, Wolfgang Wick, Michael Weller, Evanthia Galanis, Jayashree Kalpathy-Cramer, Lalitha Shankar, Paula Jacobs, Caroline Chung, Martin J van den Bent, Susan Chang, W K Al Yung, Timothy F Cloughesy, Patrick Y Wen, Mark R Gilbert, Bruce R Rosen, Benjamin M Ellingson, and Kathleen M Schmainda, and Jumpstarting Brain Tumor Drug Development Coalition Imaging Standardization Steering Committee
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Summary: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.
Item Description:Gesehen am 01.03.2021
Physical Description:Online Resource
ISSN:1523-5866
DOI:10.1093/neuonc/noaa141

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