Pediatric Brain Optional Add-On 1.5T
Siemens Healthineers – MR Gadopiclenol (VUEWAY®) Protocols
Instructions And Patient Preparation
- Instructions
- Optional sequences added to the brain core based on clinical indication.
- Position
- Head first supine
- Coil
- Head 20 or Head 64
- Patient Preparation
- Landmark per department pediatric protocol — pending sign-off.
- Add-On Sequence Indications and Coverage
- • Optic Pathway Glioma — COR T2 TSE W/ FAT SAT: Cover mid globe through floor of 4th ventricle.
• Craniopharyngioma — COR CISS (SELLA): Cover back of globe to mid thalamus.
• Embryonal Tumor — Replace TRAN T2 FLAIR FS with TRAN T2 FLAIR FS 2.5 (only difference between the sequences is slice thickness).
• Scalp or Osseous Calvarial Lesion — COR STIR covering all soft tissue from tip of nose through posterior scalp.
• IAC — TRAN CISS IAC (ISO). MPR images into Coronal and Sagittal planes. This is a very long isotropic sequence. If a radiologist is available to check the images, coverage can be narrowed down. If no radiologist available, coverage is as follows: Superior — Above midbrain; Inferior — Lower border of C2; Anterior — Mid orbit; Posterior — Soft tissue of occipital scalp; Left to Right — Skin to skin.
• High Grade Glioma — TRAN DSC WHOLE BRAIN: see Contrast Agent Parameters above for injection timing.
Contrast Agent Parameters
| Contrast Agent | Dose | Injection Rate | Dose Timing Method and Scan Delay | |||||
|---|---|---|---|---|---|---|---|---|
| Gadopiclenol (VUEWAY) | 0.05 mmol/kg | DSC: power injected at 4 mL/s | DSC perfusion (TRAN DSC WHOLE BRAIN) — injected during the 15th dynamic; acquired for 60 dynamics | |||||
| Comments | • Among these optional sequences, contrast affects only the DSC perfusion and the TRAN T2 FLAIR FS; the other add-ons may be acquired at any time or as clinically indicated. CISS is typically performed pre-contrast. • Use minimal dose for patients with a GFR <60 mL/sec • Report agent administered and dose |
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Imaging Parameters
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT | COR CISS (sella) | TRAN T2 FLAIR FS 2.5 | COR STIR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| View Image | View Image | View Image | View Image | View Image | View Image | |
| Clinical Indication | High Grade Glioma | Optic Pathway Glioma | Craniopharyngioma | Embryonal Tumor | Scalp or Osseous Calvarial Lesion | IAC |
| Sequence Name | epfid | tse | ci | tir | tir | ci |
| Mode | Interleaved | Interleaved | Sequential | Interleaved | Interleaved | Sequential |
| PAT Mode | GRAPPA | None | ― | None | None | ― |
| Dimension | ― | 2D | 3D | 2D | 2D | 3D |
| Acceleration Factor PE | 2 | ― | ― | ― | ― | ― |
| Acceleration Factor 3D | ― | ― | ― | ― | ― | ― |
Scan Parameters
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT | COR CISS (sella) | TRAN T2 FLAIR FS 2.5 | COR STIR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| TR | 2680.0 ms | 7680.0 ms | 5.99 ms | 10000.0 ms | 4000.0 ms | 7.57 ms |
| TE | 25.00 ms | 96.00 ms | 2.61 ms | 86.00 ms | 38.00 ms | 3.48 ms |
| TI | ― | ― | ― | 2600 ms | 160 ms | ― |
| Flip Angle | 30 deg | 150 deg / 90 deg | 70 deg | 150 deg / 90 deg | 150 deg / 90 deg | 50 deg |
| Turbo Factor | ― | 16 | ― | 17 | 8 | ― |
| Bandwidth | 1516 Hz/Px | 191 Hz/Px | 399 Hz/Px | 179 Hz/Px | 159 Hz/Px | 399 Hz/Px |
| EPI Factor | 110 | ― | ― | ― | ― | ― |
| Fat Saturation Mode | ― | Strong | ― | Strong | ― | ― |
| Fat Suppression | Fat Saturation | Fat Saturation | Standard | Fat Saturation | Standard | Standard |
| Gradient Mode | Fast | Normal | Fast | Normal | Normal | Fast |
| RF Pulse Type | Normal | Normal | Normal | Normal | Low SAR | Low SAR |
| Asymmetric Echo | ― | ― | Allowed | ― | ― | Allowed |
Acquisition Parameters
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT | COR CISS (sella) | TRAN T2 FLAIR FS 2.5 | COR STIR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| Base Resolution | 110 | 256 | 256 | 256 | 320 | 256 |
| Phase Resolution | 100 % | 80 % | 100 % | 70 % | 80 % | 100 % |
| Slice Resolution | ― | ― | 100 % | ― | ― | 100 % |
| Averages | 1 | 3 | 1 | 1 | 1 | 1 |
| Concatenations | 1 | 1 | ― | 2 | 2 | ― |
| b-value | ― | ― | ― | ― | ― | ― |
| FoV Read | 220 mm | 120 mm | 120 mm | 210 mm | 210 mm | 220 mm |
| FoV Phase | 100.0 % | 100.0 % | 100.0 % | 100.0 % | 93.8 % | 96.9 % |
| Phase Encoding Dir. | A >> P | R >> L | R >> L | R >> L | R >> L | R >> L |
| Phase Oversampling | 0% | 30 % | 30 % | 0% | 0% | 0% |
| Slice Oversampling | ― | ― | 55.6 % | ― | ― | 66.7 % |
| Phase Partial Fourier | 7/8 | Off | Off | Off | Off | Off |
| Slice Partial Fourier | ― | ― | Off | ― | ― | Off |
| Flow Compensation | ― | None | None | None | None | None |
Scanning Range
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT | COR CISS (sella) | TRAN T2 FLAIR FS 2.5 | COR STIR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| Elliptical Filter | On | On | On | On | Off | On |
| Normalize | Prescan | Prescan | Prescan | Prescan | Prescan | Prescan |
| Distortion Correction | Off | 2D | 2D | 2D | 2D | 2D |
| Slice Thickness | 4.0 mm | 3.0 mm | 1.00 mm | 2.5 mm | 4.0 mm | 0.90 mm |
| Distance Factor | 0% | 0% | 0% | 0% | 0% | 0% |
| Slices | 41 | 39 | 72 | 59 | 49 | 96 |
| Acquisition Time | 3:29 min | 6:49 min | 5:52 min | 4:02 min | 4:10 min | 7:53 min |