Pediatric Brain Optional Add-On 3T
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 DR | COR CISS (SELLA) | TRAN T2 FLAIR FS 2.5 | COR STIR DR | 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_rs | ci | tir | tir | ci |
| Mode | Interleaved | Interleaved | Sequential | Interleaved | Interleaved | Sequential |
| PAT Mode | GRAPPA | GRAPPA | ― | GRAPPA | GRAPPA | ― |
| Dimension | ― | 2D | 3D | 2D | 2D | 3D |
| Acceleration Factor PE | 2 | 2 | ― | 2 | 2 | ― |
| Acceleration Factor 3D | ― | ― | ― | ― | ― | ― |
Scan Parameters
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT DR | COR CISS (SELLA) | TRAN T2 FLAIR FS 2.5 | COR STIR DR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| TR | 2720.0 ms | 5610.0 ms | 6.10 ms | 10000.0 ms | 4500.0 ms | 8.03 ms |
| TE | 25.00 ms | 100.00 ms | 2.64 ms | 107.00 ms | 25.00 ms | 3.69 ms |
| TI | ― | ― | ― | 2600 ms | 200 ms | ― |
| Flip Angle | 30 deg | 140 deg | 50 deg | 130 deg | 180 deg | 50 deg |
| Turbo Factor | ― | 19 | ― | 12 | 7 | ― |
| Bandwidth | 1196 Hz/Px | 250 Hz/Px | 425 Hz/Px | 349 Hz/Px | 130 Hz/Px | 401 Hz/Px |
| EPI Factor | 110 | ― | ― | ― | ― | ― |
| Fat Saturation Mode | ― | Strong | ― | Strong | ― | ― |
| Fat Suppression | Fat Saturation | Fat Saturation | Standard | Fat Saturation | Standard | Standard |
| Gradient Mode | Fast | Fast | Fast | Fast | Fast | Fast |
| RF Pulse Type | Normal | Normal | Normal | Low SAR | Normal | Low SAR |
| Asymmetric Echo | ― | ― | Allowed | ― | ― | Allowed |
Acquisition Parameters
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT DR | COR CISS (SELLA) | TRAN T2 FLAIR FS 2.5 | COR STIR DR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| Base Resolution | 110 | 256 | 256 | 256 | 256 | 192 |
| Phase Resolution | 100 % | 80 % | 96 % | 80 % | 97 % | 100 % |
| Slice Resolution | ― | ― | 100 % | ― | ― | 94 % |
| Averages | 1 | 4 | 1 | 1 | 1 | 1 |
| Concatenations | 1 | 2 | ― | 2 | 2 | ― |
| b-value | ― | ― | ― | ― | ― | ― |
| FoV Read | 220 mm | 120 mm | 120 mm | 210 mm | 210 mm | 130 mm |
| FoV Phase | 100.0 % | 100.0 % | 100.0 % | 93.8 % | 93.8 % | 115.6 % |
| Phase Encoding Dir. | A >> P | R >> L | R >> L | R >> L | R >> L | R >> L |
| Phase Oversampling | 0% | 0% | 30 % | 0% | 0% | 10 % |
| Slice Oversampling | ― | ― | 66.7 % | ― | ― | 60.0 % |
| Phase Partial Fourier | 7/8 | Off | Off | Off | Off | Off |
| Slice Partial Fourier | ― | ― | 7/8 | ― | ― | Off |
| Flow Compensation | ― | Slice | None | None | None | None |
Scanning Range
| Scan Description | TRAN DSC WHOLE BRAIN | COR T2 TSE W FAT SAT DR | COR CISS (SELLA) | TRAN T2 FLAIR FS 2.5 | COR STIR DR | TRAN CISS IAC (ISO) |
|---|---|---|---|---|---|---|
| Elliptical Filter | Off | Off | On | Off | 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 | 0.70 mm |
| Distance Factor | 0% | 0% | 0% | 0% | 0% | 0% |
| Slices | 41 | 37 | 72 | 61 | 57 | 60 |
| Acquisition Time | 3:32 min | 4:58 min | 5:52 min | 3:22 min | 3:02 min | 4:53 min |