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Table 3: Standard protocol for brain tumor imaging based on expert panel discussion following the framework of the ACRIN 6686 component of the RTOG 0825 protocol⁷³
Standardized MR imaging protocol
    3-Plane localizer/scout (in order of acquisition)
    T1-weighted precontrast (spin-echo)
    T2-weighted axial
    FLAIR (optional to perform after contrast)
    T1 map (quantitation) for DCE MR imaging—3D gradient-echo T1 or 2D TSE/FSE T1^{^a}
    DWI and/or DTI (can extract DWI data trace/ADC from DTI)^{^a}
    T2* DSC MR imaging (after presaturation DCE MR imaging sequence)^{^a}
    T1-weighted postcontrast (spin-echo)
    Functional language, auditory, visual, motor testing, and MRS^{^a}
    Can do FLAIR before DSC MR imaging
    SWI, gradient-echo, additional optional sequences^{^a}
General parameter recommendations
    Section thickness not greater than 5 mm
    Delay is recommended, which can be built in by performing DWI and/or DTI before acquiring T1 sequences. Another option is to perform FLAIR (or even T2) before T1 sequences, which may give additional sensitivity for leptomeningeal disease⁷⁴
    Target duration ≤30 minutes (maximum, 1.5–2.0 hr)

Note:—ACRIN indicates American College of Radiology Imaging Network; SWI, susceptibility-weighted imaging; RTOG = Radiation Therapy Oncology Group.


↵a Part of the ACRIN 6686 protocol but can be used as an adjunct in the clinical brain tumor protocol.