Table 1.
Overview of our institutional imaging workup for common intracranial lesions: magnetic resonance imaging (MRI) protocol for patients with intracranial tumors include T1 spin echo and T2 turbo spin echo sequences with 1 mm and isotropic 3D sequences (1 mm) including T1 w/gadolinium contrast (3D multiplane reformation, MPR), T2 (3D sampling perfection with application optimized contrast using different flip angle evolution, SPACE), 3D fluid attenuation inversion recovery, FLAIR, and constructive interference in steady-state (CISS MRI).
| Suspected diagnosis | Low grade glioma | High grade glioma/metastasis | Vascular lesions (aneurysms/AVM) | Skull base tumor |
|---|---|---|---|---|
| MRI | SE T1 w/o CM, SE T2, 3D MPR w/contrast, 3D T2, 3D FLAIR | SE T1 w/o CM, T2, 3D MPR w/contrast, 3D T2, 3D FLAIR | SE T1 w/o CM, SE T2, 3D MPR w/contrast, 3D TOF, TWIST | SE T1 w/o CM, SE T2, 3D MPR w/contrast, 3D TOF, T2* CISS |
| CT thin-sliced skull base (1 mm) | *✓ | ✓ | ✓ | |
| FET-PET | ✓ | *✓ | ||
| fMRI, rsfMRI | ✓ | ✓ | *✓ | |
| DTI | ✓ | ✓ | *✓ | |
| CFD simulation | *✓ |
mandatory,
optional.
3D time-of-flight (TOF) and time-resolved angiography with interleaved stochastic trajectories (TWIST) sequences are obtained in vascularized tumors. Positron emission tomography (PET) with O-(2-[18F]fluoroethyl)-L-tyrosine ([18F]FET) (FET-PET) is used for non-contrast enhancing and recurrent contrast-enhancing gliomas. Functional MRI (fMRI) and resting state (rs) fMRI are conducted for visualizing functional areas.