FIELD	DETAIL	NOTES/ALLOWED VALUES
Examination Data
Examination date
Clinical indication		Post neoadjuvant treatment
Scanner field strength	1.5T/3T
Sequences (detail visible only if DWI is selected)		FSE T2 weighted in axial plane FSE T2 weighted in sagittal plane FSE T2 weighted in coronal plane FSE T1 weighted in axial plane DWI ADC
	b-value	Numeric [s/mm2]
MDC
MDC (detail visible only if “Yes”)	Yes/No
	Molecule
	Commercial name
	Volume	Numeric [mL]
	Flow rate	Numeric [mL/s]
	Concentration	Numeric [mg I/mL]
	Notes
Premedication for allergy	Yes/No
	Notes
Renal function	Creatinine	Numeric [mg/dL]
	GFR (Glomerular Filtration Rate)	Numeric [mL/min] GFR = 141 × min (serum creatinine/kappa, 1) alpha × max (serum creatinine/kappa, 1) − 1.209 × 0.993Age × Gender × Race https://www.merckmanuals.com/medical-calculators/GFR_CKD_EPI-it.htm, accessed on 21 January 2021
	Preventive hydration	Yes/No
	Notes
ADVERSE EVENTS
Ongoing adverse events (detail visible only if “Yes”)	Yes/No
	Date and event time
	Grade	Mild (Symptoms are generally self-limiting without evidence of progression and should be monitored) Moderate (Symptoms are more pronounced and some can become severe if left untreated) Severe (Symptoms are often life-threatening)
	Timing	Early Late Numeric [min] (optional)
	Type	ALLERGIC/ALLERGIC-LIKE mild Ponfi sparse/itchy Skin edema Mild itching/velvety in the throat Nasal congestion Sneezing Conjunctivitis Runny nose Moderate Widespread wheals/intense itching Diffuse skin erythema Facial edema without dyspnea Feeling of suffocation or hoarseness Shortness of breath/mild bronchospasm without hypoxia Severe Dyspnea Erythema—diffuse mucosal-cutaneous manifestations Laryngeal edema with stridor and/or hypoxia Shortness of breath/bronchospasm Significant hypoxia Anaphylactic shock (severe hypotension and bradi-tachi-arrhythmia) NOT ALLERGIC Mild Slight limited nausea/vomiting Chills/heat/transient redness Headache/dizziness/anxiety/impaired taste Mild increase in blood pressure Self-resolving vaso-vagal reaction Moderate Prolonged nausea/vomiting High blood pressure Isolated chest pain Vaso-vagal reaction Severe Vaso-vagal reaction resistant to treatment Arrhythmia Seizures Marked arterial hypertension
	Treatment type	Observation Drug administration + field notes for detail Called resuscitator
	Event resolution	Spontaneously After therapy After hospitalization Other
	Notes