Axial / 400-600 / min. (15) / 220-240 / 75% / 5mm / 1mm / 256x192 / R-L / 1
T2
FSE / Plane / TR / TE / Echo Train / FOV / Phase FOV% / Slice Thickness / Gap / Matrix / Phase / NEX / NSA
Axial / 2500-4500 / 100-130 / 13-25 / 220-240 / 75% / 5mm / 1mm / 512x256 / R-L / 2
FLAIR / Plane / TR / TE / TI / FOV / Phase FOV% / Slice Thickness / Gap / Matrix / Phase / NEX / NSA
Axial 1.5T / 10000 / 100-150 / 2200 / 220-240 / 75% / 5mm / 1mm / 256x192 / R-L / 1
Axial 3T / 10000 / 70-130 / 2500 / 220-240 / 75% / 5mm / 1mm / 256x192 / R-L / 1
Diffusion DWI / DTI
2D EPI / Plane / TR / TE / B Value / # of Directions / FOV / Phase FOV% / Slice Thickness / Gap / Matrix / Phase / NEX / NSA
Axial / Min / Min / ~1000 / 3 (min) / 220-240 / 100% / 5mm / 1mm / 128x128 minimum / R-L / 1
(min)
------POST - CONTRAST IMAGING------
T1 Post Contrast Spin Echo / Plane / TR / TE / FOV / Phase FOV% / Slice Thickness / Gap / Matrix / Phase / NEX / NSAAxial* / 400-600 / min. (<15) / 220-240 / 75% / 5mm / 1mm / 256x256 / R-L / 1
*This post-contrast imaging must be performed in at least the plane that the pre-contrast imaging was obtained in
(e.g., axial, sagittal, coronal). Also, post-contrast imaging should be acquired in at least two planes (e.g., axial and coronal, axial and sagittal, or coronal and sagittal). 3D T1-weighted volumetric imaging (e.g., SPGR or MPRAGE) with 1.5mm isotropic voxel size or better should be considered as well. An example of this series is below:
(Siemens) / 2530 / 3.44(min) / 1100 / 7° / 256 / 100% / 1.3mm / 0mm / 256x256 / A-P / 1
(GE) / ~10 / ~2.8 / 450 / 20° / 25 / 100% / 1.3mm / 0mm / 256x256 / A-P / 1-2
RTOG SITE NUMBER: RTOG SUBJECT ID: Subject DOB: 19 (dd/month/19yy)
SITE NAME: ______Study Date: 20
TIMEPOINT: Pre-Op Post-Op Pre cyc1(post TX) 6mon (week 26) Progression
Comments: ______
Form Completed By: ______ Date: 20 (dd/month/20yy)
Email: ______Phone: ______