Development of a common MRI protocol for the collaborative European neuro trauma effectiveness research in TBI study

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

B-0294

Type:

Scientific Paper

Keywords:

Neuroradiology brain, Trauma, MR, MR-Diffusion/Perfusion, MR-Functional imaging, Efficacy studies, Imaging sequences, Structured reporting, Quality assurance

Authors:

P. Pullens¹, J. Verheyden², W. Van Hecke², A. Maas¹, P. M. Parizel¹; ¹Antwerp/BE, ²Leuven/BE

DOI:

10.1594/ecr2015/B-0294

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/B-0294

Fig. 1: CENTER-TBI MRI sites overview.

Fig. 2: Example images (healthy subject, male 34 y/o) at 3 different scanner vendors...

Fig. 3: TBI patient (59 y/o male, fall from 2.5m ladder) scanned according to the...

Purpose

CENTER-TBI [1,2] is an international consortium study, which aims to improve care for patients with traumatic brain injury (TBI). A key component is neuroimaging to characterize the disease course. Over the next years, 1,800 patients with mild, moderate and severe TBI will undergo dedicated (follow-up) MRI sessions from as early as 72 hours after presentation up to 2 years. MRI scans will be collected at 30 European sites. The challenge is to develop standardized imaging protocols to be used in a clinical setting using 3T...

Methods and materials

72 clinical sites (hospitals, imaging centers) are enrolled in CENTER-TBI. 30 centers will collect 3T (follow-up) MRI on 1800 patients with mild, moderate and severe TBI from as early as 72 hours up to two years after injury. The imaging protocol was based on the TRACK-TBI [3] protocol and consists of 3D-T2, 3D-FLAIR, 3D-T1, SWI, DTI and rs-fMRI. Total imaging time is approx. 45 minutes. T2, FLAIR and T1 are based on recommendations from TRACK-TBI; SWI based on [4]; DTI 2mm isotropic with b=1000 s/mm2,...

Results

MR SitesFig. 1 shows an overview of the included MR sites. Not all sites have provided the required information (scanner type, serial number, software version) for participation in the study. Sequences Highly similar 3D-T2, 3D-FLAIR and 3D-T1 images were obtained, see fig 2, but adjustments of stock sequences were needed. T1 MP-RAGE (Philips-Siemens) and IR-SGPR (GE) were accelerated with a factor two. FLAIR, SWI, DTI and rs-fMRI required most adjustments. To obtain visually similar contrast, FLAIR inversion time is 1650ms on Philips Achieva, 2100ms on...

Conclusion

Harmonization of an imaging protocol on such a large multi-site, multi-vendor scale with many different clinical set-ups is a daunting challenge. Vendor specific sequence implementations, licenses and software release versions cannot be ignored. Our experiences in setting up MR acquisition protocols for CENTER-TBI demonstrated great challenges, but these could largely be overcome. We consider this work as a ‘trailblazing’ effort and, hopefully, future studies will be able to benefit from the foundations laid down now.

Personal information

Pim Pullens, Ph.D. Dept of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, BE. pim.pullens AT uantwerpen.be Jan Verheyden, MSc icometrix NV, Leuven, BE. Wim van Hecke, Ph.D. icometrix NV, Leuven, BE. Andrew Maas, M.D. Ph.D. Dept of Neurosurgery, Antwerp University Hospital & University of Antwerp, Antwerp, BE. Paul M Parizel, M.D. Ph.D. Dept of Radiology, Antwerp University Hospital & University of Antwerp, Antwerp, BE.

References

[1] www.center-tbi.eu [2] Maas, A et al. Neurosurgery. 2015 Jan;76(1):67-80 [3] Yue, JK et al. J Neurotrauma 30(22):1831-44(2013) [4] Haacke EM et al. jMRI 32:516-543(2010) [5] https://neuro-imaging.center-tbi.eu