New and Advanced Magnetic Resonance Imaging Diagnostic Imaging Techniques in the Evaluation of Cranial Nerves and the Skull Base

Imaging of Pediatric Calvarial and Skull Base Tumors: A Cog Diagnostic Imaging Committee/SPR Oncology Committee/Aspnr White Paper

“…Entire brain imaging is necessary to assess the integrity of the subjacent brain and dura. The role of advanced MRI techniques such as DWI, MR perfusion, or MR spectroscopy remains under investigation in research 35 . MRA and MRV (or CTA/CTV) are adjunctive radiological exams that can be used to assess vascular anatomy (compression, displacement, invasion) 23 .…”

“…In addition, they do not provide detail regarding tumor histoarchitecture and physiology or imaging parameters that can be used for risk stratification. As a result, over past decades, there has been great effort in developing advanced imaging techniques that can address these formidable challenges 35,[40][41][42] .…”

“…There are several advanced MRI techniques that are used for imaging of tumors in the skull base and head and neck region, such as high-resolution 3D MRI, DWI, MR perfusion, and MR spectroscopy. These techniques have demonstrated a wide range of potential utilities in diagnosis, tumor prognostication and posttreatment evaluation 35,40,41 . Moreover, newer MR technology such as fast MRI sequences can reduce the scan time which is particularly useful in pediatric population as it can minimize motion artifact and decrease sedation needs 45 .…”

Imaging of pediatric calvarial and skull base tumors: A COG Diagnostic Imaging Committee/SPR Oncology Committee/ASPNR White Paper

“…As a result, over past decades, there has been great effort in developing advanced imaging techniques that can address these formidable challenges. 35,[40][41][42] Dual-energy CT allows acquisition of images at high-and lowenergy spectra simultaneously with radiation doses that are equal to or less than the conventional single-energy CT. Virtual non-contrast images can be generated from dual-energy CT dataset, reducing acquisition time and radiation.…”

“…These techniques have demonstrated a wide range of potential utilities in diagnosis, tumor prognostication, and posttreatment evaluation. 35,40,41 Moreover, newer MR technology, such as fast MRI sequences, can reduce the scan time, which is particularly useful in pediatric population as it can minimize motion artifact and decrease sedation needs. 45 Furthermore, zero echo time (TE) sequences, so called black bone MRI, may show promise in bone evaluation due to its high soft tissue/bone contrast reducing the need for CT. 46,47 More scientific data and research are needed to evaluate the efficacy of these advanced techniques in clinical practice.…”