SOP: Brain MRI Inital version Gorm Greisen. CONTENT 1.0 Timing of Brain MRI Informed consent...1

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SOP: Brain MRI Author(s) Date Changes Approved by Cornelia Hagmann Manon Benders Anne Mette Plomgaard 23.09.2012 1.0 Inital version Gorm Greisen CONTENT 1.0 Timing of Brain MRI...1 2.0 Informed consent...1 3.0 Which sequences to take...1 4.0 The procedure...2 5.0 Saving and transferring data to CTU...3 6.0 Appendix A: scanning detales...5 1.0 Timing of Brain MRI Brain MRI should take place between 40 44 weeks of corrected gestational age. 2.0 Informed consent According to the SafeBoosC protocol separate informed consent must be obtained before conducting the brain MRI. Unless it is localy standard care to have an MRI at term equivalent age. 3.0 Which sequences to take The following sequences should be conducted (if software is available at the study site) 1 sagittal T1 SE 2 coronal T2W 1.2mm 3 coronal T1W 3D 4 DWI with ADCMAP, either coronal or axial 5 DTI 45 directions axial (angulation leftright zero) See scanning details in the attachment/appendix.

Some general remarks: 1. be sure the whole brain in scanned including the CSF until outside the skull 2. preferable on 3T, second choice 1.5T 3. for T2/T1 we prefer coronal slices, second choice is axonal/transverse slices 4. slice thickness <2mm, for T1 And T2, scan without a gap (gap zero) 5. Scans we prefer: T1 sagittal, t2w, T1W, DWI, DTI Country AT...1.5T, erich.sorantin@medunigraz.at BE... CH GE, 3T DE Siemens 1.5 DK Siemens 3T Magnetom Trio, Poul.Henrik.Frandsen@regionh.dk ES GE1.5 and 3T, Fernando FR Philips 1.5T, laurent.guibaud@chulyon.fr IE Siemens 1.5T IT Philips, 3T, claudia.cinnante@policlinico.mi.it NL Philips 3T SE... UK GE 1.5T 4.0 The Procedure These are suggested guidelines of how to perform a Brain MRI; however, local instructions may be used. There are two ways on performing the brain MRI: either the infant is scanned during natural sleep or under sedation. For sedation oral Cholralhydrate (5060 mg/kg) may be used. Before starting: Make sure that the baby s body suits and clothes are metal free. If any surgical metal (PDA clip, VP shunt etc) has been used, one needs to check with the surgeons / radiologists whether it is MR compatible metal. 4.1 Natural sleep: When scanning is done during natural sleep it is essential to plan well in advance: 3060 minutes before the scanning the mother should feed the child Change the nappy if necessary Pulsoximetry is applied on the foot check the signal. Place MRI compatible electrodes for monitoring heart rate Ear plugs and ear muffs are applied (a hat may be applied to keep the ear protection in place) Wrap a blanket tightly around the baby so that the shoulders and arms are within the blanket. Check the signal of the heart rate. If you hav a bellybelt for respiratory rate, we recommend to use this as well

If using a vacuum mattress Wait until the baby falls asleep. Place the baby on the vacuum mattress on the scanner please make sure that the baby s head is in the midline before applying the vacuum. If using an MRI compatible incubator (with / without a vacuum mattress) Put the child in the MRincubator Wait until the child is a sleep If using a vacuum mattress: please make sure that the baby s head is in the midline before applying the vacuum The Scanning can start. If the baby wakes up consider Glucose drops or feeding again. After the scanning is done, the parent(s) can take the baby home. 4.2 Sedation (with oral Cloralhydrate): Sedation should be given 45 minutes before scanning starts oral Cloralhydrate (50 60 mg/kg). Pulsoximetry is applied on the foot check the signal. Place electrodes for monitoring heart rate check the signal. (The baby can be fed as long as it still awake.) The ear protection and the wrapping of the baby is as in the paragraph natural sleep. After the scanning it is advised to keep the baby for 1224 hours on the monitor when sedation has been used. 5.0 Saving and transferring data to CTU After the first MRI Manon Benders and Cornelia Hagmann must be alerted in order to check the quality of the images. The MRI data must be saved in the local archive with patient id Within one month after the MRI is condusted, a copy of the MRI file either anonymised or called by studyid must be send with FTP (File Transfer Protocol) to the CTU (Copenhagen Trial Unit) For information regarding the data transferring please go to the SafeBoosC homepage and find the SOP: Data transfer to Copenhagen Trial Unit. Link to the SafeBoosC homepage: www.safeboosc.eu

6.0 Appendix A: scanning details 3T Philips Sagittal T1W SE (Philips 3T)

Coronal T2 1.2mm (Philips T3)

Coronal T1W 3D (Philips T3)

DWI: Diffusion weighted imaging with ADCMAP (Philips T3)

DTI: Diffusion Tensor imaging with 45 directions (Philips T3) Multitransmit = "no"; Nucleus = "H1"; Coil selection = "SENSEFlexS"; element selection = "12"; connection = "d"; Dual coil = "no"; CLEAR "yes"; body tuned = "no"; FOV RL (mm) = 160; AP (mm) = 160; FH (mm) = 90; Voxel size RL (mm) = 2; AP (mm) = 2; Slice thickness (mm) = 2; Recon voxel size (mm) =2; Small FOV imaging = "no"; Foldover suppression = "no"; Reconstruction matrix = 80; SENSE = "yes"; P reduction (AP) = 1.39999998; P os factor = 1; kt BLAST = "no"; Stacks = 1; type = "parallel"; slices = 45; slice gap = "user defined"; gap (mm) = 0; slice orientation = "transverse"; foldover direction = "AP"; fat shift direction = "P"; Stack c. AP (P=+mm) = 35.4536819; RL (L=+mm) = 3.62022781; FH (H=+mm) = 8.57342815; Ang. AP (deg) = 2.41241336; RL (deg) = 18.1080379; FH (deg) = 5.14448023; Minimum number of packages = 1; Slice scan order = "default"; Large table movement ="no"; PlanAlign = "no"; REST slabs = 0; Shim Size AP (mm) = 87.5996399; RL (mm) = 58.2509651; FH (mm) = 54.9007835; c. AP (P=+mm) = 35.4573975; RL (L=+mm) = 4.14247704; FH (H=+mm) = 13.7650223; Ang. AP (deg) = 4.31364822; RL (deg) = 0; FH (deg) = 4.89545584; Catheter tracking = "no"; Interactive positioning = "no"; Allow table movement = "no"; Patient position = "head first"; orientation = "R decub"; Scan type = "Imaging"; Scan mode = "MS"; technique = "SE"; Modified SE = "no"; Acquisition mode = "cartesian"; Fast Imaging mode = "EPI"; shot mode = "singleshot"; Echoes = 1; partial echo = "no"; TE = "user defined"; (ms) = 80; Flip angle (deg) = 90;

TR = "user defined"; (ms) = 6500; Halfscan = "no"; Waterfat shift = "user defined"; (pixels) = 20; Shim = "PBvolume"; ShimAlign = "no"; mdixon = "no"; Fat suppression = "SPIR"; strength = "strong"; frequency offset = "user defined"; offset (Hz) = 200; Water suppression = "no"; Grad. rev. offres. supp. ="no"; BB pulse = "no"; MTC = "no"; Research prepulse = "no"; Diffusion mode = "DTI"; sequence = "SE"; gradient duration = "maximum"; gradient overplus = "no"; directional resolution ="user defined"; nr of directions = 45; user defined dirs = 1, (2) 0, 0.456999987, 0.889999986, 0, 0.264999986, 0.485000014, 0.833999991, 0.936999977, 0.284000009, 0.202000007, 0.063000001, 0.805999994, 0.588, 0.67900002, 0.0939999968, 0.727999985, 0.686999977, 0.279000014, 0.671000004, 0.232999995, 0.949999988, 0.209000006, 0.922999978, 0.179000005, 0.342000008, 0.111000001, 0.980000019, 0.164000005, 0.131999999, 0.853999972, 0.503000021, 0.367000014, 0.768999994, 0.523000002, 0.291000009, 0.704999983, 0.647000015, 0.675999999, 0.713999987, 0.185000002, 0.598999977, 0.0780000016, 0.796999991, 0.73299998, 0.67900002, 0.0390000008, 0.800000012, 0.216000006, 0.559000015, 0.558000028, 0.340999991, 0.755999982, 0.435000002, 0.598999977, 0.671999991, 0.785000026, 0.596000016, 0.170000002, 0.495999992, 0.791000009, 0.356999993, 0.660000026, 0.433999985, 0.614000022, 0.842000008, 0.144999996, 0.519999981, 0.143999994, 0.430000007, 0.890999973, 0.301999986, 0.282000005, 0.911000013, 0.229000002, 0.930999994, 0.284000009, 0.943000019, 0.0120000001, 0.333999991, 0.0109999999, 0.0250000004, 0.999000013, 0.402999997, 0.84799999, 0.344999999, 0.921999991, 0.388000011, 0.00999999978, 0.0399999991, 0.486999989, 0.871999979, 0.296999991, 0.145999998, 0.944000006, 0.374000013, 0.165999994, 0.912, 0.284999996, 0.219999999, 0.933000028,

0.856000006, 0.317999989, 0.407999992, 0.902999997, 0.382999986, 0.194999993, 0.538999975, 0.728999972, 0.421999991, 0.477999985, 0.878000021, 0.0399999991, 0.764999986, 0.531000018, 0.363999993, 0.518999994, 0.426999986, 0.74000001, 0.66900003, 0.606999993, 0.42899999, 0.104000002, 0.97299999, 0.204999998, 0.660000026, 0.569999993, 0.49000001, 0.0350000001, 0.690999985, 0.722000003, 0.333000004, 0.606000006, 0.722000003, (249) 0; nr of bfactors =2; bfactor order ="ascending"; max bfactor =800; average high b ="user defined"; bfactor averages =4, (15) 1; SAR mode = "high"; B1 mode = "default"; SAR Patient data = "auto"; PNS mode = "moderate"; Gradient mode = "enhanced"; SofTone mode = "no"; Cardiac synchronization ="no"; Heart rate > 250 bpm = "no"; Respiratory compensation ="no"; Navigator respiratory comp = "no"; Flow compensation = "no"; Temporal slice spacing = "default"; NSA = 1; Manual start = "no"; Dynamic study = "no"; dyn stabilization = "no"; Arterial Spin labeling = "no"; Preparation phases = "auto"; Interactive F0 = "no"; SmartPlan survey = "no"; B0 field map = "no"; B1 field map = "no"; MIP/MPR = "no"; Images = " M", (3) " no"; Autoview image = " M"; Calculated images = (4) " no"; Reference tissue = "User defined"; Tissue T1 = 2000; Tissue T2 = 150; Tissue rho = 100; EPI 2D phase correction = "no"; Preset window contrast = "soft"; Reconstruction mode = "immediate"; Save raw data = "no"; Hardcopy protocol = "no"; Ringing filtering = "default"; Geometry correction = "default"; IF_info_seperator = 1634755923; Total scan duration = "05:25.0"; Rel. signal level (%) = 100; Act. TR (ms) = "6500"; Act. TE (ms) = "80"; ACQ matrix M x P = "80 x 78"; ACQ voxel MPS (mm) = "2.00 / 2.03 / 2.00"; REC voxel MPS (mm) = "2.00 / 2.00 / 2.00"; Scan percentage (%) = 98.3871002; Packages = 1; Min. slice gap (mm) = 0;

Diffusion gradient timing DELTA / delta (ms) = "38.8 / 9.5"; EPI factor = 61; WFS (pix) / BW (Hz) = "20.000 / 21.7"; BW in EPI freq. dir. (Hz) = "2638.7"; Min. TR (ms) = "5346"; SPIR offset act./default (Hz) = "200 [135]" SAR / local torso = "< 54 %"; Whole body / level = "< 0.5 W/kg / normal"; B1 rms = "1.18 ut"; PNS / level = "73 % / normal"; Sound Pressure Level (db) = 20.1907005;

1.5T Philips Sagittal T1W SE (Philips T1.5)

Coronal T2W (Philips T1.5): please change slice orientation in geometry from transverse into coronal: Inverse recovery: IR (Philips T1.5) please change slice orientation in geometry from transverse into coronal:

\

DWI: Diffusion weighted imaging (Philips T1.5)

DTI: diffusion tensor imaging please scan axial. (Philips T1.5) We prefer the settings that are explained above for the 3T, however if you will not manage to get nice images, please try the settings below for 1.5T

Simens Magnetom trio 3T

Properties Prio Recon Before measurement After measurement Load to viewer Inline movie Auto store images Load to stamp segments Load images to graphic segments Auto open inline display Start measurement without further preparation Wait for user to start Start measurements SIEMENS MAGNETOM TrioTim syngo MR B17 \\USER\Cerebrum\Projekter\SafeBoosC phase ll MRI.\localizer TA: 0:25 PAT: Voxel size: 1.1 1.0 7.0 mm Rel. SNR: 1.00 SIEMENS: gre single Routine Slice group 1 Slices 4 Dist. factor 20 % Position R11.6 A103.7 H2.1 Orientation Transversal Phase enc. dir. A >> P Rotation 0.00 deg Slice group 2 Slices 3 Dist. factor 20 % Position R11.6 A104.7 F0.1 Orientation Coronal Phase enc. dir. R >> L Rotation 0.00 deg Slice group 3 Slices 5 Dist. factor 30 % Position R3.2 A104.7 F0.1 Orientation Sagittal Phase enc. dir. A >> P Rotation 0.00 deg Phase oversampling 0 % FoV read 250 mm FoV phase 100.0 % Slice thickness 7.0 mm TR 8.6 ms TE 4.00 ms Averages 1 Concatenations 12 Filter Distortion Corr.(2D), Elliptical filter, B1 filter Coil elements NHA Contrast TD MTC Magn. preparation Flip angle Fat suppr. Water suppr. 0 ms 20 deg Averaging mode Short term Reconstruction Magnitude Measurements 1 Multiple series Each measurement Resolution Base resolution 256 Phase resolution 90 % Phase partial Fourier Interpolation PAT mode Matrix Coil Mode Auto (CP) Image Filter Distortion Corr. Mode Unfiltered images Prescan Normalize Normalize B1 filter Intensity Unfiltered images Raw filter Elliptical filter Mode Geometry Multislice mode Series 2D Medium Inplane Sequential Interleaved Saturation mode Standard Special sat. Tim CT mode System Body NBA NHA Positioning mode REF Table position H Table position 0 mm MSMA S C T Sagittal R >> L Coronal P >> A Transversal H >> F Save uncombined Coil Combine Mode Adaptive Combine AutoAlign Auto Coil Select Shim mode Tune up Adjust with body coil Confirm freq. adjustment Assume Silicone? Ref. amplitude 1H 0.000 V Adjustment Tolerance Auto Adjust volume Position Isocenter Orientation Transversal Rotation 0.00 deg R >> L 350 mm A >> P 263 mm F >> H 350 mm Physio 1st Signal/Mode Segments 1 Tagging Dark blood Resp. control Inline 1/+

SIEMENS MAGNETOM TrioTim syngo MR B17 Subtract Liver registration StdDevSag StdDevCor StdDevTra StdDevTime MIPSag MIPCor MIPTra MIPTime Save original images Wash In Wash Out TTP PEI MIP time Sequence Introduction Dimension 2D Phase stabilisation Asymmetric echo Allowed Contrasts 1 Bandwidth 320 Hz/Px Flow comp. No Allowed delay 0 s RF pulse type Gradient mode Excitation RF spoiling Normal Normal Slicesel. 2/+

Properties Prio Recon Before measurement After measurement Load to viewer Inline movie Auto store images Load to stamp segments Load images to graphic segments Auto open inline display Start measurement without further preparation Wait for user to start Start measurements SIEMENS MAGNETOM TrioTim syngo MR B17 \\USER\Cerebrum\Projekter\SafeBoosC phase ll MRI.\t1_se_sag_3mm_200mm TA: 3:48 PAT: Voxel size: 1.0 0.8 3.0 mm Rel. SNR: 1.00 SIEMENS: tse single Routine Slice group 1 Slices 31 Dist. factor 10 % Position R4.2 A96.9 F9.9 Orientation S > C5.2 > T3.4 Phase enc. dir. A >> P Rotation 0.00 deg Phase oversampling 0 % FoV read 200 mm FoV phase 100.0 % Slice thickness 3.0 mm TR 550 ms TE 12 ms Averages 1 Concatenations 2 Filter Prescan Normalize, Elliptical filter Coil elements NHA Contrast TD MTC Magn. preparation Flip angle Fat suppr. Water suppr. Restore magn. 0.0 ms 90 deg Averaging mode Long term Reconstruction Magnitude Measurements 1 Multiple series Each measurement Resolution Base resolution 256 Phase resolution 80 % Phase partial Fourier Trajectory Cartesian Interpolation PAT mode Matrix Coil Mode Auto (CP) Image Filter Distortion Corr. Unfiltered images Prescan Normalize Normalize B1 filter Raw filter Elliptical filter Mode Geometry Multislice mode Series Inplane Interleaved Interleaved Special sat. Tim CT mode System Body NBA NHA Positioning mode REF Table position H Table position 0 mm MSMA S C T Sagittal R >> L Coronal P >> A Transversal H >> F Save uncombined Coil Combine Mode Adaptive Combine AutoAlign Auto Coil Select Default Shim mode Tune up Adjust with body coil Confirm freq. adjustment Assume Silicone? Ref. amplitude 1H 0.000 V Adjustment Tolerance Auto Adjust volume Position Isocenter Orientation Transversal Rotation 0.00 deg R >> L 350 mm A >> P 263 mm F >> H 350 mm Physio 1st Signal/Mode Dark blood Resp. control Inline Subtract StdDevSag StdDevCor StdDevTra StdDevTime MIPSag MIPCor MIPTra MIPTime Save original images Sequence Introduction Dimension 2D Compensate T2 decay Reduce Motion Sens. Contrasts 1 3/+

SIEMENS MAGNETOM TrioTim syngo MR B17 Bandwidth 215 Hz/Px Flow comp. Slice Allowed delay 60 s Define Turbo factor Turbo factor 1 Echo trains per slice 205 RF pulse type Low SAR Gradient mode Normal 4/+

Properties Prio Recon Before measurement After measurement Load to viewer Inline movie Auto store images Load to stamp segments Load images to graphic segments Auto open inline display Start measurement without further preparation Wait for user to start Start measurements SIEMENS MAGNETOM TrioTim syngo MR B17 \\USER\Cerebrum\Projekter\SafeBoosC phase ll MRI.\t2_tse_cor_1,2mm_448_p2 TA: 5:10 PAT: 2 Voxel size: 0.9 0.7 1.2 mm Rel. SNR: 1.00 SIEMENS: tse single Routine Slice group 1 Slices 110 Dist. factor 20 % Position R4.5 A101.2 F4.7 Orientation C > S3.5 > T1.5 Phase enc. dir. R >> L Rotation 0.00 deg Phase oversampling 0 % FoV read 180 mm FoV phase 100.0 % Slice thickness 1.2 mm TR 4900 ms TE 148 ms Averages 2 Concatenations 7 Filter Prescan Normalize, Elliptical filter Coil elements NHA Contrast TD MTC Magn. preparation Flip angle Fat suppr. Water suppr. Restore magn. 0.0 ms 120 deg Averaging mode Long term Reconstruction Magnitude Measurements 1 Multiple series Each measurement Resolution Base resolution 256 Phase resolution 79 % Phase partial Fourier Trajectory Cartesian Interpolation PAT mode GRAPPA Accel. factor PE 2 Ref. lines PE 32 Matrix Coil Mode Auto (Triple) Reference scan mode Selfcalibration Image Filter Distortion Corr. Unfiltered images Prescan Normalize Normalize B1 filter Raw filter Elliptical filter Mode Geometry Multislice mode Series Inplane Interleaved Interleaved Special sat. Tim CT mode System Body NBA NHA Positioning mode REF Table position H Table position 0 mm MSMA S C T Sagittal R >> L Coronal P >> A Transversal H >> F Save uncombined Coil Combine Mode Adaptive Combine AutoAlign Auto Coil Select Default Shim mode Standard Adjust with body coil Confirm freq. adjustment Assume Silicone? Ref. amplitude 1H 0.000 V Adjustment Tolerance Auto Adjust volume Position R4.5 A101.2 F4.7 Orientation C > S3.5 > T1.5 Rotation 0.00 deg F >> H 180 mm R >> L 180 mm A >> P 159 mm Physio 1st Signal/Mode Dark blood Resp. control Inline Subtract StdDevSag StdDevCor StdDevTra StdDevTime MIPSag MIPCor MIPTra MIPTime Save original images Sequence Introduction Dimension 5/+ 2D

SIEMENS MAGNETOM TrioTim syngo MR B17 Compensate T2 decay Reduce Motion Sens. Contrasts 1 Bandwidth 254 Hz/Px Flow comp. No Allowed delay 60 s Echo spacing 11.4 ms Define Turbo factor Turbo factor 26 Echo trains per slice 4 RF pulse type Normal Gradient mode Normal 6/+

SIEMENS MAGNETOM TrioTim syngo MR B17 \\USER\Cerebrum\Projekter\SafeBoosC phase ll MRI.\t1_mpr_cor TA: 4:05 PAT: 2 Voxel size: 0.9 0.8 1.2 mm Rel. SNR: 1.00 SIEMENS: tfl Properties Prio Recon Before measurement After measurement Load to viewer Inline movie Auto store images Load to stamp segments Load images to graphic segments Auto open inline display Start measurement without further preparation Wait for user to start Start measurements single Routine Slab group 1 Slabs 1 Dist. factor 50 % Position R4.2 A96.9 F9.9 Orientation S > C5.2 > T3.4 Phase enc. dir. A >> P Rotation 0.00 deg Phase oversampling 20 % Slice oversampling 14.3 % Slices per slab 112 FoV read 200 mm FoV phase 100.0 % Slice thickness 1.20 mm TR 1900 ms TE 2.94 ms Averages 1 Concatenations 1 Filter Prescan Normalize, Elliptical filter Coil elements NHA Contrast Magn. preparation TI Flip angle Fat suppr. Water suppr. Nonsel. IR 900 ms 9 deg Averaging mode Long term Reconstruction Magnitude Measurements 1 Multiple series Each measurement Resolution Base resolution 256 Phase resolution 86 % Slice resolution 100 % Phase partial Fourier 7/8 Slice partial Fourier Interpolation PAT mode Accel. factor PE 2 Ref. lines PE 24 Accel. factor 3D 1 GRAPPA Matrix Coil Mode Auto (Triple) Reference scan mode Integrated Image Filter Distortion Corr. Unfiltered images Prescan Normalize Normalize B1 filter Raw filter Elliptical filter Mode Geometry Multislice mode Series Inplane Single shot Ascending System Body NBA NHA Positioning mode FIX Table position H Table position 0 mm MSMA S C T Sagittal R >> L Coronal P >> A Transversal H >> F Save uncombined Coil Combine Mode Adaptive Combine AutoAlign Auto Coil Select Default Shim mode Tune up Adjust with body coil Confirm freq. adjustment Assume Silicone? Ref. amplitude 1H 0.000 V Adjustment Tolerance Auto Adjust volume Position Isocenter Orientation Coronal Rotation 0.00 deg R >> L 350 mm A >> P 263 mm F >> H 350 mm Physio 1st Signal/Mode Dark blood Resp. control Inline Subtract StdDevSag StdDevCor StdDevTra StdDevTime MIPSag MIPCor MIPTra MIPTime Save original images Sequence Introduction Dimension Elliptical scanning Asymmetric echo 3D Allowed

SIEMENS MAGNETOM TrioTim syngo MR B17 Bandwidth 140 Hz/Px Flow comp. No Echo spacing 9 ms RF pulse type Gradient mode Excitation RF spoiling Normal Normal Nonsel. 8/+

SIEMENS MAGNETOM TrioTim syngo MR B17 \\USER\Cerebrum\Projekter\SafeBoosC phase ll MRI.\ep2d_diff_orth_p2_tra TA: 1:31 PAT: 2 Voxel size: 1.2 1.2 4.0 mm Rel. SNR: 1.00 SIEMENS: ep2d_diff Properties Prio Recon Before measurement After measurement Load to viewer Inline movie Auto store images Load to stamp segments Load images to graphic segments Auto open inline display Start measurement without further preparation Wait for user to start Start measurements single Routine Slice group 1 Slices 28 Dist. factor 30 % Position R3.2 A106.3 H9.7 Orientation T > S4.5 > C2.9 Phase enc. dir. A >> P Rotation 0.00 deg Phase oversampling 0 % FoV read 230 mm FoV phase 100.0 % Slice thickness 4.0 mm TR 4700 ms TE 102 ms Averages 4 Concatenations 1 Filter Raw filter, Distortion Corr.(2D), Prescan Normalize Coil elements NHA Contrast MTC Magn. preparation Fat suppr. Fat sat. Averaging mode Reconstruction Delay in TR Long term Magnitude 0 ms Resolution Base resolution 192 Phase resolution 100 % Phase partial Fourier 6/8 Interpolation PAT mode GRAPPA Accel. factor PE 2 Ref. lines PE 24 Matrix Coil Mode Auto (Triple) Reference scan mode Separate Distortion Corr. Mode 2D Unfiltered images Prescan Normalize Raw filter Intensity Weak Slope 25 Elliptical filter Hamming Geometry Multislice mode Series Interleaved Interleaved Special sat. System Body NBA NHA Positioning mode REF Table position H Table position 0 mm MSMA S C T Sagittal R >> L Coronal P >> A Transversal H >> F Coil Combine Mode Adaptive Combine AutoAlign Auto Coil Select Default Shim mode Standard Adjust with body coil Confirm freq. adjustment Assume Silicone? Ref. amplitude 1H 0.000 V Adjustment Tolerance Auto Adjust volume Position R3.2 A106.3 H9.7 Orientation T > S4.5 > C2.9 Rotation 0.00 deg R >> L 230 mm A >> P 230 mm F >> H 145 mm Physio 1st Signal/Mode Resp. control Diff Diffusion mode Orthogonal Diff. weightings 2 bvalue 1 0 s/mm² bvalue 2 800 s/mm² Diff. weighted images Trace weighted images Average ADC maps Individual ADC maps FA maps Mosaic Tensor Noise level 40 Diff. directions 3 Sequence Introduction Bandwidth Free echo spacing Echo spacing 1184 Hz/Px 0.93 ms 9/+ EPI factor 192 RF pulse type Normal Gradient mode Fast

SIEMENS MAGNETOM TrioTim syngo MR B17 \\USER\Cerebrum\Projekter\SafeBoosC phase ll MRI.\ep2d_diff_mddw_30_p2 TA: 9:28 PAT: 2 Voxel size: 2.0 2.0 2.0 mm Rel. SNR: 1.00 SIEMENS: ep2d_diff Properties Prio Recon Before measurement After measurement Load to viewer Inline movie Auto store images Load to stamp segments Load images to graphic segments Auto open inline display Start measurement without further preparation Wait for user to start Start measurements single Routine Slice group 1 Slices 49 Dist. factor 30 % Position R3.2 A106.3 H9.7 Orientation T > S4.5 > C2.9 Phase enc. dir. A >> P Rotation 0.00 deg Phase oversampling 0 % FoV read 250 mm FoV phase 100.0 % Slice thickness 2.0 mm TR 5900 ms TE 81 ms Averages 3 Concatenations 1 Filter Prescan Normalize Coil elements NHA Contrast MTC Magn. preparation Fat suppr. Fat sat. Averaging mode Reconstruction Delay in TR Multiple series Long term Magnitude 0 ms Resolution Base resolution 122 Phase resolution 100 % Phase partial Fourier 6/8 Interpolation PAT mode GRAPPA Accel. factor PE 2 Ref. lines PE 24 Matrix Coil Mode Auto (Triple) Reference scan mode Separate Distortion Corr. Prescan Normalize Raw filter Elliptical filter Hamming Geometry Multislice mode Series Interleaved Interleaved Special sat. System Body NBA NHA Positioning mode FIX Table position H Table position 0 mm MSMA S C T Sagittal R >> L Coronal P >> A Transversal H >> F Coil Combine Mode Adaptive Combine AutoAlign Auto Coil Select Default Shim mode Standard Adjust with body coil Confirm freq. adjustment Assume Silicone? Ref. amplitude 1H 0.000 V Adjustment Tolerance Auto Adjust volume Position R3.2 A106.3 H9.7 Orientation T > S4.5 > C2.9 Rotation 0.00 deg R >> L 250 mm A >> P 250 mm F >> H 127 mm Physio 1st Signal/Mode Resp. control Diff Diffusion mode MDDW Diff. weightings 2 bvalue 1 0 s/mm² bvalue 2 800 s/mm² Diff. weighted images Trace weighted images Average ADC maps Individual ADC maps FA maps Mosaic Tensor Noise level 30 Diff. directions 30 Sequence Introduction Bandwidth Free echo spacing Echo spacing 1518 Hz/Px 0.74 ms 10/+ EPI factor 122 RF pulse type Normal Gradient mode Fast

SIEMENS MAGNETOM TrioTim syngo MR B17 Table of contents \\USER Cerebrum Projekter SafeBoosC phase ll MRI. localizer t1_se_sag_3mm_200mm t2_tse_cor_1,2mm_448_p2 t1_mpr_sag ep2d_diff_orth_p2_tra ep2d_diff_mddw_30_p2

SafeBoosC phase II SOP Brain MRI Version 1.0 29