Where can I find the MRI (Magnetic Resonance Imaging) protocol?

Where to Find MRI Protocols

MRI protocols are found in published consensus guidelines from specialty societies, institutional radiology departments, and standardized protocol documents developed by expert working groups—with the most authoritative sources being disease-specific guidelines from organizations like MAGNIMS for multiple sclerosis, ACR for cranial neuropathy, and consensus recommendations for brain tumors. 1

Primary Sources for MRI Protocols

Published Clinical Guidelines

• Disease-specific consensus guidelines provide the most authoritative MRI protocols, including detailed sequence parameters, anatomic coverage, and timing recommendations 1
• The MAGNIMS consensus guidelines (Nature Reviews Neurology, 2015) provide comprehensive brain and spinal cord MRI protocols specifically for multiple sclerosis diagnosis, including standardized sequences, slice thickness, and field strength requirements 1
• The ACR Appropriateness Criteria offer detailed imaging protocols for specific clinical scenarios like cranial neuropathy, with recommendations on sequence selection and anatomic coverage 1
• Neuro-Oncology consensus recommendations (2015) provide standardized brain tumor imaging protocols with specific technical parameters for 1.5T and 3T scanners 1
• Onco-RADS guidelines (Radiology, 2021) detail whole-body MRI protocols for cancer screening, including standard and short protocols with specific sequence parameters and acquisition times 1

Institutional Protocol Documents

• Radiology departments maintain standardized protocol templates that organize sequences by clinical indication, with specific technical parameters for each scanner 2, 3
• Large health systems create centralized protocol documents with numbering systems to allow efficient order-to-protocol assignment across multiple sites 2, 3
• These institutional protocols are typically developed by radiologist-led working groups in collaboration with MR physicists and technologists to balance clinical need with technical capability 3

Key Protocol Components Found in Guidelines

Technical Specifications

• Magnetic field strength: Minimum 1.5T (preferably 3.0T for most applications) 4
• Slice thickness: Maximum 3-4mm for brain imaging, with thinner cuts (1-1.5mm) for 3D sequences 1, 4
• Spatial resolution: In-plane resolution of 1×1mm (voxel size 3×1×1mm) 4
• Acquisition time: Total scan time typically 25-40 minutes for brain protocols, up to 50-60 minutes for whole-body protocols 1, 4

Standard Sequence Requirements

• Brain MRI protocols should include: T2-weighted sequences, FLAIR, diffusion-weighted imaging, pre- and post-contrast T1-weighted sequences 1, 4
• Multiple sclerosis protocols require: axial T2, proton-density, sagittal T2-FLAIR, and post-gadolinium T1-weighted sequences 1
• Brain tumor protocols specify: 3D T1-weighted IR-GRE (MPRAGE), axial T2-weighted, FLAIR, and diffusion-weighted imaging with specific b-values 1
• Whole-body MRI protocols include: sagittal T1- and T2-weighted spine imaging, axial T1-weighted, T2-weighted, and diffusion-weighted sequences from vertex to feet 1

How to Access Protocols

From Published Literature

• Search specialty society guidelines in high-impact journals (Nature Reviews Neurology, Radiology, Neuro-Oncology, JACR) for disease-specific protocols 1
• Review consensus statements from expert panels like MAGNIMS, ACR, and Onco-RADS for standardized acquisition parameters 1

Within Healthcare Systems

• Contact your institutional radiology department for access to standardized protocol documents and templates 2, 3
• Request protocols through radiology information systems where they are stored electronically with specific numbering systems for ordering 2, 3
• Participate in protocol working groups or committees that develop and maintain institutional standards 3

Common Pitfalls to Avoid

Protocol Variability

• "Protocol creep" occurs when individual radiologists and technologists alter protocols without oversight, leading to inconsistent imaging across sites 2
• Nonstandardized examinations are often of inadequate quality and may be interpreted without appropriate expertise, leading to erroneous diagnoses 1
• Lack of uniformity increases exponentially when multiple departments function within large health systems without centralized governance 2

Implementation Challenges

• Scanner-specific differences in vendor terminology (e.g., MPRAGE vs IR-SPGR vs TFE) require translation of protocol parameters across platforms 1
• Hardware limitations at different sites may prevent exact protocol replication, requiring physicist input to optimize sequences for available equipment 3
• Patient-specific factors (claustrophobia, metallic implants, inability to cooperate) may necessitate protocol modifications, but these should follow established alternative pathways 1

Quality Control

• Protocols should include formalized change request processes to prevent unauthorized modifications 2
• Governance structures with radiologist leadership are essential to maintain protocol stability over time 2, 3
• Regular review and updates based on emerging evidence ensure protocols remain current with best practices 1, 3