The Oxford Brain Health Centre (BHC) is an integrated research and clinical service, where NHS patients referred by their GP with memory problems will undergo brain MRI scanning (3T, aligned with the UK Biobank brain imaging study) and cognitive testing as part of their clinical care. Patients will also have the opportunity to take part in additional research MRI scanning and cognitive testing on the same day as their clinical testing.

The protocol is divided in two sets of sequences: a core clinical protocol including the sequences that are currently clinically useful for dementia diagnosis (T1, FLAIR, DWI, SWI), and a research protocol (dMRI, ASL, rs-fMRI) that patients can opt-in to receive if they consent to additional research assessments.

See attached radiographers scanning procedure for full usage guidance. 

Please note that while the guidelines under "Protocol Sequences" are valid as general recommendations for the use of this protocol, the instructions about interfacing with clinical notes (CRIS), PACS and DICOM SERVER ("Pre Scan", "Post Scan" and Appendices) are study-specific and may not be directly applicable/relevant in other settings.

Citing this protocol: doi:10.5281/zenodo.6598036

Other relevant publications:

• Melissa Clare O'Donoghue, Jasmine Blane, Grace Gillis, Robert Mitchell, Karen Lindsay, Juliet Semple, Pieter M Pretorius, Ludovica Griffanti, Jane Fossey, VanessaRaymont, Lola Martos, Clare E Mackay. The Oxford Brain Health Clinic: Protocol and Research Database. medRxiv 2022.05.26.22275565; doi:https://doi.org/10.1101/2022.05.26.22275565

Acknowledgements: The development of this resource was funded by the NIHR Oxford Health Biomedical Research Centre, the NIHR Oxford Cognitive Health Clinical Research Facility and the Wellcome Centre for Integrative Neuroimaging.

License: This resource is distributed under Creative Commons Attribution 4.0 International Public License (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/). 

Contact: Please contact Clare Mackay (clare.mackay@psych.ox.ac.uk) to discuss the implementation of this protocol. 

Localiser

Notes:

- Auto-runs, no adjustment required

Part of the core clinical protocol.

Clinical DWI sequence, 3 diffusion directions. 

Notes:

- Axial orientation, angle to ACPC, straighten on coronal if required

- Cover whole brain

Part of the core clinical protocol.

Susceptibility-weighted MRI (swMRI) scan. Adapted from UK Biobank imaging study.

Can be used for SWI and QSM analyses. Coil uncombined images need to be generated at the time of scanning (please refer to the scanning procedure document for details - "Appendix 5 – Retrospective Recon of SWI Data")

Notes:

- Axial orientation, straighten on coronal if required

- Copy COSG&SR from ep2d_diff….

- Cover whole brain (move slice slab if necessary)

Part of the core clinical protocol.

Matched with UK Biobank imaging study.

Notes:

- Sagittal orientation, straighten on coronal & axial if required

- Cover whole brain, position to reduce phase wrap

Part of the core clinical protocol.

Matched with UK Biobank imaging study.

Notes:

- Auto-copies COSG&SR from T1_p2_1mm…. (same FoV as T1)

Part of the (optional) research protocol.

Used to localise neck vessels for ASL sequence.

Notes: see details in scanning procedure document and ASL appendix

- Plan true axial covering the neck vessels. Cerebellum down. (see details in scanning procedure document)

Part of the (optional) research protocol.

Matched with UK Biobank imaging study.

Notes:

* MANUAL SHIM X 3 * Before running

- Scan parallel to the AC-PC line (axial oblique)

- Cover entire brain

- Copy centre of slices from 2. ep2d_diff_3scan_trace_p2_130

- Warn patient this scan and the next are very noisy and they may feel the table vibrate

- Don’t need to swap phase and frequency

Part of the (optional) research protocol.

Matched with UK Biobank imaging study.

Notes:

- Scan parallel to the AC-PC line (axial oblique)

- Cover entire brain

- Copy centre of slices from diff_PA_MPopt_MB3_3b0_lowflip - Don’t need to swap phase and frequency

Part of the (optional) research protocol.

Notes: see details in scanning procedure document and ASL appendix

- Axial orientation, angle to ACPC and adjust Sat region 1 to match

- Copy adj vol from diff_PA…

- Go to the Geometry Tab, select the Saturation Sub-Tab, choose Sat. region 1 and centre and angle to cover the scan volume

- Select Sat. region 2 and click the … button, input the height chosen above, (e.g. F76.8) and click enter in the centre of XX box.

- Ensure the orientation is set to “transverse” If not, click on the three dots next to the orientation and reset it to “transverse”

- NB do not angle Sat region 2.

- Resting state instructions: “Look at the cross for the next scan, blink normally and try not to fall asleep.”

Part of the (optional) research protocol.

Matched with UK Biobank imaging study.

Notes:

- Copy COSG&SR from diff_PA…

- Copy Adj Vol from diff_PA…

- Cover whole brain

- Resting state instructions: “Look at the cross for the next scan, blink normally and try not to fall asleep.”