- All patients must have a brain MRI with and without contrast (gadolinium) within 30 days prior to study enrollment. All patients with history of spinal or leptomeningeal disease and those patients with symptoms suspicious of spinal disease, must have a spine MRI with contrast ( gadollinium) performed within 30 days prior to study enrollment. Lumbar Puncture is necessary if there is evidence of tumor dissemination on the MRI of spine