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DSC-MR imaging using preload, intermediate (60°) flip angle and postprocessing leakage correction has gained traction as a standard methodology. Simulations suggest that DSC-MR imaging with flip angle = 30° and no preload yields relative CBV practically equivalent to the reference standard. Eighty-four patients with brain lesions were enrolled in this 3-institution study. Forty-three patients satisfied the inclusion criteria. DSC-MR imaging (3T, single-dose gadobutrol, gradient recalled-echo–EPI, TE=20–35 ms, TR=1.2–1.63 seconds) was performed twice for each patient, with flip angle = 30°–35° and no preload (P-) or provided preload (P+) for an intermediate flipangle = 60°. Compared with 60°/P+/C+, 30°/P-/C+ had closest mean standardized relative CBV, highest Lin concordance correlation coefficient, and lowest Bland-Altman bias.