BACKGROUND: Concerns over gadolinium (Gd) retention encourage the use of lower Gd doses. However, lower Gd doses may compromise imaging performance. Higher relaxivity gadobenate may be suited to reduced dose protocols. PURPOSE: To compare 0.05 mmol/kg and 0.1 mmol/kg gadobenate in patients undergoing enhanced MRI of the central nervous system (CNS). STUDY TYPE: Retrospective, multicenter. POPULATION: Three hundred and fifty-two patients receiving 0.05 (n = 181) or 0.1 (n = 171) mmol/kg gadobenate. FIELD STRENGTH/SEQUENCES: 1.5 T and 3.0 T/precontrast and postcontrast T1-weighted spin echo/fast spin echo (SE/FSE) and/or gradient echo/fast field echo (GRE/FFE); precontrast T2-weighted FSE and T2-FLAIR. ASSESSMENT: Images of patients with extra-axial lesions at 1.5 T or any CNS lesion at 3.0 T were reviewed by three blinded, independent neuroradiologists for qualitative (lesion border delineation, internal morphology visualization, contrast enhancement; scores from 1 = poor to 4 = excellent) and quantitative (lesion-to-brain ratio [LBR], contrast-to-noise ratio [CNR]; SI measurements at regions-of-interest on lesion and normal parenchyma) enhancement measures. Noninferiority of 0.05 mmol/kg gadobenate was determined for each qualitative endpoint if the lower limit of the 95% confidence interval (CI) for the difference in precontrast + postcontrast means was above a noninferiority margin of -0.4. STATISTICAL TESTS: Student's t-test for comparison of mean qualitative endpoint scores, Wilcoxon signed rank test for comparison of LBR and CNR values; Wilcoxon rank sum test for comparison of SI changes. Tests were significant for P < 0.05. RESULTS: The mean change from precontrast to precontrast + postcontrast was significant for all endpoints. Readers 1, 2, and 3 evaluated 304, 225, and 249 lesions for 0.05 mmol/kg gadobenate, and 382, 309, and 298 lesions for 0.1 mmol/kg gadobenate. The lower limit of the 95% CI was above -0.4 for all comparisons. Significantly, higher LBR and CNR was observed with the higher dose. DATA CONCLUSION: 0.05 mmol/kg gadobenate was noninferior to 0.1 mmol/kg gadobenate for lesion visualization. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 3.

• MeSH
• Gadolinium DTPA MeSH
• Contrast Media MeSH
• Humans MeSH
• Magnetic Resonance Imaging MeSH
• Meglumine analogs & derivatives   MeSH
• Brain diagnostic imaging   MeSH
• Brain Neoplasms * MeSH
• Organometallic Compounds * MeSH
• Retrospective Studies MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Randomized Controlled Trial MeSH

BACKGROUND AND PURPOSE: Gadobenate dimeglumine (MultiHance) has higher r1 relaxivity than gadoterate meglumine (Dotarem) which may permit the use of lower doses for MR imaging applications. Our aim was to compare 0.1- and 0.05-mmol/kg body weight gadobenate with 0.1-mmol/kg body weight gadoterate for MR imaging assessment of brain tumors. MATERIALS AND METHODS: We performed crossover, intraindividual comparison of 0.1-mmol/kg gadobenate with 0.1-mmol/kg gadoterate (Arm 1) and 0.05-mmol/kg gadobenate with 0.1-mmol/kg gadoterate (Arm 2). Adult patients with suspected or known brain tumors were randomized to Arm 1 (70 patients) or Arm 2 (107 patients) and underwent 2 identical examinations at 1.5 T. The agents were injected in randomized-sequence order, and the 2 examinations were separated by 2-14 days. MR imaging scanners, imaging sequences (T1-weighted spin-echo and T1-weighted high-resolution gradient-echo), and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images for diagnostic information (degree of definition of lesion extent, lesion border delineation, visualization of lesion internal morphology, contrast enhancement) and quantitatively for percentage lesion enhancement and lesion-to-background ratio. Safety assessments were performed. RESULTS: In Arm 1, a highly significant superiority (P < .002) of 0.1-mmol/kg gadobenate was demonstrated by all readers for all end points. In Arm 2, no significant differences (P > .1) were observed for any reader and any end point, with the exception of percentage enhancement for reader 2 (P < .05) in favor of 0.05-mmol/kg gadobenate. Study agent-related adverse events were reported by 2/169 (1.2%) patients after gadobenate and by 5/175 (2.9%) patients after gadoterate. CONCLUSIONS: Significantly superior morphologic information and contrast enhancement are demonstrated on brain MR imaging with 0.1-mmol/kg gadobenate compared with 0.1-mmol/kg gadoterate. No meaningful differences were recorded between 0.05-mmol/kg gadobenate and 0.1-mmol/kg gadoterate.

• MeSH
• Adult MeSH
• Cross-Over Studies MeSH
• Contrast Media MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Meglumine analogs & derivatives   MeSH
• Brain Neoplasms pathology   MeSH
• Organometallic Compounds MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

AIM: To compare the quality of magnetic resonance angiographies (MRAs) performed with different contrast agents and to evaluate the effect of body mass index (BMI) and ejection fraction (EF) on the quality of these MRAs. MATERIALS AND METHODS: 120 patients between the age of 43 and 86 years were subjected to MRAs with different contrast agents (Gadobutrolum, Dimeglumini gadobenas, Gadofosveset trisodium). Each patient's BMI was calculated, and EF was established using MR examination of the heart. Objective evaluations of the quality of the MRAs were done using abdominal fat-to-aorta enhancement ratio (FAR) comparisons. This ratio was then correlated with the patient's BMI and EF. Subjective evaluations of the quality of the MRAs were done by 5 blinded evaluators. Correlation analysis and analysis of variance were used for statistical assessement. RESULTS: There was no statistically significant difference in FAR for any of the contrast agent groups. There was a mesoscale correlation between a patient's BMI and FAR. However, no correlation was found between the EF and FAR for any of the contrast agent groups. The results of the subjective evaluation showed that there was no statistical difference in the quality of MRAs regardless of the contrast agent used. CONCLUSION: Subjectively there was no statistically significant difference in the quality of the MRAs. Irrespective of the type of contrast used or the patient's EF, the lower the BMI of a patient the higher the signal enhancement and hence the better the quality of the MRA produced in that patient.

• MeSH
• Aorta, Abdominal pathology   MeSH
• Leg blood supply   MeSH
• Adult MeSH
• Gadolinium diagnostic use   MeSH
• Body Mass Index MeSH
• Contrast Media MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging, Cine MeSH
• Magnetic Resonance Angiography MeSH
• Meglumine analogs & derivatives   diagnostic use   MeSH
• Peripheral Arterial Disease diagnosis   physiopathology   MeSH
• Organometallic Compounds diagnostic use   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Heart MeSH
• Stroke Volume MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Comparative Study MeSH

BACKGROUND AND PURPOSE: Gadobenate dimeglumine has proved advantageous compared with other gadolinium-based contrast agents for contrast-enhanced brain MR imaging. Gadobutrol is a more highly concentrated agent (1.0 mol/L). This study intraindividually compared 0.1-mmol/kg doses of these agents for qualitative and quantitative evaluation of brain tumors. MATERIALS AND METHODS: Adult patients with suspected or known brain tumors underwent 2 identical MR imaging examinations at 1.5T, 1 with gadobenate dimeglumine and the other with gadobutrol, both at a dose of 0.1-mmol/kg body weight. The agents were injected in randomized order separated by 3-14 days. Imaging sequences and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images qualitatively for diagnostic information (lesion extent, delineation, morphology, enhancement, global preference) and quantitatively for CNR and LBR. RESULTS: One hundred fourteen of 123 enrolled patients successfully underwent both examinations. Final diagnoses were intra-axial tumors, metastases, extra-axial tumors, "other" tumors, and "nontumor" (49, 46, 8, 7, and 4 subjects, respectively). Readers 1, 2, and 3 demonstrated preference for gadobenate dimeglumine in 46 (40.7%), 54 (47.4%), and 49 (43.0%) patients, respectively, compared with 6, 7, and 7 patients for gadobutrol (P < .0001, all readers). Highly significant (P < .0001, all readers) preference for gadobenate dimeglumine was demonstrated for all other qualitative end points. Inter-reader agreement was good for all evaluations (κ = 0.414-0.629). Significantly superior CNR and LBR were determined for gadobenate dimeglumine (P < .019, all readers). CONCLUSIONS: Significantly greater morphologic information and lesion enhancement are achieved on brain MR imaging with 0.1-mmol/kg gadobenate dimeglumine compared with gadobutrol at an equivalent dose.

• MeSH
• Adult MeSH
• Contrast Media MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Meglumine analogs & derivatives   diagnostic use   MeSH
• Young Adult MeSH
• Brain Neoplasms pathology   MeSH
• Observer Variation MeSH
• Organometallic Compounds diagnostic use   MeSH
• Reproducibility of Results MeSH
• Aged MeSH
• Sensitivity and Specificity MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Research Support, Non-U.S. Gov't MeSH
• Randomized Controlled Trial MeSH
• Comparative Study MeSH
• Geographicals
• Czech Republic MeSH

Cíl. Prezentace prvních zkušeností s technikou vakuové biopsie na magnetické rezonanci (MR). Metoda. Všechna vyšetření byla provedena na přístroji Magnetom Avanto 1,5T (Siemens, Erlangen, Německo) s využitím systému Breast Biopsy System (Siemens, Erlangen, Německo). Vlastní biopsie byly prováděny bioptickým systémem Vacora Vacuum Assisted Breast Biopsy pracujícím na principu vakuové biopsie. Výsledky. V období od srpna 2007 do dubna 2008 bylo vyšetřeno 17 pacientek. Histologicky se jednalo o 6× invazivní karcinom (36 %), 2× DCIS (11 %), 6× benigní nález (36 %), 3× normální tkáň mamy (17 %). Žádné vyšetření nemuselo být zrušeno či předčasně ukončeno z důvodů technických či jiných, během vyšetření ani po vyšetření nebyla zaznamenána žádná zdravotní komplikace. Závěr. Biopsie pod MR kontrolou vhodně doplňuje celý vyšetřovací algoritmus při diagnostice karcinomu prsu. V kombinaci s magnetickou rezonancí se biopsie vyznačuje vysokou senzitivitou. Uplatnění nachází zejména v případech, kdy ložisková léze v prsu nemá korelát v jiných modalitách.

Aim. Presentation of our first experiences with vacuum biopsy technique guided by magnetic resonance (MR). Materials and method. All examinations were performed on MR Magnetom Avanto 1.5T system (Siemens, Erlangen, Germany) with Breast Biopsy device system (Siemens, Erlangen, Germany). The biopsies were done using Vacora Vacuum Assisted Breast Biopsy system. Results. 17 patients were examined from September 2007 till April 2008. Histological verification was 6× invasive carcinoma (36%), 2× DCIS (11%), 6× benign lesion (36%), 3× normal breast tissue (17%). No examination had to be cancelled or precociously ended from any reasons, there was no medical complication after the procedure. Conclusion. Biopsy guided under MR control precisely fills up the whole examination algorithm in diagnostics of breast carcinoma. Such biopsy in combination with MR displays high sensitivity. The use of this technique is especially valuable in cases, where breast lesion has no correlation in any other modality.

• MeSH
• Biopsy methods   instrumentation   utilization   MeSH
• Histological Techniques methods   utilization   MeSH
• Contrast Media MeSH
• Humans MeSH
• Magnetic Resonance Imaging, Interventional methods   instrumentation   utilization   MeSH
• Meglumine analogs & derivatives   diagnostic use   MeSH
• Breast Neoplasms diagnosis   MeSH
• Breast Diseases diagnosis   MeSH
• Prospective Studies MeSH
• Sensitivity and Specificity MeSH
• Outcome and Process Assessment, Health Care methods   trends   utilization   MeSH
• Check Tag
• Humans MeSH
• Female MeSH

Cíl. Zhodnotit vlastní zkušenosti s MR mammografií jakožto doplňkovou metodou k mammografii, respektive ultrasonografii a srovnat je s dostupnými výsledky. Metoda. Celkově od 6/04 do 1/08 vyšetřeno 342 pacientek. Byl použit přístroj Magnetom Symphony (Siemens) s dedikovanou dvojitou prsní cívkou. Ve vyšetřovacím protokolu byly provedeny tyto sekvence: nativně T1W a STIR, dynamické T1W sekvence s potlačením signálu tuku a postkontrastní T1W s potlačením signálu tuku ve vysokém rozlišení pro multiplanární rekonstrukce (MPR). Výsledky. Z 342 případů byl u 63 výsledek histologicky verifikován ? 27 invazivních karcinomů, 5 prekanceróz a 31 benigních lézí. Naše senzitivita MRM při znalosti výsledků předchozího mammologického vyšetření byla 93,75 %, specificita 67,74 %, pozitivní prediktivní hodnota 75 % a negativní prediktivní hodnota 91 %. Závěr. Námi zjištěné hodnoty senzitivity, specificity, pozitivní prediktivní a negativní prediktivní hodnoty byly ve shodě s literárními zdroji. Tyto hodnoty dle literatury jsou však značně odlišné, pokud je hodnotíme u jednotlivých indikačních skupin.

Aim. It was evaluate experience with the breast MR imaging as adjunctive techniques to mammography/sonography and to comparison with research studies. Methods. There were investigated 342 patients from 6/04 to 1/08. We used equipment- Magnetom Symphony (Siemens) and dedicated breast coil. It was used to acquire non-contrast T1WI, STIR, than followed by the dynamic-contrast-enhanced images and fat-suppressed T1W with high resolution usable for MPR. Results. 63 of all patiens were histologically proved - 27 invasive cancers, 5 precancers, 31 benign lesions. Our sensitivity reached 93.75%, and specificity 67.74%. Positive predictive value was 75% and negative predictive value of 91%. Conclusion. The sensitivity, specificity, positive predictive value and negative predictive value breast MR imaging was similarly like these values in published research studies.

• MeSH
• Histological Techniques methods   utilization   MeSH
• Contrast Media MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   utilization   MeSH
• Mammography methods   utilization   MeSH
• Meglumine analogs & derivatives   diagnostic use   MeSH
• Breast Diseases diagnosis   MeSH
• Organometallic Compounds diagnostic use   MeSH
• Prospective Studies MeSH
• Sensitivity and Specificity MeSH
• Statistics as Topic methods   MeSH
• Ultrasonography, Mammary methods   utilization   MeSH
• Outcome and Process Assessment, Health Care methods   trends   utilization   MeSH
• Check Tag
• Humans MeSH
• Female MeSH