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.
- Klíčová slova
- GBCA safety, comparative studies, contrast efficacy, gadobenate dimeglumine,
- MeSH
- diethylentriaminpentaacetát gadolinia MeSH
- kontrastní látky MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- meglumin analogy a deriváty MeSH
- mozek diagnostické zobrazování MeSH
- nádory mozku * MeSH
- organokovové sloučeniny * MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- diethylentriaminpentaacetát gadolinia MeSH
- gadobenic acid MeSH Prohlížeč
- kontrastní látky MeSH
- meglumin MeSH
- organokovové sloučeniny * 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
- dospělí MeSH
- klinické křížové studie MeSH
- kontrastní látky MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- meglumin analogy a deriváty MeSH
- nádory mozku patologie MeSH
- organokovové sloučeniny MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
- Názvy látek
- gadobenic acid MeSH Prohlížeč
- gadoterate meglumine MeSH Prohlížeč
- kontrastní látky MeSH
- meglumin MeSH
- organokovové sloučeniny 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
- dospělí MeSH
- kontrastní látky MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- meglumin analogy a deriváty MeSH
- mladý dospělý MeSH
- nádory mozku patologie MeSH
- odchylka pozorovatele MeSH
- organokovové sloučeniny * MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH
- Názvy látek
- gadobenic acid MeSH Prohlížeč
- gadobutrol MeSH Prohlížeč
- kontrastní látky MeSH
- meglumin MeSH
- organokovové sloučeniny * 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 abdominalis patologie MeSH
- bérec krevní zásobení MeSH
- dospělí MeSH
- gadolinium * MeSH
- index tělesné hmotnosti * MeSH
- kontrastní látky * MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonance kinematografická * MeSH
- magnetická rezonanční angiografie * MeSH
- meglumin analogy a deriváty MeSH
- onemocnění periferních arterií diagnóza patofyziologie MeSH
- organokovové sloučeniny * MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- srdce MeSH
- tepový objem * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- gadobenic acid MeSH Prohlížeč
- gadobutrol MeSH Prohlížeč
- gadofosveset trisodium MeSH Prohlížeč
- gadolinium * MeSH
- kontrastní látky * MeSH
- meglumin MeSH
- organokovové sloučeniny * MeSH
One of the recognised complications of catheter ablation is pulmonary venous stenosis. The aim of this study was to compare two methods of evaluation of pulmonary venous diameter for follow-up assessment of the above complication: (1) a linear approach evaluating two main diameters of the vein, (2) semiautomatically measured cross-sectional area (CSA). The study population consists of 29 patients. All subjects underwent contrast-enhanced magnetic resonance angiography (CeMRA) of the pulmonary veins (PVs) before and after the ablation; 14 patients were also scanned 3 months later. PV diameter was evaluated from two-dimensional multiplanar reconstructions by measuring either the linear diameter or CSA. A comparison between pulmonary venous CSA and linear measurements revealed a systematic difference in absolute values. This difference was not significant when comparing the relative change CSA and quadratic approximation using linear extents (linear approach). However, a trend towards over-estimation of calibre reduction was documented for the linear approach. Using CSA assessment, significant PV stenosis was found in ten PVs (8%) shortly after ablation. Less significant PV stenosis, ranging from 20 to 50% was documented in other 18 PVs (15%). CeMRA with CSA assessment of the PVs is suitable method for evaluation of PV diameters.
- MeSH
- dospělí MeSH
- fantomy radiodiagnostické MeSH
- fibrilace síní chirurgie MeSH
- katetrizační ablace škodlivé účinky MeSH
- kontrastní látky MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční angiografie metody MeSH
- meglumin analogy a deriváty MeSH
- organokovové sloučeniny MeSH
- počítačové zpracování obrazu MeSH
- reprodukovatelnost výsledků MeSH
- senioři MeSH
- stenóza pulmonální chlopně diagnóza etiologie MeSH
- studie případů a kontrol MeSH
- venae pulmonales * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Názvy látek
- gadobenic acid MeSH Prohlížeč
- kontrastní látky MeSH
- meglumin MeSH
- organokovové sloučeniny MeSH