Contrast-enhanced MR angiography of the run-off vasculature: intraindividual comparison of gadobenate dimeglumine with gadopentetate dimeglumine

PURPOSE: To compare intraindividually gadobenate dimeglumine (Gd-BOPTA) with gadopentetate dimeglumine (Gd-DTPA) for multi-station MR Angiography of the run-off vessels. MATERIALS AND METHODS: Twenty-one randomized healthy volunteers received either Gd-BOPTA or Gd-DTPA as a first injection and then the other agent as a second injection after a minimum interval of 6 days. Each agent was administered at a dose of 0.1 mmol/kg bodyweight followed by a 25-mL saline flush at a single constant flow rate of 0.8 mL/second. Images were acquired sequentially at the level of the pelvis, thigh, and calf using a fast three-dimensional (3D) gradient echo sequence. Source, subtracted source, maximum intensity projection (MIP), and subtracted MIP image sets from each examination were evaluated quantitatively and qualitatively on a segmental basis involving nine vascular segments. RESULTS: Significantly (P < 0.05) higher signal-to-noise and contrast-to-noise ratios were noted for Gd-BOPTA compared to Gd-DTPA, with the more pronounced differences evident in the more distal vessels. Qualitative assessmentrevealed no differences in the abdominal vasculature, a preference for Gd-BOPTA in the pelvic vasculature, and markedly better performance for Gd-BOPTA in the femoral and tibial vasculature. Summation of individual diagnostic quality scores for each segment revealed a significantly (P = 0.0001) better performance for Gd-BOPTA compared to Gd-DTPA. CONCLUSION: Greater vascular enhancement of the run-off vasculature is obtained after Gd-BOPTA, particularly in the smaller more distal vessels. Enhancement differences are not merely dose dependent, but may be due to different vascular enhancement characteristics of the agents.     

Safety characteristics of gadobenate dimeglumine: clinical experience from intra- and interindividual comparison studies with gadopentetate dimeglumine

PURPOSE: To evaluate the safety and tolerability of gadobenate dimeglumine (Gd-BOPTA) relative to that of gadopentetate dimeglumine (Gd-DTPA) in patients and volunteers undergoing MRI for various clinical conditions. MATERIALS AND METHODS: A total of 924 subjects were enrolled in 10 clinical trials in which Gd-BOPTA was compared with Gd-DTPA. Of these subjects, 893 were patients with known or suspected disease and 31 were healthy adult volunteers. Of the 893 patients, 174 were pediatric subjects (aged two days to 17 years) referred for MRI of the brain or spine. Safety evaluations included monitoring vital signs, laboratory values, and adverse events (AE). RESULTS: The rate of AE in adults was similar between the two agents (Gd-BOPTA: 51/561, 9.1%; Gd-DTPA: 33/472, 7.0%; P = 0.22). In parallel-group studies in which subjects were randomized to either agent, the rate of AE was 10.9% for Gd-BOPTA and 7.9% for Gd-DTPA (P = 0.21). In the subset of subjects receiving both agents in intraindividual crossover trials, the rate of AE was 8.0% for Gd-BOPTA and 8.5% for Gd-DTPA (P = 0.84). Results of other safety assessments (laboratory tests, vital signs) were similar for the two agents. CONCLUSION: The safety profile of Gd-BOPTA is similar to Gd-DTPA in patients and volunteers. Both compounds are equally well-tolerated in patients with various disease states undergoing MRI.     

Optimized high-resolution contrast-enhanced hepatobiliary imaging at 3 tesla: a cross-over comparison of gadobenate dimeglumine and gadoxetic acid

Purpose:

To evaluate the signal to noise ratio (SNR) and contrast to noise ratio (CNR) performance of 0.05 mmol/kg gadoxetic acid and 0.1 mmol/kg gadobenate dimeglumine for dynamic and hepatobiliary phase imaging. In addition, flip angles (FA) that maximize relative contrast‐to‐noise performance for hepatobiliary phase imaging were determined.

Materials and Methods:

A cross‐over study in 10 volunteers was performed using each agent. Imaging was performed at 3 Tesla (T) with a 32‐channel phased‐array coil using breathheld 3D spoiled gradient echo sequences for SNR and CNR analysis, and for FA optimization of hepatobiliary phase imaging.

Results:

Gadobenate dimeglumine (0.1 mmol/kg) had superior SNR performance during the dynamic phase, statistically significant for portal vein and hepatic vein in the portal venous and venous phase (for all, P < 0.05) despite twice the approved dose of gadoxetic acid (0.05 mmol/kg), while gadoxetic acid had superior SNR performance during the hepatobiliary phase. Optimal FAs for hepatobiliary phase imaging using gadoxetic acid and gadobenate dimeglumine were 25–30° and 20–30° for relative contrast liver versus muscle (surrogate for nonhepatocellular tissues), and 45° and 20° (relative contrast liver versus biliary structures), respectively.

Conclusion:

Gadobenate dimeglumine may be preferable for applications that require dynamic phase imaging only, while gadoxetic acid may be preferable when the hepatobiliary phase is clinically important. Hepatobiliary phase imaging with both agents benefits from flip angle optimization. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.     

Contrast‐enhanced whole‐heart coronary MRI with bolus infusion of gadobenate dimeglumine at 1.5 T

We sought to investigate the T₁ kinetics of blood and myocardium after three infusion schemes of gadobenate dimeglumine (Gd‐BOPTA) and subsequently compared contrast‐enhanced whole‐heart coronary MRI after a bolus Gd‐BOPTA infusion with nonenhanced coronary MRI at 1.5 T. Blood and myocardium T₁ was measured in seven healthy adults, after each underwent three Gd‐BOPTA infusion schemes (bolus: 0.2 mmol/kg at 2 mL/sec, hybrid: 0.1 mmol/kg at 2 mL/sec followed by 0.1 mmol/kg at 0.1 mL/sec, and slow: 0.2 mmol/kg at 0.3 mL/sec). Fourteen additional subjects underwent contrast‐enhanced coronary MRI with an inversion‐recovery steady‐state free precession sequence after bolus Gd‐BOPTA infusion. Images were compared with nonenhanced T₂‐prepared steady‐state free precision whole‐heart coronary MRI in signal‐to‐noise ratio, contrast‐to‐noise ratio, depicted vessel length, vessel sharpness, and subjective image quality. Bolus and slow infusion schemes resulted in similar T₁ during coronary MRI, whereas the hybrid infusion method yielded higher T₁ values. A bolus infusion of Gd‐BOPTA significantly improved signal‐to‐noise ratio, contrast‐to‐noise ratio, depicted coronary artery length, and subjective image quality, when all segments were collectively compared but not when compared segment by segment. In conclusion, whole‐heart steady‐state free precision coronary MRI at 1.5 T can benefit from a bolus infusion of 0.2 mmol/kg Gd‐BOPTA. Magn Reson Med, 2011. © 2010 Wiley‐Liss, Inc.     

Enhancement of the liver and pancreas in the hepatic arterial dominant phase: Comparison of hepatocyte‐specific MRI contrast agents,gadoxetic acid and gadobenate dimeglumine,on 3 and 1.5 tesla MRI in the same patient

Purpose:

To evaluate the relative enhancement of liver, pancreas, focal nodular hyperplasia (FNH), pancreas‐to‐liver index, and FNH‐to‐liver index in the hepatic arterial dominant phase (HADP) after injection of hepatocyte‐specific MRI contrast agents, gadoxetic acid and gadobenate dimeglumine, on 3 and 1.5 Tesla (T) MRI in the same patient.

Materials and Methods:

The MRI database was retrospectively searched to identify consecutive patients who underwent abdominal MRI at 3T and 1.5T systems, using both 0.025 mmol/kg gadoxetic acid‐enhanced and 0.05 mmol/kg gadobenate dimeglumine‐enhanced MRI at the same magnetic strength field system. 22 patients were identified, 10 were scanned at 3T system and 12 at 1.5T system. The enhancement of liver, pancreas, and FNH was evaluated quantitatively on MR images.

Results:

The relative enhancement of liver in HADP in the gadobenate dimeglumine‐enhanced group in all subjects was significantly higher than that in gadoxetic acid‐enhanced group (P = 0.023). The gadobenate dimeglumine‐enhanced group in HADP had better relative enhancement of pancreas and FNH, pancreas‐to‐liver index, and FNH‐to‐liver index than gadoxetic acid‐enhanced group, but the difference was not statistically significant.

Conclusion:

The 0.05 mmol/kg gadobenate dimeglumine‐enhanced abdominal MRI studies at 3T and 1.5T MR systems are superior in relative enhancement of the liver in HADP to 0.025 mmol/kg gadoxetic acid‐enhanced MRI. This type of assessment may provide comparative effectiveness data. J. Magn. Reson. Imaging 2013;37:903–908. © 2012 Wiley Periodicals, Inc.     

Primary and secondary brain tumors at MR imaging: bicentric intraindividual crossover comparison of gadobenate dimeglumine and gadopentetate dimeglumine

PURPOSE: To evaluate the safety of and compare the enhancement characteristics of gadobenate dimeglumine (MultiHance; Bracco Imaging, Milan, Italy) with those of a standard gadolinium chelate (gadopentetate dimeglumine, Magnevist; Schering, Berlin, Germany) in primary and secondary brain tumors on the basis of qualitative and quantitative parameters, on an intraindiviual basis. MATERIALS AND METHODS: Twenty-seven patients with either high-grade glioma or metastases were enrolled in a bicentric intraindividual crossover study to compare lesion enhancement with doses of 0.1 mmol per kilogram of body weight of 0.5 mol/L gadopentetate dimeglumine and 0.5 mol/L gadobenate dimeglumine. MR imaging was performed before injection (T1-weighted spin-echo [SE] and T2-weighted fast SE acquisitions) and at 1, 3, 5, 7, 9, and 16 minutes after injection (T1-weighted SE acquisitions). Qualitative assessment was performed by blinded off-site readers (for 22 patients) and on-site investigators (for 24 patients) in terms of global contrast enhancement, lesion-to-brain contrast, lesion delineation, internal lesion morphology and structure, tumor vascularization, and global image preference. Additional quantitative assessment with region-of-interest analysis was performed by off-site readers alone. Statistical analysis of qualitative data was performed with the Wilcoxon signed rank test, whereas a nonparametric approach was adopted for analysis of quantitative data. RESULTS: Significant (P <.05) preference for gadobenate dimeglumine over gadopentetate dimeglumine was noted both off-site and on-site for the global assessment of contrast enhancement. For off-site readers 1 and 2 and the on-site investigators, respectively, gadobenate dimeglumine was preferred in 13, 17, and 16 patients; gadopentetate dimeglumine was preferred in four, four, and four patients; and equality was found in five, one, and four patients). Similar preference for gadobenate dimeglumine was noted by off-site readers and on-site investigators for lesion-to-brain contrast and all other qualitative parameters. Off-site quantitative evaluation revealed significantly (P <.05) superior enhancement for gadobenate dimeglumine compared with that for gadopentetate dimeglumine at all time points from 3 minutes after injection. CONCLUSION: Significantly superior contrast enhancement of intraaxial enhancing brain tumors was achieved with 0.1 mmol/kg gadobenate dimeglumine compared with that with 0.1 mmol/kg gadopentetate dimeglumine.     

Enhancing lesions of the brain: intraindividual crossover comparison of contrast enhancement after gadobenate dimeglumine versus established gadolinium comparators

RATIONALE AND OBJECTIVES: Gadobenate dimeglumine (Gd-BOPTA) possesses a two-fold higher T1 relaxivity compared to other available gadolinium contrast agents. The study was conducted to evaluate the benefits of this increased relaxivity for MR imaging of intracranial enhancing brain lesions. MATERIALS AND METHODS: Forty-five patients (31 males, 14 females) with suspected glioma or cerebral metastases were evaluated. Patients received Gd-BOPTA and either Gd-DTPA (n = 23) or Gd-DOTA (n = 22) in fully randomized order at 0.1 mmol/kg body weight and at a flow rate of 2 ml/s. The second agent was administered 1-14 days after the first agent. Images were acquired precontrast (T1wSE, T2wFSE sequences) and at sequential postcontrast time-points (T1wSE sequences at 0, 2, 4, 6, and 8 and 15 min and a T1wSE-MT sequence at 12 min) at 1.0 or 1.5 T using a head coil. Determination of contrast enhancement was performed quantitatively (lesion-to-brain ratio, contrast-to-noise ratio, and percent enhancement) and qualitatively (border delineation, internal morphology, contrast enhancement, and diagnostic preference) by two independent, fully blinded readers. RESULTS: Images from 43/45 patients were available for quantitative assessment. After correction for precontrast values, significantly greater lesion-to-brain ratio (P < .003), contrast-to-noise ratio (P < .03), and percent enhancement (P < .0001) was noted by both readers for Gd-BOPTA-enhanced images at all time-points from 2 min postcontrast. Qualitative assessment of all patients similarly revealed significant preference for Gd-BOPTA for lesion border delineation (P < .004), lesion internal morphology (P < .008), contrast enhancement (P < .0001), and diagnostic preference (P < .0005). CONCLUSIONS: The greater T1 relaxivity of Gd-BOPTA permits improved visualization of intracranial enhancing lesions compared to conventional gadolinium agents.     

钆贝酸二葡甲胺与钆喷酸葡胺乳腺MRI的多中心、双盲、随机、个体间交叉对照研究(检出实验)

目的利用前瞻性、多中心双盲随机数据对0.1mmol/kg剂量的钆贝酸二葡甲胺与钆喷酸葡胺对比剂增强乳腺MRI行个体间对照研究。材料与方法研究经学院评     

Breathhold‐regulated blood oxygenation level‐dependent (BOLD) MRI of human brain at 3 tesla

Purpose:

To investigate the cerebrovascular response to repeated breathhold challenges using blood oxygenation level‐dependent (BOLD) MRI at 3T and compare the results with previous data at 1.5T.

Materials and Methods:

Six normal volunteers and six patients with brain tumors were recruited for this 3T study. For the normal group, BOLD MRI during repeated breathholds of different durations (five to 30 seconds) were acquired. Maximum signal change, full‐width at half‐maximum (FWHM) and onset time (defined as the time to the first half‐maximum) were determined by curve fitting. The fractional activation volume was also calculated. Patients performed a 10‐ or 15‐second breathhold paradigm according to individual capability.

Results:

Significant BOLD signal increases in the gray matter for a breathhold period as short as 5 seconds at 3T, instead of 10 seconds at 1.5T. The fractional activation volume vs. breathhold duration reached a plateau of 49.54 ± 7.26% at 15 seconds at 3T, which was higher and shorter than that at 1.5T. The maximum signal changes were significantly larger (a 69% increase) at 3T than at 1.5T. In the patient group, there were BOLD signal increases in gray matter but not in tumor bulk or perifocal edema, which agreed with the results previously found at 1.5T.

Conclusion:

BOLD MRI at 3T is more sensitive for detecting breathhold‐regulated signal changes than at 1.5T, which allows a shorter and more feasible breathhold paradigm for clinical applications in patients with brain tumors. J. Magn. Reson. Imaging 2010;31:78–84. © 2009 Wiley‐Liss, Inc.     

Measurement of brain perfusion,blood volume,and blood‐brain barrier permeability,using dynamic contrast‐enhanced T1‐weighted MRI at 3 tesla

Assessment of vascular properties is essential to diagnosis and follow‐up and basic understanding of pathogenesis in brain tumors. In this study, a procedure is presented that allows concurrent estimation of cerebral perfusion, blood volume, and blood‐brain permeability from dynamic T₁‐weighted imaging of a bolus of a paramagnetic contrast agent passing through the brain. The methods are applied in patients with brain tumors and in healthy subjects. Perfusion was estimated by model‐free deconvolution using Tikhonov's method (gray matter/white matter/tumor: 72 ± 16/30 ± 8/56 ± 45 mL/100 g/min); blood volume (6 ± 2/4 ± 1/7 ± 6 mL/100 g) and permeability (0.9 ± 0.4/0.8 ± 0.3/3 ± 5 mL/100 g/min) were estimated by using Patlak's method and a two‐compartment model. A corroboration of these results was achieved by using model simulation. In addition, it was possible to generate maps on a pixel‐by‐pixel basis of cerebral perfusion, cerebral blood volume, and blood‐brain barrier permeability. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.     

A double-blind,comparative study of gadodiamide injection and gadopentetate dimeglumine in MRI of the central nervous system

Summary Seventy-nine patients with known or suspected central nervous system lesions were studied with MRI in a phase III double-blind study. Forty were given gadopentetate dimeglumine (Gd-DTPA) and 39 gadodiamide injection (Gd-DTPA BMA), a new low-osmolar nonionic contrast enhancing medium. The dosage was 0.1 mmol/kg body weight, corresponding to 0.2 ml/kg. Spin-echo sequences were performed before and immediately after injection. The safety and efficacy of the two contrast media were assessed. No changes were observed in blood pressure, heart rate or neurological status. Five adverse effects (two episodes of headaches, two of nausea and one of dizziness) were reported by 2 patients who received gadodiamide injection and 1 who received gadopentetate dimeglumine. All events were mild and their relationship to the contrast media was uncertain. For both contrast media statistically significant changes in serum iron were observed 24 h after injection. More than 70% of the patients had abnormal findings on MRI, and in 56% of these contrast enhancement of the abnormal structure or lesion was seen. Contrast enhancement provided the diagnosis in about 50%, changed it in 40% and increased diagnostic confidence in 95%.