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Dekker HM, Stroomberg GJ, Van der Molen AJ, Prokop M. Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents. Insights Imaging 2024; 15:62. [PMID: 38411847 PMCID: PMC10899148 DOI: 10.1186/s13244-024-01626-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Gadolinium-based contrast agents (GBCA) are essential for diagnostic MRI examinations. GBCA are only used in small quantities on a per-patient basis; however, the acquisition of contrast-enhanced MRI examinations worldwide results in the use of many thousands of litres of GBCA per year. Data shows that these GBCA are present in sewage water, surface water, and drinking water in many regions of the world. Therefore, there is growing concern regarding the environmental impact of GBCA because of their ubiquitous presence in the aquatic environment. To address the problem of GBCA in the water system as a whole, collaboration is necessary between all stakeholders, including the producers of GBCA, medical professionals and importantly, the consumers of drinking water, i.e. the patients. This paper aims to make healthcare professionals aware of the opportunity to take the lead in making informed decisions about the use of GBCA and provides an overview of the different options for action.In this paper, we first provide a summary on the metabolism and clinical use of GBCA, then the environmental fate and observations of GBCA, followed by measures to reduce the use of GBCA. The environmental impact of GBCA can be reduced by (1) measures focusing on the application of GBCA by means of weight-based contrast volume reduction, GBCA with higher relaxivity per mmol of Gd, contrast-enhancing sequences, and post-processing; and (2) measures that reduce the waste of GBCA, including the use of bulk packaging and collecting residues of GBCA at the point of application.Critical relevance statement This review aims to make healthcare professionals aware of the environmental impact of GBCA and the opportunity for them to take the lead in making informed decisions about GBCA use and the different options to reduce its environmental burden.Key points• Gadolinium-based contrast agents are found in sources of drinking water and constitute an environmental risk.• Radiologists have a wide spectrum of options to reduce GBCA use without compromising diagnostic quality.• Radiology can become more sustainable by adopting such measures in clinical practice.
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Affiliation(s)
- Helena M Dekker
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands.
| | - Gerard J Stroomberg
- RIWA-Rijn - Association of River Water Works, Groenendael 6, 3439 LV, Nieuwegein, The Netherlands
| | - Aart J Van der Molen
- Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Mathias Prokop
- Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
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Comparison of Gadobenate-Enhanced MRI and Gadoxetate-Enhanced MRI for Hepatocellular Carcinoma Detection Using LI-RADS Version 2018: A Prospective Intraindividual Randomized Study. AJR Am J Roentgenol 2021; 218:687-698. [PMID: 34817191 DOI: 10.2214/ajr.21.26818] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: Gadobenate and gadoxetate demonstrate different degrees of intracellular accumulation within hepatocytes, potentially impacting these agents' relative performance for hepatocellular carcinoma (HCC) diagnosis. Objective: To perform an intraindividual comparison of gadobenate-enhanced MRI and gadoxetate-enhanced MRI for detection of HCC, and to assess the impact of inclusion of hepatobiliary phase images on HCC detection for both agents. Methods: This prospective study enrolled 126 patients (112 men, 14 women; mean age 52.3 years) at high risk for HCC who consented to undergo two 3-T liver MRI examinations [one using gadobenate (0.05 mmol/kg), one using gadoxetate (0.025 mmol/kg)], separated by 7-14 days. The order of the two contrast agents was randomized. All examinations included post-contrast dynamic and hepatobiliary phase images (120 minutes for gadobenate; 20 minutes for gadoxetate). Three radiologists independently reviewed the gadobenate and gadoxetate examinations in separate sessions and recorded the location of detected observations. Observations were classified using LI-RADS version 2018 and using a LI-RADS modification whereby hepatobiliary phase hypointensity may upgrade observations from LR-4 to LR-5. Observations classified as LR-5 were considered positive interpretations for HCC. Diagnostic performance for histologically confirmed HCC (n=96) was assessed. Results: Across readers, sensitivity for HCC using dynamic images alone was 74.0%-80.2% for gadobenate versus 54.2%-67.7% for gadoexetate and using dynamic and hepatobiliary phase images was 82.1%-87.4% for gadobenate versus 66.3%-81.1% for gadoxetate. For HCCs measuring 1.0-2.0 cm, sensitivity using dynamic images alone was 61.9% (all readers) for gadobenate versus 38.1%-57.1% for gadoxetate and using dynamic and hepatobiliary phase images was 76.2%-85.7% for gadobenate versus 52.4%-61.9% for gadoxetate. PPV for HCC ranged from 88.6%-97.4% across readers, agents, and image sets. Conclusion: Sensitivity for HCC was higher for gadobenate than for gadoxetate, whether using dynamic images alone or dynamic and hepatobiliary phase images; the improved sensitivity using gadobenate was more pronounced for small HCCs. While hepatobiliary phase images improved sensitivity for both agents, sensitivity of gadobenate using dynamic images alone compared favorably with that of gadoxetate using dynamic and hepatobiliary phase images. Clinical Impact: The findings support gadobenate as a preferred agent over gadoxetate when performing liver MRI in patients at high risk for HCC.
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3
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DeLano MC, Spampinato MV, Chang EY, Barr RG, Lichtenstein RJ, Colosimo C, Vymazal J, Wen Z, Lin DDM, Kirchin MA, Pirovano G. Dose-Lowering in Contrast-Enhanced MRI of the Central Nervous System: A Retrospective, Parallel-Group Comparison Using Gadobenate Dimeglumine. J Magn Reson Imaging 2021; 54:1660-1675. [PMID: 34018290 PMCID: PMC9290706 DOI: 10.1002/jmri.27731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
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
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Affiliation(s)
- Mark C DeLano
- Spectrum Health System, Advanced Radiology Services PC, Division of Radiology and Biomedical Imaging, College of Human Medicine, Michigan State University, Michigan, USA
| | - Maria Vittoria Spampinato
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Richard G Barr
- Department of Radiology, Rootstown, Northeastern Ohio Medical University, Rootstown, Ohio, USA
| | | | - Cesare Colosimo
- Institute of Radiology, Radiodiagnostica e Neuroradiologia, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Josef Vymazal
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Doris D M Lin
- Division of Neuroradiology, Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Miles A Kirchin
- Global Medical & Regulatory Affairs, Bracco Imaging SpA, Milan, Italy
| | - Gianpaolo Pirovano
- Global Medical & Regulatory Affairs, Bracco Diagnostics Inc., Monroe, New Jersey, USA
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Cha DI, Choi GS, Kim YK, Kim JM, Kang TW, Song KD, Ahn SH. Extracellular contrast-enhanced MRI with diffusion-weighted imaging for HCC diagnosis: prospective comparison with gadoxetic acid using LI-RADS. Eur Radiol 2020; 30:3723-3734. [DOI: 10.1007/s00330-020-06753-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/05/2020] [Accepted: 02/17/2020] [Indexed: 02/08/2023]
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Enterline DS, Martin KW, Parmar HA, Triulzi FM, Colosimo C. Safety and Diagnostic Efficacy of Gadobenate Dimeglumine in MRI of the Brain and Spine of Neonates and Infants. AJNR Am J Neuroradiol 2019; 40:2001-2009. [PMID: 31727753 DOI: 10.3174/ajnr.a6319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 09/18/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced MR imaging provides essential information for pediatric imaging applications. We evaluated gadobenate dimeglumine for contrast-enhanced MR imaging of infants younger than 2 years of age. MATERIALS AND METHODS Ninety children younger than 2 years of age (including 55 children younger than 1 year) who underwent enhanced MR imaging of the CNS with gadobenate dimeglumine at 0.1 mmol/kg body weight ± 25% by volume were retrospectively enrolled at 2 imaging centers. Safety data were assessed for adverse events and, when available, vital signs and electrocardiogram and clinical laboratory values obtained from 48 hours before until 48 hours after the MR imaging examination. The efficacy of gadobenate dimeglumine-enhanced MR imaging was evaluated prospectively by 3 blinded, unaffiliated readers in terms of the accuracy of combined pre- and postcontrast images relative to precontrast images alone for differentiation of tumor from non-neoplastic disease and the correct diagnosis of specific disease. Differences were tested using the McNemar test. A possible effect of dose on diagnostic accuracy was assessed using the Fisher exact test. RESULTS Nine nonserious adverse events were reported for 8 (8.8%) patients. Five adverse events occurred in patients 12 months of age or older. All events occurred at least 24 hours after gadobenate dimeglumine administration, and in each case, the investigating radiologist considered that there was no reasonable possibility of a relationship to gadobenate dimeglumine. No clinically meaningful changes in vital signs, electrocardiogram results, or laboratory parameters were reported. Accurate differentiation of tumor from non-neoplastic disease and exact matching of each specific MR imaging-determined diagnosis with the on-site final diagnosis were achieved in significantly more patients by each reader following evaluation of combined pre- and postcontrast images relative to precontrast images alone (91.0%-94.4% versus 75.3%-87.6%, P < .04, and 66.3%-73.0% versus 52.8%-58.4%, P < .02, respectively). No significant differences (P > .133) in diagnostic accuracy were noted between patients receiving ≤0.08 mmol/kg of gadobenate dimeglumine and patients receiving >0.08 mmol/kg of gadobenate dimeglumine. CONCLUSIONS Gadobenate dimeglumine is safe and effective for pediatric MR imaging.
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Affiliation(s)
- D S Enterline
- From the Department of Radiology (D.S.E.), Duke University, Durham, North Carolina
| | - K W Martin
- Department of Diagnostic Imaging (K.W.M.), University of California, San Francisco, Benioff Children's Hospital, Oakland, California
| | - H A Parmar
- Department of Radiology (H.A.P.), University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, Michigan
| | - F M Triulzi
- Department of Neuroradiology (F.M.T.), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinic, Milan, Italy
| | - C Colosimo
- Radiodiagnostica e Neuroradiologia (C.C.), Institute of Radiology, Fondazione Policlinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Rome, Italy
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6
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Messina C, Albano D, Orlandi D, Chianca V, Corazza A, Ferrari F, Gitto S, Sconfienza LM. Potential use of a diluted high-relaxivity gadolinium-based intra-articular contrast agent for magnetic resonance arthrography: an in-vitro study. BMC Med Imaging 2019; 19:83. [PMID: 31653206 PMCID: PMC6815038 DOI: 10.1186/s12880-019-0387-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 10/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background Magnetic resonance arthrography (MRA) requires intra-articular injection of gadolinium-based diluted paramagnetic contrast material. To our knowledge, gadobenate dimeglumine (Gd-BOPTA) has never been used for intra-articular applications. Our aim was to test in vitro different concentrations of Gd-BOPTA to be potentially used to perform MRA. Methods Gd-BOPTA was diluted in saline (NaCl 0.9%) to achieve different concentrations (4 mmol/l; 2 mmol/l; 1 mmol/l; 0.67 mmol/l; 0.5 mmol/l). Six sets of five sterile pipes were prepared with 5 ml of each solution, five sets added with 0.5 ml of fresh synovial fluid. Two separate pipes were prepared with 5 ml of gadopentetate dimeglumine (Gd-DTPA) at 2 mmol/l, one pipe added with 0.5 ml of synovial fluid. Pipes were imaged using a T1-weighted sequence at 1.5 T. For each pipe, signal intensity (SI) in arbitrary units (au) was measured. Results SI reproducibility range was 86–99%. Mean Gd-BOPTA SI in pipes containing synovial fluid increased from 1236 ± 8au (0.5 mmol/l) up to 1610 ± 44au (1 mmol/l) and down to 1405 ± 33au (4 mmol/l). Mean Gd-BOPTA SI in pipes without synovial fluid increased from 1184 ± 29au (0.5 mmol/l) up to 1530 ± 38au (1 mmol/l), and down to 1347 ± 39au (4 mmol/l). SI of pipes without synovial fluid was lower than that of pipes with synovial fluid for both Gd-BOPTA and Gd-DTPA (P ≤ 0.002). Regarding pipes with synovial fluid, mean Gd-DTPA SI at 2 mmol/l was 1246 ± 27au. Compared with Gd-BOPTA, SI was not different at 0.5 mmol/l (− 0.2%, P = 0.587) while it was higher (P < 0.001) at all other concentrations (range + 13.3%[4 mmol/l] − + 28.3%[1 mmol/l]). Regarding pipes without synovial fluid, mean Gd-DTPA SI at 2 mmol/l was 1275 ± 56au. Compared with Gd-BOPTA, SI was lower at 0.5 mmol/l (− 6.8%,P < 0.001), while it was higher (P < 0.001) at all other concentrations (range + 6.1%[4 mmol/l] − + 19.6% [1 mmol/l]). Conclusions In vitro, Gd-BOPTA at 1 mmol/ had a + 28% SI increase in comparison to Gd-DTPA 2 mmol/l. SI similar to Gd-DTPA can be obtained using one fourth concentration of Gd-BOPTA.
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Affiliation(s)
- Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20100, Milan, Italy
| | - Domenico Albano
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy. .,Sezione di Scienze Radiologiche, Dipartimento di Biomedicina, Neuroscienze e Diagnostica Avanzata, Università degli Studi di Palermo, Via del Vespro 127, 90127, Palermo, Italy.
| | - Davide Orlandi
- Dipartimento di Radiologia, Ospedale Evangelico Internazionale, Piazzale Gianasso 1, 16129, Genoa, Italy
| | - Vito Chianca
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy
| | - Angelo Corazza
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy
| | - Federica Ferrari
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Salvatore Gitto
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via R. Galeazzi 4, 20161, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20100, Milan, Italy
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Nacif MS, Raman FS, Gai N, Jones J, van der Geest RJ, T Sibley C, Liu S, David AB. Myocardial T1 mapping and determination of partition coefficients at 3 tesla: comparison between gadobenate dimeglumine and gadofosveset trisodium. Radiol Bras 2018; 51:13-19. [PMID: 29559761 PMCID: PMC5846320 DOI: 10.1590/0100-3984.2016.0071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objective To compare an albumin-bound gadolinium chelate (gadofosveset trisodium) and
an extracellular contrast agent (gadobenate dimeglumine), in terms of their
effects on myocardial longitudinal (T1) relaxation time and partition
coefficient. Materials and Methods Study subjects underwent two imaging sessions for T1 mapping at 3 tesla with
a modified look-locker inversion recovery (MOLLI) pulse sequence to obtain
one pre-contrast T1 map and two post-contrast T1 maps (mean 15 and 21 min,
respectively). The partition coefficient was calculated as
ΔR1myocardium
/ΔR1blood , where
R1 is 1/T1. Results A total of 252 myocardial and blood pool T1 values were obtained in 21
healthy subjects. After gadolinium administration, the myocardial T1 was
longer for gadofosveset than for gadobenate, the mean difference between the
two contrast agents being −7.6 ± 60 ms (p = 0.41).
The inverse was true for the blood pool T1, which was longer for gadobenate
than for gadofosveset, the mean difference being 56.5 ± 67 ms
(p < 0.001). The partition coefficient (λ)
was higher for gadobenate than gadofosveset (0.41 vs. 0.33), indicating
slower blood pool washout for gadofosveset than for gadobenate. Conclusion Myocardial T1 times did not differ significantly between gadobenate and
gadofosveset. At typical clinical doses of the contrast agents, partition
coefficients were significantly lower for the intravascular contrast agent
than for the extravascular agent.
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Affiliation(s)
- Marcelo Souto Nacif
- MD, PhD, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Fabio S Raman
- Biomedical Engineer, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Neville Gai
- MD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Jacquin Jones
- PhD, National Institutes of Health Clinical Center, Bethesda, MD, USA
| | | | - Christopher T Sibley
- MD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - Songtao Liu
- MD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
| | - A Bluemke David
- MD, PhD, National Institutes of Health Clinical Center, National Institute of Biomedical Imaging and Bioengineering, Bethesda, MD, USA
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Bussi S, Penard L, Bonafè R, Botteron C, Celeste R, Coppo A, Queliti R, Kirchin MA, Tedoldi F, Maisano F. Non-clinical assessment of safety and gadolinium deposition after cumulative administration of gadobenate dimeglumine (MultiHance ®) to neonatal and juvenile rats. Regul Toxicol Pharmacol 2017; 92:268-277. [PMID: 29278694 DOI: 10.1016/j.yrtph.2017.12.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 12/21/2017] [Indexed: 01/01/2023]
Abstract
To determine the impact of single and cumulative doses of MultiHance on toxicity, pharmacokinetics, tissue gadolinium presence, behavior and neurological function in juvenile rats. Juvenile male and female rats received either physiological saline or MultiHance at 0.6, 1.25 or 2.5 mmol/kg bodyweight. Animals received either single or six consecutive MultiHance administrations and were sacrificed the day after the last administration or after a 60-day treatment-free period. Animals were assessed for behavior, cognitive function, grip strength, gait, pupillary reflex, and auditory reflex, as well as for physical development, sexual maturation and histopathology. Gadolinium presence in brain, femur, kidneys, liver and skin was determined using inductively coupled plasma-mass spectrometry (ICP-MS). No effects of MultiHance on behavior, cognitive function or any other parameter were noted, even for the highest administered cumulative dose (15 mmol/kg). Gadolinium presence was variable across tissues and decreased during the 60-day treatment-free period. The highest levels were noted in the femur and the lowest levels in the brain. Gadolinium presence in juvenile rat brain following single or repeated MultiHance administrations was minimal and non-impactful.
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Affiliation(s)
- Simona Bussi
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Laure Penard
- Charles River, 329 Impasse du Domaine Rozier, 69210 Saint Germain-Nuelles, Lyon, France.
| | - Roberta Bonafè
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Catherine Botteron
- Bracco Suisse SA, Route de la Galaise 31, 1228 Plan-les-Ouates, Genève, Switzerland.
| | - Roberto Celeste
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Alessandra Coppo
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Roberta Queliti
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Miles A Kirchin
- Bracco Imaging Spa, Via Caduti di Marcinelle 13, 20134 Milano, Italy.
| | - Fabio Tedoldi
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
| | - Federico Maisano
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa, TO, Italy.
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Arnoldussen CWKP, Lam Y, Ito N, Winkens B, Kooi ME, Wittens CHA, Wildberger JE. Gadobutrol versus gadofosveset-trisodium in MR venography of the lower extremities. Eur Radiol 2017; 27:4986-4994. [PMID: 28674964 PMCID: PMC5674132 DOI: 10.1007/s00330-017-4902-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 04/30/2017] [Accepted: 05/16/2017] [Indexed: 11/25/2022]
Abstract
Objectives MR venography (MRV) protocols have used bloodpool contrast agents and long scan sequences to identify patients suitable for treatment and preoperatively. However, variable availability of bloodpool contrast agents, high costs and a need to shorten acquisition times for routine MR protocols hamper everyday practice. Materials 20 patients (11 men; mean age 54 ± 11.8 years; body mass index 23.6 ± 2.5) were enrolled in this prospective study. An intra-individual comparison of image quality, interpretation and findings for two different contrast agents (regular gadolinium contrast agent gadobutrol vs. bloodpool contrast agent gadofosveset-trisodium) and two different scan protocols (long acquisition time protocol using a high-resolution fast field echo (FFE) sequence vs. short acquisition time protocol using an ultra-fast gradient echo (GE) sequence) were performed. Results Image quality (average of 4.94 vs. 4.92 on a five-point scale), interpretation and contrast-to-noise ratio (44 vs. 45) were equal for both contrast agents. Image findings showed no statistical significant differences between the MR protocols or contrast agents (overall p = 0.328). Conclusions For high-resolution MRV, it is possible to replace gadofosveset-trisodium with gadobutrol. Furthermore, an ultra-fast GE sequence for MRV might considerably shorten acquisition time, without loss of image quality or diagnostic yield. Key Points • High-quality MRV can be performed with a regular gadolinium-based contrast agent. • Ultra-fast GRE vs. HR-FFE MRV: equally suitable for evaluation of venous obstruction. • Regular gadolinium-based contrast agent can supersede a bloodpool contrast agent for MRV. • Equal confidence for gadobutrol vs gadofosveset-trisodium in MRV. • MRV accessible for routine daily practice.
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Affiliation(s)
- Carsten W K P Arnoldussen
- Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, P.Debyelaan 25, 6202 AZ, Maastricht, The Netherlands. .,Department of Radiology, VieCuri Medical Center, Venlo, The Netherlands.
| | - Yeelai Lam
- Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nobutake Ito
- Department of Diagnostic Radiology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Diagnostic Radiology, Keio University Hospital, Tokyo, Japan
| | - Bjorn Winkens
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
| | - M Eline Kooi
- Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, P.Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.,Maastricht University Medical Center, CARIM - School for Cardiovascular Diseases, Maastricht, The Netherlands
| | - Cees H A Wittens
- Department of Vascular Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Vascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Joachim E Wildberger
- Department of Radiology, Maastricht University Medical Center, P.O. Box 5800, P.Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.,Maastricht University Medical Center, CARIM - School for Cardiovascular Diseases, Maastricht, The Netherlands
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Channual S, Pahwa A, Lu DS, Raman SS. Enhancements in hepatobiliary imaging: the spectrum of gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid usages in hepatobiliary magnetic resonance imaging. Abdom Radiol (NY) 2016; 41:1825-41. [PMID: 27225503 DOI: 10.1007/s00261-016-0767-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Gadolinium-ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) is a unique hepatocyte-specific contrast agent approved for clinical use in the United States in 2008. Gd-EOB-DTPA-enhanced MR has shown to improve detection and characterization of hepatic lesions. Gd-EOB-DTPA is now being routinely used in daily clinical practice worldwide. Therefore, it is important for radiologists to be familiar with the potential uses and pitfalls of Gd-EOB-DTPA, which extends beyond the assessment of focal hepatic lesions. The purpose of this article is to review the various usages of Gd-EOB-DTPA in hepatobiliary MR imaging.
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Affiliation(s)
- Stephanie Channual
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza Rm 1921H, Los Angeles, CA, 90095, USA.
| | - Anokh Pahwa
- Department of Radiological Sciences, Olive View-UCLA Medical Center, David Geffen School of Medicine at UCLA, 14445 Olive View Drive, Sylmar, CA, 91342, USA
| | - David S Lu
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza Rm 1921H, Los Angeles, CA, 90095, USA
| | - Steven S Raman
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza Rm 1921H, Los Angeles, CA, 90095, USA
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Comparison of Low-Dose Higher-Relaxivity and Standard-Dose Lower-Relaxivity Contrast Media for Delayed-Enhancement MRI: A Blinded Randomized Crossover Study. AJR Am J Roentgenol 2015; 205:533-9. [PMID: 26295638 DOI: 10.2214/ajr.14.13749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The gadolinium-based MRI contrast agent gadobenate dimeglumine has nearly twice the MR relaxivity of gadopentetate dimeglumine at 1.5 T. The purpose of this study was to determine whether a lower dose (0.1 mmol/kg) of gadobenate dimeglumine can be used to obtain delayed-enhancement MR images comparable to those obtained with a standard dose (0.2 mmol/kg) of gadopentetate dimeglumine. SUBJECTS AND METHODS In this blinded randomized crossover study, 20 patients with known myocardial infarction underwent two separate delayed-enhancement MRI examinations after receiving 0.1 mmol/kg gadobenate dimeglumine and 0.2 mmol/kg gadopentetate dimeglumine (random administration). The conspicuity of lesion enhancement 5, 10, and 20 minutes after contrast administration was quantified as relative enhancement ratio (RER). RESULTS With either gadolinium-based contrast agent, damaged myocardium had higher signal intensity than normal remote myocardium (RER > 4) on delayed-enhancement MR images, and the blood RER declined over time after contrast administration. The blood RER was not significantly higher for gadobenate dimeglumine than for gadopentetate dimeglumine at 5 and 10 minutes. Nevertheless, there was a larger reduction in blood RER for gadobenate dimeglumine than for gadopentetate dimeglumine between 5 and 10 minutes and between 10 and 20 minutes. The volumes of enhancement were similar for gadobenate dimeglumine (13.6 ± 8.8 cm(3)) and gadopentetate dimeglumine (13.5 ± 8.9 cm(3)) (p = 0.98). The mean difference in Bland-Altman analysis for delayed-enhancement volume between the agents was 0.1 cm(3). CONCLUSION Qualitatively and quantitatively, delayed-enhancement MR images of ischemic myocardium obtained with 0.1 mmol/kg gadobenate dimeglumine are comparable to those obtained with 0.2 mmol/kg gadopentetate dimeglumine 5, 10, and 20 minutes after contrast administration.
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Low-dose gadobenate dimeglumine-enhanced MRI of the kidney for the differential diagnosis of localized renal lesions. Radiol Med 2015; 120:1100-11. [PMID: 26088468 PMCID: PMC4646924 DOI: 10.1007/s11547-015-0548-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 04/28/2015] [Indexed: 02/06/2023]
Abstract
Objective To evaluate low-dose gadobenate dimeglumine-enhanced MRI for the differential diagnosis of malignant renal tumors. Methods Sixty-two consecutive patients with unclear diagnosis at MDCT/ultrasound underwent dynamic CE-MRI of the kidneys with 0.05 mmol/kg gadobenate dimeglumine. Retrospective image evaluation was performed by two blinded readers. Lesion diagnosis at CE-MRI was correlated with findings from histology following tumor resection or from imaging follow-up after at least 1 year. Assessments were performed of diagnostic quality and level of diagnostic information. Results Thirty-nine (63 %) patients were correctly diagnosed with malignant lesions (36 with RCC, 2 with renal metastases, 1 with lymphoma) while 14 (22.6 %) patients were correctly diagnosed with benign (n = 12) or no (n = 2) lesions. Eight patients were considered false positive (5 with oncocytoma, 3 with atypical AML) and 1 patient false negative (atypical RCC). The sensitivity, specificity, accuracy, PPV, and NPV for the diagnosis of malignant renal lesions were 97.5 % (39/40), 63.6 % (14/22), 85.5 % (53/62), 83.0 % (39/47), and 93.3 % (14/15), respectively. Images were excellent in 60 and good in 2 patients. Minimal artifacts that did not compromise diagnosis were noted in 4/62 patients. Conclusion Low-dose gadobenate dimeglumine-enhanced MRI is effective for the differential diagnosis of malignant renal tumors.
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Chavhan GB, Mann E, Kamath BM, Babyn PS. Gadobenate-dimeglumine-enhanced magnetic resonance imaging for hepatic lesions in children. Pediatr Radiol 2014; 44:1266-74. [PMID: 24771094 DOI: 10.1007/s00247-014-2975-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 02/10/2014] [Accepted: 03/12/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Magnetic resonance imaging enhanced by hepatocyte-specific contrast media has been found useful to characterize liver lesions in adults and children. OBJECTIVE To present our experience with gadobenate dimeglumine (Gd-BOPTA)-enhanced MRI for evaluation of focal liver lesions in children. MATERIALS AND METHODS We retrospectively reviewed gadobenate-dimeglumine-enhanced MR images obtained for evaluation of suspected hepatic lesions in 30 children. Signal characteristics on various sequences including 45- to 60-min hepatobiliary phase images were noted by two radiologists. Chart review identified relevant clinical details including history of cancer treatment, available pathology and stability of lesion size on follow-up imaging. RESULTS Of the 30 children who had gadobenate-enhanced MRI, 26 showed focal lesions. Diagnoses in 26 children were focal nodular hyperplasia (FNH) in 15, hemangiomas in 3, regenerating nodules in 3, focal fatty infiltration in 2, indeterminate lesions in 3, and one patient each with adenomas, hepatoblastoma and metastasis. Two patients had multiple diagnoses. All FNH lesions (39), all regenerative nodules (19) and an indeterminate lesion were iso- or hyperintense on hepatobiliary-phase images while all other lesions (28) were hypointense to hepatic parenchyma. The average follow-up period was 21.7 months. CONCLUSION Our experience with gadobenate-enhanced MRI indicates potential utility of gadobenate in the evaluation of pediatric hepatic lesions in differentiating FNH and regenerating nodules from other lesions.
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Affiliation(s)
- Govind B Chavhan
- Department of Diagnostic Imaging, The Hospital for Sick Children and University of Toronto, 555 University Ave., Toronto, Canada, M5G 1X8,
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Inter- and intra-individual comparative study of two gadolinium-based agents: A pilot study. ACTA ACUST UNITED AC 2014; 40:865-74. [DOI: 10.1007/s00261-014-0248-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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15
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Contrast-enhanced MR angiography: does a higher relaxivity MR contrast agent permit a reduction of the dose administered for routine vascular imaging applications? Radiol Med 2014; 120:239-50. [DOI: 10.1007/s11547-014-0434-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 03/13/2014] [Indexed: 10/24/2022]
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16
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Khouri Chalouhi K, Papini GD, Bandirali M, Sconfienza LM, Di Leo G, Sardanelli F. Less is better? Intraindividual and interindividual comparison between 0.075 mmol/kg of gadobenate dimeglumine and 0.1 mmol/kg of gadoterate meglumine for cranial MRI. Eur J Radiol 2014; 83:1245-1249. [DOI: 10.1016/j.ejrad.2014.03.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/17/2014] [Accepted: 03/22/2014] [Indexed: 10/25/2022]
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Pirovano G, Kirchin MA, Lorusso V, Patel R, Shen N. Pharmacokinetics of gadobenate dimeglumine in children 2 to 5 years of age undergoing MRI of the central nervous system. J Magn Reson Imaging 2014; 41:1096-103. [PMID: 24807269 DOI: 10.1002/jmri.24653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 04/17/2014] [Accepted: 04/17/2014] [Indexed: 01/13/2023] Open
Abstract
PURPOSE To determine the pharmacokinetic profile of gadobenate dimeglumine in children aged between 2 and 5 years. MATERIALS AND METHODS Fifteen children scheduled to undergo contrast-enhanced MRI for suspected disease of the central nervous system received a single intravenous injection of 0.1 mmol/kg gadobenate dimeglumine. Children were stratified into three age groups: 2 to <3 years, 3 to <4 years, and 4 to 5 (i.e., <6 years). Serial blood and urine samples collected at prespecified time-points before and after contrast administration were analyzed for gadolinium concentrations. Pharmacokinetic parameters were calculated using noncompartmental and compartmental techniques. RESULTS Mean values of 65.7 μg/mL for highest blood gadolinium concentration, 0.2 L/h/kg for blood clearance, 0.32 L/kg for steady-state volume of distribution, and 1.2 h for terminal elimination half-life were determined across all age groups combined. On average, more than 80% of the dose was eliminated in the urine during the first 24 h after administration. All pharmacokinetic parameters were similar between age groups and no effects of gender were noted. No adverse events considered related to gadobenate dimeglumine administration were reported. CONCLUSION In terms of pharmacokinetic profile no dosage adjustment from the approved adult gadobenate dimeglumine dose of 0.1 mmol/kg bodyweight is necessary in children aged between 2 and 5 years.
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Affiliation(s)
- Gianpaolo Pirovano
- Global Medical and Regulatory Affairs, Bracco Diagnostics Inc, Monroe, New Jersey, USA
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Half-dose gadobenate dimeglumine versus standard-dose gadodiamide in dynamic magnetic resonance imaging of non-cirrhotic livers: a retrospective intra-individual crossover comparison. ACTA ACUST UNITED AC 2014; 39:955-62. [DOI: 10.1007/s00261-014-0123-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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D'Onofrio M, Crosara S, De Robertis R, Canestrini S, Cantisani V, Morana G, Mucelli RP. Malignant focal liver lesions at contrast-enhanced ultrasonography and magnetic resonance with hepatospecific contrast agent. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2013; 22:91-8. [PMID: 27433201 DOI: 10.1177/1742271x13513888] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of this study was to compare the diagnostic accuracy of the late phase of CEUS and the hepatobiliary phase of CE-MR with Gd-BOPTA in the characterization of focal liver lesions in terms of benignity and malignancy. A total of 147 solid focal liver lesions (38 focal nodular hyperplasias, 1 area of focal steatosis, 3 regenerative nodules, 8 adenomas, 11 cholangiocarcinomas, 36 hepatocellular carcinomas and 49 metastases) were retrospectively evaluated in a multicentre study, both with CEUS, using sulphur hexafluoride microbubbles (SonoVue, Bracco, Milan, Italy) and CE-MR, performed with Gd-BOPTA (Multihance, Bracco, Milan, Italy). All lesions thought to be malignant were cytohistologically proven, while all lesions thought to be benign were followed up. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values and accuracy were calculated for the late phase of CEUS and the hepatobiliary phase of CE-MRI, respectively, and in combination. Analysis of data revealed 42 benign and 105 malignant focal liver lesions. We postulated that all hypoechoic/hypointense lesions on the two phases were malignant. The diagnostic errors were 13/147 (8.8%) by CEUS and 12/147 (8.2%) by CE-MR. Sensitivity, specificity, PPV, NPV and accuracy of the late phase of CEUS were 90%, 93%, 97%, 80% and 91%, 93%, 97%, 81% and 92% for the hepatobiliary phase of CE-MRI, respectively. If we considered both techniques, the misdiagnosis diminished to 3/147 (2%) and sensitivity, specificity, PPV, NPV and accuracy were 98%, 98%, 99%, 95% and 98%. The combination of the late phase of CEUS and the hepatobiliary phase of CE-MR in the characterization of solid focal liver lesions in terms of benignity and malignancy is more accurate than the two techniques used separately.
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Affiliation(s)
- M D'Onofrio
- Department of Radiology, University Hospital G.B. Rossi, University of Verona, Verona, Italy
| | - S Crosara
- Department of Radiology, University Hospital G.B. Rossi, University of Verona, Verona, Italy
| | - R De Robertis
- Department of Radiology, University Hospital G.B. Rossi, University of Verona, Verona, Italy
| | - S Canestrini
- Department of Radiology, University Hospital G.B. Rossi, University of Verona, Verona, Italy
| | - V Cantisani
- Department of Radiology, University of Rome, Rome, Italy
| | - G Morana
- Department of Radiology, Treviso Hospital, Treviso, Italy
| | - R Pozzi Mucelli
- Department of Radiology, University Hospital G.B. Rossi, University of Verona, Verona, Italy
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20
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Comparison of gadobenate dimeglumine-enhanced breast MRI and gadopentetate dimeglumine-enhanced breast MRI with mammography and ultrasound for the detection of breast cancer. J Magn Reson Imaging 2013; 39:1272-86. [DOI: 10.1002/jmri.24434] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Burke C, Alexander Grant L, Goh V, Griffin N. The role of hepatocyte-specific contrast agents in hepatobiliary magnetic resonance imaging. Semin Ultrasound CT MR 2013; 34:44-53. [PMID: 23395317 DOI: 10.1053/j.sult.2012.11.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Hepatocyte-specific contrast agents have been made available in the last 15 years for magnetic resonance imaging of the liver. These agents are differentially taken up by functioning hepatocytes and excreted in the biliary system. They can help distinguish focal liver lesions of hepatocellular origin from lesions of nonhepatocellular origin, and can also be used in the evaluation of the biliary tree. The purpose of this review is to summarize the different types of hepatocyte-specific contrast agents presently available, their use in the characterization of focal liver lesions, their role in the evaluation of biliary pathology, and their potential future applications.
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Affiliation(s)
- Chistopher Burke
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, Westminster Bridge Road, London, UK
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22
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Kim MJ, Kim SH, Kim HJ, Kim BS, Hernandes M, Semelka RC. Enhancement of liver and pancreas on late hepatic arterial phase Imaging: Quantitative comparison among multiple gadolinium-based contrast agents at 1.5 tesla MRI. J Magn Reson Imaging 2013; 38:102-8. [DOI: 10.1002/jmri.23934] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2012] [Accepted: 10/01/2012] [Indexed: 12/22/2022] Open
Affiliation(s)
| | | | | | | | - Mateus Hernandes
- Department of Radiology; University of North Carolina at Chapel Hill; Chapel Hill; North Carolina; USA
| | - Richard C. Semelka
- Department of Radiology; University of North Carolina at Chapel Hill; Chapel Hill; North Carolina; USA
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Raman FS, Nacif MS, Cater G, Gai N, Jones J, Li D, Sibley CT, Liu S, Bluemke DA. 3.0-T whole-heart coronary magnetic resonance angiography: comparison of gadobenate dimeglumine and gadofosveset trisodium. Int J Cardiovasc Imaging 2013; 29:1085-94. [PMID: 23515949 DOI: 10.1007/s10554-013-0192-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/30/2013] [Indexed: 10/27/2022]
Abstract
Gadolinium enhanced coronary magnetic resonance angiography (MRA) at 3 T appears to be superior to non-contrast methods. Gadofosveset is an intravascular contrast agent that may be well suited to this application. The purpose of this study was to perform an intra-individual comparison of gadofosveset and gadobenate for coronary MRA at 3 T. In this prospective randomized study, 22 study subjects [8 (36%) male; 27.9 ± 6 years; BMI = 22.8 ± 2 kg/m(2)] underwent two studies using a contrast-enhanced inversion recovery three-dimensional fast low angle shot MRA at 3 T. The order of contrast agent administration was varied randomly, separated by an average of 30 ± 5 days, using either gadobenate dimeglumine (Gd-BOPTA; Bracco, 0.1 mmol/Kg) or gadofosveset trisodium (MS-325; Lantheus Med, 0.03 mmol/Kg). Acquisition time, signal-to-noise ratio (SNR) of coronary vessels and contrast-to-noise ratio (CNR) were evaluated. Of 308 coronary arteries and veins segment analyzed, overall SNR of coronary arteries and veins segments were not different for the two contrast agents (132 ± 79 for gadofosveset vs. 135 ± 78 for gadobenate, p = 0.69). Coronary artery CNR was greater for gadofosveset in comparison to gadobenate (73.5 ± 46.9 vs. 59.3 ± 75.7 respectively, p = 0.03). Gadofosveset-enhanced MRA images displayed better image quality than gadobenate-enhanced MRA images (2.77 ± 0.61 for gadofosveset vs. 2.11 ± 0.51, p < .001). Inter- and intra-reader variability was excellent (ICC > 0.90) for both contrast agents. Gadofosveset trisodium appears to show slightly better performance for coronary MRA at 3 T compared to gadobenate.
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Affiliation(s)
- Fabio S Raman
- Radiology and Imaging Sciences, National Institutes of Health of Clinical Center, 10 Center Drive, Building 10, Rm 1C355, Bethesda, MD 20892-1182, USA
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Fontarensky M, Montoriol PF, Buc E, Poincloux L, Petitcolin V, Da Ines D. Advantages of gadobenate dimeglumine-enhanced MR cholangiography in the diagnosis of post-liver transplant bile leakage. Diagn Interv Imaging 2013; 94:443-52. [PMID: 23433543 DOI: 10.1016/j.diii.2013.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the value of magnetic resonance cholangiography with gadobenate dimeglumine (Gd-BOPTA) where there is a suspicion of bile leakage in the post-liver transplant patient. PATIENTS AND METHODS Eight patients who had undergone a liver transplant underwent 14 MR cholangiograms, five of whom presented bile leakage while the other three had no biliary system complications. The results were compared to conventional bile duct opacification (by endoscopy or t-tube cholangiogram). The analysis covered whether there was opacification of the common bile duct and intrahepatic bile ducts on T1-weighted sequences after an injection of Gd-BOPTA on delayed biliary excretion phase sequences that were carried out on average 74 min after the injection. Enhancing perihepatic collections were also taken into account. RESULTS Opacification of the bile ducts on delayed-phase MR cholangiogram sequences was always seen in the absence of bile leakage, and was never found when leakage was present. Enhancing perihepatic collections pointed to bile leakage every time. CONCLUSION Gd-BOPTA-enhanced MR cholangiography is a simple and non-invasive technique for detecting bile leakage in the post-liver transplant patient.
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Affiliation(s)
- M Fontarensky
- Clermont-Ferrand University Hospital, Estaing University Hospital, Radiology and Medical Imaging Department, 1 place Lucie-Aubrac, Clermont-Ferrand cedex 1, France
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Schneider G, Schürholz H, Kirchin MA, Bücker A, Fries P. Safety and adverse effects during 24 hours after contrast-enhanced MRI with gadobenate dimeglumine (MultiHance) in children. Pediatr Radiol 2013. [PMID: 23179483 DOI: 10.1007/s00247-012-2498-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Gadolinium-based MR contrast agents have long been considered safe for routine diagnostic imaging. However, the advent of nephrogenic systemic fibrosis (NSF) among certain patients with severe renal insufficiency has brought the issue of safety into question. Nowhere is safety of greater concern than among children who frequently require multiple contrast-enhanced MRI examinations over an extended period of time. OBJECTIVE To retrospectively evaluate the safety of gadobenate dimeglumine for contrast-enhanced (CE) MRI across a range of indications. MATERIALS AND METHODS Two hundred pediatric inpatients (age: 4 days to 15 years) underwent CE MRI as part of clinical routine. The children received a gadobenate dimeglumine dose of either 0.05 mmol/kg body weight (liver, abdominal imaging, musculoskeletal imaging, brain and other rare indications) or 0.1 mmol/kg bodyweight (cardiovascular imaging, MR-urography). Young (< 8 years) children with congenital heart disease were intubated and underwent MRA evaluation with controlled ventilation. Monitoring for adverse events was performed for at least 24 h after each gadobenate dimeglumine injection. Depending on clinical necessity, laboratory measurements and, in some cases, vital sign and ECG determinations were made before and after contrast injection. Safety was evaluated by age group, indication and dose administered. RESULTS No clinically adverse events were reported among children who had one MRI scan only or among children who had several examinations. There were no changes in creatinine or bilirubin levels even in very young children. CONCLUSIONS No adverse events were recorded during the first 24 h following administration of gadobenate dimeglumine in 200 children.
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Johansson L, Kirchin MA, Ahlström H. Gadobenate dimeglumine (MultiHance) in MR angiography: an in-vitro phantom comparison with gadopentetate dimeglumine (Magnevist) at different concentrations. Acta Radiol 2012; 53:1112-7. [PMID: 23081961 DOI: 10.1258/ar.2012.120181] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Numerous clinical studies suggest that gadobenate dimeglumine is diagnostically superior to other gadolinium chelates for MR imaging applications, including contrast-enhanced MR angiography (CE-MRA). However, confirmatory in-vitro phantom studies have thus far been lacking. PURPOSE To evaluate the difference in signal intensity achieved with the high-relaxivity MR contrast agent gadobenate dimeglumine (MultiHance) relative to that achieved with the standard-relaxivity non-specific agent gadopentetate dimeglumine (Magnevist) at different concentrations using an in-vitro phantom study design. MATERIAL AND METHODS Test tubes with whole human blood were prepared with concentrations of gadobenate dimeglumine or gadopentetate dimeglumine ranging from 0 to 12 mM. A three-dimensional (3D) T1-weighted gradient echo sequence normally used for CE-MRA of the renal arteries was performed at flip angles of 25° and 35°. The signal-to-noise ratio (SNR) was calculated for all concentrations of both contrast agents. Furthermore a Look-Locker sequence was used and quantitative T1 mapping was performed for all the test tubes. The contrast agent concentration in the aorta was simulated using previously published data on T1 in the aorta during the first pass of a contrast agent. The differences between gadobenate dimeglumine and gadopentetate dimeglumine were compared at the simulated concentrations. RESULTS The SNR achieved with gadobenate dimeglumine was consistently greater than that achieved with gadopentetate dimeglumine at all concentrations. An improvement of 15-25% in SNR was obtained when increasing the flip angle from 25° to 35°. The relative improvement in SNR with gadobenate dimeglumine relative to gadopentetate dimeglumine ranged from 25-72% and was markedly greater at lower concentrations with a flip angle of 35°. CONCLUSION Our findings suggest that the relative benefit of gadobenate dimeglumine over gadopentetate dimeglumine for CE-MRA applications is greater at lower concentrations.
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Affiliation(s)
- Lars Johansson
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
| | - Miles A Kirchin
- Worldwide Medical & Regulatory Affairs, Bracco Imaging SpA, Milan, Italy
| | - Håkan Ahlström
- Department of Radiology, Uppsala University Hospital, Uppsala, Sweden
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Kim HJ, Kim BS, Kim MJ, Kim SH, de Campos ROP, Hernandes M, Semelka RC. 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. J Magn Reson Imaging 2012; 37:903-8. [PMID: 23065959 DOI: 10.1002/jmri.23874] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 09/11/2012] [Indexed: 01/01/2023] Open
Abstract
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.
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Affiliation(s)
- Hee Jin Kim
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7510, USA
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Li Y, Li X, Li D, Lu J, Xing X, Yan F, Li Y, Wang X, Iezzi R, De Cobelli F. Multicenter, intraindividual comparison of single-dose gadobenate dimeglumine and double-dose gadopentetate dimeglumine for MR angiography of the supra-aortic arteries (the Supra-Aortic VALUE study). AJNR Am J Neuroradiol 2012; 34:847-54. [PMID: 23042922 DOI: 10.3174/ajnr.a3298] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Gadobenate dimeglumine has markedly higher R1 relaxivity compared to gadopentetate dimeglumine meaning that lower doses can be used to achieve similar contrast enhancement. Our aim was to prospectively compare single-dose gadobenate dimeglumine with double-dose gadopentetate dimeglumine for contrast-enhanced MRA of the supra-aortic vasculature. MATERIALS AND METHODS Forty-six patients (37 men, 9 women; mean age, 63.5±10.1 years) with known or suspected steno-occlusive disease of the supra-aortic vessels underwent 2 identical CE-MRA examinations at 1.5T. Contrast agents were administered in randomized order, with the 2-fold greater volume of gadopentetate dimeglumine injected at a 2 times faster rate. Image assessment was performed by 3 independent blinded readers for vessel anatomic delineation, detection/exclusion of pathology, and global preference. Diagnostic performance (sensitivity, specificity, accuracy, PPV, and NPV) for detection of ≥60% stenosis was determined for 39/46 patients who underwent preinterventional DSA. Data were analyzed by using the Wilcoxon signed-rank, McNemar, and Wald tests in terms of the noninferiority of single-dose gadobenate dimeglumine compared with double-dose gadopentetate dimeglumine. Quantitative enhancement (signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)) was also compared. RESULTS All images were technically adequate. No differences (P=1.0) were noted by any reader for any qualitative parameter. All readers considered single-dose gadobenate dimeglumine and double-dose gadopentetate dimeglumine equivalent in at least 42/46 patients (91.3% three-reader agreement) for all parameters. Nonsignificant superiority for gadobenate dimeglumine was reported for all diagnostic performance indicators (sensitivity: 82.7%-88.5% versus 75.0%-80.8%; specificity: 96.4%-98.6% versus 94.6%-98.6%; accuracy: 94.6%-96.1% versus 92.4%-94.9%; PPV: 81.5%-91.5% versus 73.7%-90.7%; NPV: 96.8%-97.8% versus 95.4%-96.4%). No differences (P>.05) in quantitative enhancement were noted. CONCLUSIONS The image quality and diagnostic performance achieved with 0.1-mmol/kg gadobenate dimeglumine is at least equivalent to that achieved with 0.2-mmol/kg gadopentetate dimeglumine.
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Affiliation(s)
- Yanjun Li
- Department of Radiology, Shanghai Changhai Hospital, and Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Chang P, Saddleton E, Laumann AE, Schmitz B, West DP, Belknap SM, Parthasarathy S, Edwards BJ, McKoy JM, Miller FH. Comparison of the sensitivity of a pre-MRI questionnaire and point of care eGFR testing for detection of impaired renal function. Acad Radiol 2012; 19:1181-5. [PMID: 22831822 DOI: 10.1016/j.acra.2012.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 04/16/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022]
Abstract
RATIONALE AND OBJECTIVES The Food and Drug Administration recommends renal function estimation using laboratory testing for patients at risk for chronically reduced kidney function before the administration of gadolinium-based contrast agents (GBCAs). Point-of-care (POC) estimated glomerular filtration rate (eGFR) testing was added to the pre-magnetic resonance (MR) questionnaire at our institution in June 2008 for all patients undergoing a contrast-enhanced MR exam. This study was done to evaluate the effectiveness of a pre-MR screening questionnaire about kidney disease and to assess POC eGFR detection of additional patients at risk for nephrogenic systemic fibrosis. MATERIALS AND METHODS This retrospective study was approved by our institutional review board and determined to be Health Insurance Portability and Accountability Act compliant. Medical records, laboratory data, and pre-MR questionnaires of all patients who presented for contrast-enhanced MR scans during October 2008 were reviewed. The National Kidney Disease Education Program isotope-dilution mass spectrometry-traceable Modification of Diet in Renal Disease equation was used to calculate eGFRs using the POC creatinine laboratory value, age, race, and gender. Sensitivity and specificity were calculated using 2 × 2 tables, and 95% confidence intervals were calculated with exact binomial confidence intervals. RESULTS A total of 1167 individuals presented for contrast-enhanced MR scans. Of 13 individuals on dialysis, 2 did not report renal disease. Of 1154 individuals not on dialysis, 25 had an eGFR <30 mL/min/1.73 m(2) (95% CI 1.41%-3.18%). Of these 25, 13 did and 12 did not report renal disease. The sensitivity of the questionnaire for identifying patients with an eGFR <30 mL/min/1.73 m(2) was 63.2%. POC eGFR estimations identified a prevalence of 2.17% (95% CI: 1.41%-3.18%) of the total individuals not on dialysis, with an eGFR <30 mL/min/1.73 m(2). Patients who denied kidney dysfunction had a 1.08% (95% CI: 0.56%-1.88%) posttest probability of having an eGFR <30 mL/min/1.73 m(2). CONCLUSIONS POC eGFR testing identified a significant number of individuals with renal dysfunction not found by the pre-MR imaging questionnaire alone.
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Use of magnetic resonance imaging contrast agents in the liver and biliary tract. Magn Reson Imaging Clin N Am 2012; 20:715-37. [PMID: 23088947 DOI: 10.1016/j.mric.2012.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article presents an overview of liver and biliary contrast agents including their mechanisms of action, dosage and elimination, current clinical indications, and potential future uses.
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Diagnosis of focal nodular hyperplasia with MRI: multicenter retrospective study comparing gadobenate dimeglumine to gadoxetate disodium. AJR Am J Roentgenol 2012; 199:35-43. [PMID: 22733891 DOI: 10.2214/ajr.11.7757] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The purpose of this article is to report the results from a multicenter retrospective MRI study comparing gadobenate dimeglumine and gadoxetate disodium for diagnosis of hepatic focal nodular hyperplasia (FNH). MATERIALS AND METHODS Thirty patients (28 women and two men; mean age, 37.1 years) with hepatic FNH who underwent both gadobenate dimeglumine- and gadoxetate disodium-enhanced MRI at 1.5 T were assessed. MRI was performed during the arterial, portal venous, late venous, and hepatobiliary contrast-enhanced phases (10 and 20 minutes or 1-3 hours after contrast administration, respectively, for gadoxetate disodium and gadobenate dimeglumine). Qualitative (lesion conspicuity score) and quantitative (lesion signal intensity [SI] ratio and lesion contrast ratio) assessments were performed. RESULTS In 30 patients, 51 FNHs were assessed (mean size 3.1 ± 1.5 cm). There was equivalent qualitative lesion conspicuity in the arterial phase between the two contrast agents and higher qualitative lesion conspicuity and SI ratio in the hepatobiliary phase with gadoxetate disodium (p < 0.002). Lesion contrast ratio was significantly higher in the arterial and late venous phases with gadobenate dimeglumine (p < 0.009), with no difference in the portal venous and hepatobiliary phases between the two contrast agents (p > 0.22). CONCLUSION These results indicate an advantage for gadobenate dimeglumine for detection of FNH at the dynamic phase and for gadoxetate disodium at the hepatobiliary phase. However, the equivalent or better qualitative lesion conspicuity coupled with the ability to obtain a comprehensive evaluation of the liver within a standard 30-minute imaging window suggests that gadoxetate disodium may be a better choice for diagnosis of FNH.
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Objective evaluation of acute adverse events and image quality of gadolinium-based contrast agents (gadobutrol and gadobenate dimeglumine) by blinded evaluation. Pilot study. Magn Reson Imaging 2012; 31:96-101. [PMID: 22898688 DOI: 10.1016/j.mri.2012.06.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 05/16/2012] [Accepted: 06/21/2012] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose was to objectively evaluate a recently FDA-approved gadolinium-based contrast agent (GBCA) in comparison to our standard GBCA for acute adverse events and image quality by blinded evaluation. METHODS Evaluation was made of a recently FDA-approved GBCA, gadobutrol (Gadavist; Bayer), in comparison to our standard GBCA, gadobenate dimeglumine (MultiHance; Bracco), in an IRB- and HIPAA-compliant study. Both the imaging technologist and patient were not aware of the brand of the GBCA used. A total of 59 magnetic resonance studies were evaluated (59 patients, 31 men, 28 women, age range of 5-85 years, mean age of 52 years). Twenty-nine studies were performed with gadobutrol (22 abdominal and 7 brain studies), and 30 studies were performed with gadobenate dimeglumine (22 abdominal and 8 brain studies). Assessment was made of acute adverse events focusing on objective observations of vomiting, hives, and moderate and severe reactions. Adequacy of enhancement was rated as poor, fair and good by one of two experienced radiologists who were blinded to the type of agent evaluated. RESULTS No patient experienced acute adverse events with either agent. The target minor adverse events of vomiting or hives, and moderate and severe reactions were not observed in any patient. Adequacy of enhancement was rated as good for both agents in all patients. CONCLUSIONS Objective, blinded evaluation is feasible and readily performable for the evaluation of GBCAs. This proof-of-concept study showed that both GBCAs evaluated exhibited consistent good image quality and no noteworthy adverse events.
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Frydrychowicz A, Lubner MG, Brown JJ, Merkle EM, Nagle SK, Rofsky NM, Reeder SB. Hepatobiliary MR imaging with gadolinium-based contrast agents. J Magn Reson Imaging 2012; 35:492-511. [PMID: 22334493 DOI: 10.1002/jmri.22833] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The advent of gadolinium-based "hepatobiliary" contrast agents offers new opportunities for diagnostic magnetic resonance imaging (MRI) and has triggered great interest for innovative imaging approaches to the liver and bile ducts. In this review article we discuss the imaging properties of the two gadolinium-based hepatobiliary contrast agents currently available in the U.S., gadobenate dimeglumine and gadoxetic acid, as well as important pharmacokinetic differences that affect their diagnostic performance. We review potential applications, protocol optimization strategies, as well as diagnostic pitfalls. A variety of illustrative case examples will be used to demonstrate the role of these agents in detection and characterization of liver lesions as well as for imaging the biliary system. Changes in MR protocols geared toward optimizing workflow and imaging quality are also discussed. It is our aim that the information provided in this article will facilitate the optimal utilization of these agents and will stimulate the reader's pursuit of new applications for future benefit.
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Affiliation(s)
- Alex Frydrychowicz
- Department of Radiology and Nuclear Medicine, University of Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Abstract
Magnetic resonance imaging, MRI has more advantages than ultrasound, computed tomography, CT, positron emission tomography, PET, or any other imaging modality in diagnosing focal hepatic masses. With a combination of basic T1 and T2 weighted sequences, diffusion weighted imaging, DWI, and hepatobiliary gadolinium contrast agents, that is gadobenate dimeglumine (Gd-BOPTA) and gadoxetic acid (Gd-EOB), most liver lesions can be adequately diagnosed. Benign lesions, as cyst, hemangioma, focal nodular hyperplasia, FNH or adenoma, can be distinguished from malignant lesions. In a non-cirrhotic liver, the most common malignant lesions are metastases which may be hypovascular or hypervascular. In the cirrhotic liver hepatocellular carcinoma, HCC, is of considerable importance. Besides, intrahepatic cholangiocarcinoma and other less common malignancies has to be assessed. In this review, the techniques and typical MRI features are presented as well as the new algorithm issued by American Association for the Study of the Liver Diseases (AASLD).
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Affiliation(s)
- Nils Albiin
- Division of Radiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Kawel N, Nacif M, Zavodni A, Jones J, Liu S, Sibley CT, Bluemke DA. T1 mapping of the myocardium: intra-individual assessment of post-contrast T1 time evolution and extracellular volume fraction at 3T for Gd-DTPA and Gd-BOPTA. J Cardiovasc Magn Reson 2012; 14:26. [PMID: 22540153 PMCID: PMC3405486 DOI: 10.1186/1532-429x-14-26] [Citation(s) in RCA: 90] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 04/28/2012] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Myocardial T1 relaxation time (T1 time) and extracellular volume fraction (ECV) are altered in patients with diffuse myocardial fibrosis. The purpose of this study was to perform an intra-individual assessment of normal T1 time and ECV for two different contrast agents. METHODS A modified Look-Locker Inversion Recovery (MOLLI) sequence was acquired at 3 T in 24 healthy subjects (8 men; 28 ± 6 years) at mid-ventricular short axis pre-contrast and every 5 min between 5-45 min after injection of a bolus of 0.15 mmol/kg gadopentetate dimeglumine (Gd-DTPA; Magnevist®) (exam 1) and 0.1 mmol/kg gadobenate dimeglumine (Gd-BOPTA; Multihance®) (exam 2) during two separate scanning sessions. T1 times were measured in myocardium and blood on generated T1 maps. ECVs were calculated as ΔR1 myocardium/ΔR1 blood*1-hematocrit. RESULTS Mean pre-contrast T1 relaxation times for myocardium and blood were similar for both the first and second CMR exam (p > 0.5). Overall mean post-contrast myocardial T1 time was 15 ± 2 ms (2.5 ± 0.7%) shorter for Gd-DTPA at 0.15 mmol/kg compared to Gd-BOPTA at 0.1 mmol/kg (p < 0.01) while there was no significant difference for T1 time of blood pool (p > 0.05). Between 5 and 45 minutes after contrast injection, mean ECV values increased linearly with time for both contrast agents from 0.27 ± 0.03 to 0.30 ± 0.03 (p < 0.0001). Mean ECV values were slightly higher (by 0.01, p < 0.05) for Gd-DTPA compared to Gd-BOPTA. Inter-individual variation of ECV was higher (CV 8.7% [exam 1, Gd-DTPA] and 9.4% [exam 2, Gd-BOPTA], respectively) compared to variation of pre-contrast myocardial T1 relaxation time (CV 4.5% [exam 1] and 3.0% [exam 2], respectively). ECV with Gd-DTPA was highly correlated to ECV by Gd-BOPTA (r = 0.803; p < 0.0001). CONCLUSION In comparison to pre-contrast myocardial T1 relaxation time, variation in ECV values of normal subjects is larger. However, absolute differences in ECV between Gd-DTPA and Gd-BOPTA were small and rank correlation was high. There is a small and linear increase in ECV over time, therefore ideally images should be acquired at the same delay after contrast injection.
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Affiliation(s)
- Nadine Kawel
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
| | - Marcelo Nacif
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
| | - Anna Zavodni
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
| | - Jacquin Jones
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
| | - Songtao Liu
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
| | - Christopher T Sibley
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
- Molecular Biomedical Imaging Laboratory, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892-1074, USA
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Secchi F, Di Leo G, Papini GD, Giacomazzi F, Di Donato M, Sardanelli F. Optimizing dose and administration regimen of a high-relaxivity contrast agent for myocardial MRI late gadolinium enhancement. Eur J Radiol 2011; 80:96-102. [DOI: 10.1016/j.ejrad.2010.06.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Revised: 06/17/2010] [Accepted: 06/18/2010] [Indexed: 10/19/2022]
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Solid hypervascular liver lesions: accurate identification of true benign lesions on enhanced dynamic and hepatobiliary phase magnetic resonance imaging after gadobenate dimeglumine administration. Invest Radiol 2011; 46:225-39. [PMID: 21102346 DOI: 10.1097/rli.0b013e3181feee3a] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate hepatobiliary phase magnetic resonance imaging with gadobenate dimeglumine for differentiation of benign hypervascular liver lesions from malignant or high-risk lesions. METHODS AND MATERIALS Retrospective assessment was performed of 550 patients with 910 hypervascular lesions (302 focal nodular hyperplasia [FNH], 82 nodular regenerative hyperplasia [NRH], 59 hepatic adenoma or liver adenomatosis [HA/LA], 329 hepatocellular carcinomas [HCC], 12 fibrolamellar-HCC [FL-HCC], 21 peripheral cholangiocarcinomas [PCC], 105 metastases). Imaging was performed before and during the arterial, portal-venous, equilibrium, and hepatobiliary phases after gadobenate dimeglumine administration (0.05 mmol/kg). Histologic confirmation was available for ≥1 lesion per patient, except for patients with suspected FNH (diagnosis based on characteristic enhancement/follow-up). Lesion differentiation (benign/malignant) on the basis of contrast washout and lesion enhancement (hypo-/iso-/hyperintensity) was assessed (sensitivity, specificity, accuracy, PPV, and NPV) relative to histology or final diagnosis. RESULTS On portal-venous or equilibrium phase images, washout was not seen for 208 of 526 (39.5%) malignant (HCC, FL-HCC, PCC, metastases) and high-risk (HA/LA) lesions. Conversely, only 5 of 384 (1.3%) true benign lesions (FNH/NRH) showed washout. Taking washout as indicating malignancy, the sensitivity, specificity, and accuracy for malignant lesion identification during these phases was 61.8%, 98.7%, and 77.4%. On hepatobiliary phase images, 289 of 302 FNH, 82 of 82 NRH, 1 of 59 HA or LA, 62 of 341 HCC or FL-HCC, and 2 of 105 metastases were hyperintense or isointense. Taking iso- or hyperintensity as an indication for lesion benignity, the sensitivity, specificity, accuracy, PPV, and NPV for benign lesion identification was 96.6%, 87.6%, 91.4%, 85.1%, and 97.3%, respectively. CONCLUSIONS Hepatobiliary phase imaging with gadobenate dimeglumine is accurate for distinguishing benign lesions from malignant or high-risk lesions. Biopsy should be considered for hypointense lesions on hepatobiliary phase images after gadobenate dimeglumine.
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Filippone A, Cianci R, Patriarca G, Sabatino F, Tartaro A, Cotroneo AR. The role of hepatocyte-specific staining in liver pathology. Expert Rev Gastroenterol Hepatol 2011; 5:353-63. [PMID: 21651353 DOI: 10.1586/egh.11.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The advantages of MRI in the investigation of liver disease are well documented. Recent developments, including fast scanning technique and new MRI contrast agents, enable improved detection and characterization of focal liver lesions. Therefore, a definitive diagnosis can be made avoiding invasive procedures, such as liver biopsy. In this article, a special emphasis is placed on the clinical use of combined perfusional and hepatocyte-selective MRI contrast agents, which allow us to obtain morphologic and vascular information, owing to the dynamic study, as well as functional information, owing to the hepatocyte-selective phase of enhancement. Different clinical scenarios are considered in order to highlight the proper use of the hepatocyte phase to noninvasively characterize and detect different focal liver lesions.
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Affiliation(s)
- Antonella Filippone
- Department of Neurosciences and Imaging, Section of Radiological Imaging, G d'Annunzio University of Chieti, via dei Vestini, 66013, Chieti, Italy.
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Burke LMB, Vachiranubhap B, Tannaphai P, Semelka RC. Realce por contraste de lesões hepáticas em pacientes com cirrose: estudo cruzado comparativo de dois agentes de contraste para RM realizado em uma única instituição. Resultados preliminares. Radiol Bras 2011. [DOI: 10.1590/s0100-39842011000300005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Comparar, prospectivamente, gadopentato de dimeglumina (Gd-DTPA) e gadobenato de dimeglumina (Gd-BOPTA), ambos em dose plena, na detecção de lesões hepáticas focais, por meio de RM em pacientes com doença hepática crônica. MATERIAIS E MÉTODOS: Oito pacientes com cirrose hepática e forte suspeita de um pequeno carcinoma hepatocelular, baseada em RM anterior, foram submetidos a exames de RM contrastada, um com dose plena de Gd-DTPA e outro com dose plena de Gd-BOPTA. Os exames foram realizados com um intervalo de 72 a 108 horas. Dois radiologistas independentes realizaram avaliação às cegas das imagens, considerando número, caracterização e realce das lesões, além de preferências subjetivas. RESULTADOS: Não houve diferença estatisticamente significante entre os dois exames quanto à detecção e caracterização das lesões. Observou-se um incremento de 18% no realce da lesão dominante pelo Gd-BOPTA, em comparação com o Gd-DTPA. Na maioria dos casos, ambos os observadores cegos subjetivamente preferiram as imagens utilizando Gd-BOPTA àquelas com Gd-DTPA, com base no maior realce e melhor definição das margens das lesões. CONCLUSÃO: Em doses plenas equivalentes, Gd-BOPTA e Gd-DTPA são similares na detecção e caracterização de lesões hepáticas focais em pacientes com doença hepática crônica. Entretanto, o Gd-BOPTA foi superior em relação ao realce da lesão, assim como na preferência subjetiva dos observadores.
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Quarter-dose (0.025 mmol/kg) gadobenate dimeglumine for abdominal MRI in patients at risk for nephrogenic systemic fibrosis: preliminary observations. AJR Am J Roentgenol 2011; 196:545-52. [PMID: 21343495 DOI: 10.2214/ajr.10.4500] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study is to evaluate the feasibility of 0.025 mmol/kg gadobenate dimeglumine, which is one quarter of the standard dose, for abdominal 3-T MRI studies in patients considered to be at risk for nephrogenic systemic fibrosis, using qualitative and quantitative measures and comparison with higher doses. MATERIALS AND METHODS The MRI database was retrospectively searched to select consecutive patients who underwent quarter-dose gadobenate dimeglumine-enhanced abdominal MRI at 3 T, between January 1, 2009, and January 15, 2010, and who underwent half-dose (0.05 mmol/kg) gadobenate dimeglumine-enhanced abdominal MRI at 3 T during one randomly chosen month. There were 25 patients in the final quarter-dose group (16 men and nine women; mean age, 57 years) and 44 patients in the half-dose group (21 men and 23 women; mean age, 58 years). The enhancement of abdominal organs and aorta was evaluated qualitatively and quantitatively on contrast-enhanced images. The overall quality of abdominal enhancement was also evaluated. RESULTS Reviewers rated the diagnostic enhancement of the evaluated organs in all phases of enhancement for both studied doses, but the half dose had significantly higher ratings than did the quarter dose in all comparisons (p, 0.034 to < 0.0001), except in the pancreas in the early hepatic venous phase (p = 0.095 for reviewer 1; p = 0.0611 for reviewer 2). The overall enhancement quality of the quarter dose was rated as good in all phases of enhancement, although it was significantly lower than that for the half dose (p ≤ 0.0001). The liver, pancreas, renal cortex, and aorta had 1.52-1.93-fold, 1.53-1.90-fold, 1.46-1.77-fold, and 1.58-1.84-fold, respectively, higher percentages of enhancement with the half dose than with the quarter dose (p, 0.0049 to < 0.0001). CONCLUSION A one-quarter dose of gadobenate dimeglumine at 3 T is a feasible alternative for abdominal MRI in patients at risk for nephrogenic systemic fibrosis. Our results might have important clinical implications, because greater safety may be conferred on patients with poor renal function with this low dose of contrast agent.
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Grazioli L, Bondioni MP, Faccioli N, Gambarini S, Tinti R, Schneider G, Kirchin M. Solid focal liver lesions: dynamic and late enhancement patterns with the dual phase contrast agent gadobenate dimeglumine. J Gastrointest Cancer 2011; 41:221-32. [PMID: 20405242 DOI: 10.1007/s12029-010-9145-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The purpose of this paper is to illustrate contrast enhancement patterns of solid focal liver lesions on dynamic and late phase imaging with gadobenate dimeglumine (Gd-BOPTA). IMAGING FINDINGS Unenhanced T2- and T1-weighted, dynamic T1-weighted (arterial, portal-venous, and equilibrium) and late phase (1-3 h) Gd-BOPTA-enhanced MR imaging of different focal liver lesions (nodular regenerative hyperplasia, hepatic adenoma, liver adenomatosis, hepatocellular carcinoma, peripheral cholangiocarcinoma, hypervascular metastases, and hypovascular metastases) are shown. Dynamic imaging was performed using GRE T1-w sequences after the bolus injection of 0.1 mmol/kg Gd-BOPTA; late-phase imaging was obtained at 1-3 h after contrast injection. CONCLUSIONS Dynamic imaging with Gd-BOPTA provides the same information as with conventional gadolinium-based extracellular contrast agents, while late-phase imaging gives additional information for lesion identification and characterization.
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Affiliation(s)
- Luigi Grazioli
- Department of Radiology, University of Brescia, Brescia, Italy.
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Martincich L, Faivre-Pierret M, Zechmann CM, Corcione S, van den Bosch HCM, Peng WJ, Petrillo A, Siegmann KC, Heverhagen JT, Panizza P, Gehl HB, Diekmann F, Pediconi F, Ma L, Gilbert FJ, Sardanelli F, Belli P, Salvatore M, Kreitner KF, Weiss CM, Zuiani C. Multicenter, Double-Blind, Randomized, Intraindividual Crossover Comparison of Gadobenate Dimeglumine and Gadopentetate Dimeglumine for Breast MR Imaging (DETECT Trial). Radiology 2011; 258:396-408. [DOI: 10.1148/radiol.10100968] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chanyaputhipong J, Low SCA, Chow PKH. Gadoxetate Acid-Enhanced MR Imaging for HCC: A Review for Clinicians. Int J Hepatol 2011; 2011:489342. [PMID: 21994860 PMCID: PMC3170825 DOI: 10.4061/2011/489342] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Revised: 02/28/2011] [Accepted: 03/31/2011] [Indexed: 12/19/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is increasingly being detected at an earlier stage, owing to the screening programs and regular imaging follow-up in high-risk populations. Small HCCs still pose diagnostic challenges on imaging due to decreased sensitivity and increased frequency of atypical features. Differentiating early HCC from premalignant or benign nodules is important as management differs and has implications on both the quality of life and the overall survival for the patients. Gadoxetate acid (Gd-EOB-DTPA, Primovist(®), Bayer Schering Pharma) is a relatively new, safe and well-tolerated liver-specific contrast agent for magnetic resonance (MR) imaging of the liver that has combined perfusion- and hepatocyte-specific properties, allowing for the acquisition of both dynamic and hepatobiliary phase images. Its high biliary uptake and excretion improves lesion detection and characterization by increasing liver-to-lesion conspicuity in the added hepatobiliary phase imaging. To date, gadoxetate acid-enhanced MRI has been mostly shown to be superior to unenhanced MRI, computed tomography, and other types of contrast agents in the detection and characterization of liver lesions. This review article focuses on the evolving role of gadoxetate acid in the characterization of HCC, differentiating it from other mimickers of HCC.
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Affiliation(s)
| | - Su-Chong Albert Low
- Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, 169608, Singapore,*Su-Chong Albert Low:
| | - Pierce K. H. Chow
- Department of General Surgery, Singapore General Hospital, 169608, Singapore ,Duke-NUS Graduate Medical School, 169857, Singapore
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Poster Exhibit 1 st: Monday, 4 October – Wednesday, 6 October. Neuroradiol J 2010. [DOI: 10.1177/19714009100230s112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gerretsen SC, le Maire TF, Miller S, Thurnher SA, Herborn CU, Michaely HJ, Kramer H, Vanzulli A, Vymazal J, Wasser MN, Ballarati CEM, Kirchin MA, Pirovano G, Leiner T. Multicenter, double-blind, randomized, intraindividual crossover comparison of gadobenate dimeglumine and gadopentetate dimeglumine for MR angiography of peripheral arteries. Radiology 2010; 255:988-1000. [PMID: 20501735 DOI: 10.1148/radiol.10090357] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To prospectively compare the image quality and diagnostic performance achieved with doses of gadobenate dimeglumine and gadopentetate dimeglumine of 0.1 mmol per kilogram of body weight in patients undergoing contrast material-enhanced magnetic resonance (MR) angiography of the pelvis, thigh, and lower-leg (excluding foot) for suspected or known peripheral arterial occlusive disease. MATERIALS AND METHODS Institutional review board approval was granted from each center and informed written consent was obtained from all patients. Between November 2006 and January 2008, 96 patients (62 men, 34 women; mean age, 63.7 years +/- 10.4 [standard deviation]; range, 39-86 years) underwent two identical examinations at 1.5 T by using three-dimensional spoiled gradient-echo sequences and randomized 0.1-mmol/kg doses of each agent. Images were evaluated on-site for technical adequacy and quality of vessel visualization and offsite by three independent blinded readers for anatomic delineation and detection/exclusion of pathologic features. Comparative diagnostic performance was determined in 31 patients who underwent digital subtraction angiography. Data were analyzed by using the Wilcoxon signed-rank, McNemar, and Wald tests. Interreader agreement was determined by using generalized kappa statistics. Differences in quantitative contrast enhancement were assessed and a safety evaluation was performed. RESULTS Ninety-two patients received both agents. Significantly better performance (P < .0001; all evaluations) with gadobenate dimeglumine was noted on-site for technical adequacy and vessel visualization quality and offsite for anatomic delineation and detection/exclusion of pathologic features. Contrast enhancement (P < or = .0001) and detection of clinically relevant disease (P < or = .0028) were significantly improved with gadobenate dimeglumine. Interreader agreement for stenosis detection and grading was good to excellent (kappa = 0.749 and 0.805, respectively). Mild adverse events were reported for four (six events) and five (eight events) patients after gadobenate dimeglumine and gadopentetate dimeglumine, respectively. CONCLUSION Higher-quality vessel visualization, greater contrast enhancement, fewer technical failures, and improved diagnostic performance are obtained with gadobenate dimeglumine, relative to gadopentetate dimeglumine, when compared intraindividually at 0.1-mmol/kg doses in patients undergoing contrast-enhanced MR angiography for suspected peripheral arterial occlusive disease.
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Affiliation(s)
- Suzanne C Gerretsen
- Dept of Cardiovascular MR Research, Maastricht Univ Hosp, Peter Debijelaan 25, 6229HX Maastricht, the Netherlands
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Intraindividual In Vivo Comparison of Gadolinium Contrast Agents for Pharmacokinetic Analysis Using Dynamic Contrast Enhanced Magnetic Resonance Imaging. Invest Radiol 2010; 45:233-44. [DOI: 10.1097/rli.0b013e3181d54507] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Martin DR, Krishnamoorthy SK, Kalb B, Salman KN, Sharma P, Carew JD, Martin PA, Chapman AB, Ray GL, Larsen CP, Pearson TC. Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols. J Magn Reson Imaging 2010; 31:440-6. [PMID: 20099361 DOI: 10.1002/jmri.22024] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in patients on dialysis administered either a lower dose high-relaxivity linear gadolinium-chelate, gadobenate dimeglumine (MultiHance, MH), compared to a standard dose linear gadolinium chelate, gadodiamide (Omniscan, OM). MATERIALS AND METHODS This study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved. As per institution standardized contrast-enhanced magnetic resonance imaging (MRI) protocols, patients on dialysis were imaged using either MH, between 2/2007 to 9/2008, or OM between 10/2003 and 1/2007. Rates of NSF were compared using 95% score-based confidence intervals (CI). The Wilcoxon rank sum test was used to test similarity/difference between contrast doses given to each patient group. RESULTS Overall, 312 patients on dialysis received OM and eight (2.6%) developed NSF (95% CI: 1.30%-4.98%). In all, 784 patients on dialysis received MH at a mean cumulative dose of 0.11 mmol/kg (0.05-0.75 mmol/kg) and no cases of NSF were identified (upper 95% confidence bound of 0.45%). The mean cumulative dose of OM was 0.16 mmol/kg (0.1-0.9 mmol/kg) for all patients and 0.28 mmol/kg (0.1-0.8 mmol/kg) for the patients with NSF. The median OM dose was greater in patients who developed NSF (P = 0.03), and was greater than the median MH dose (P < 0.005). CONCLUSION NSF incidence in at-risk patients receiving contrast-enhanced MRI can be reduced after changing contrast administration protocols that includes changing the type and dose of contrast agent.
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Affiliation(s)
- Diego R Martin
- Department of Radiology, Emory University, Atlanta, Georgia, USA.
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Seale MK, Catalano OA, Saini S, Hahn PF, Sahani DV. Hepatobiliary-specific MR contrast agents: role in imaging the liver and biliary tree. Radiographics 2010; 29:1725-48. [PMID: 19959518 DOI: 10.1148/rg.296095515] [Citation(s) in RCA: 276] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Hepatobiliary-specific contrast agents are one of several classes of contrast agents available for magnetic resonance (MR) imaging of the liver. These agents are taken up by functioning hepatocytes and excreted in the bile, and their paramagnetic properties cause shortening of the longitudinal relaxation time (T1) of the liver and biliary tree. The three contrast agents that have been developed are mangafodipir trisodium (Mn-DPDP), gadobenate dimeglumine (Gd-BOPTA), and gadoxetic acid (Gd-EOB-DTPA). These three MR contrast agents vary in mode of administration and dose, mechanism of cellular uptake, degree of excretion through the biliary pathway, and imaging characteristics. In the liver, hepatobiliary-specific agents can be used to improve lesion detection, to characterize lesions as hepatocellular or nonhepatocellular, and to specifically characterize some hepatocellular lesions, notably focal nodular hyperplasia. Biliary excretion of these agents can be used to evaluate the anatomic structure and function of the biliary tree. In the future, hepatobiliary-specific contrast agents may have wider applications, such as grading of cirrhosis and quantification of liver function.
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Affiliation(s)
- Melanie K Seale
- Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, White 270, 55 Fruit St, Boston, MA 02114, USA
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Potential Conditions Causing Impairment of Selective Hepatobiliary Enhancement of Gadobenate Dimeglumine-Enhanced Delayed Magnetic Resonance Imaging. J Comput Assist Tomogr 2010; 34:113-20. [DOI: 10.1097/rct.0b013e3181aacd6b] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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50
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Altun E, Martin DR, Wertman R, Lugo-Somolinos A, Fuller ER, Semelka RC. Nephrogenic Systemic Fibrosis: Change in Incidence Following a Switch in Gadolinium Agents and Adoption of a Gadolinium Policy—Report from Two U.S. Universities. Radiology 2009; 253:689-96. [DOI: 10.1148/radiol.2533090649] [Citation(s) in RCA: 122] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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