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Shahrouki P, Nguyen KL, Moriarty JM, Plotnik AN, Yoshida T, Finn JP. Minimizing table time in patients with claustrophobia using focused ferumoxytol-enhanced MR angiography ( f-FEMRA): a feasibility study. Br J Radiol 2021; 94:20210430. [PMID: 34415199 PMCID: PMC9327752 DOI: 10.1259/bjr.20210430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/26/2021] [Accepted: 06/14/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To assess the feasibility of a rapid, focused ferumoxytol-enhanced MR angiography (f-FEMRA) protocol in patients with claustrophobia. METHODS In this retrospective study, 13 patients with claustrophobia expressed reluctance to undergo conventional MR angiography, but agreed to a trial of up to 10 min in the scanner bore and underwent f-FEMRA. Thirteen matched control patients who underwent gadolinium-enhanced MR angiography (GEMRA) were identified for comparison of diagnostic image quality. For f-FEMRA, the time from localizer image acquisition to completion of the angiographic acquisition was measured. Two radiologists independently scored images on both f-FEMRA and GEMRA for arterial and venous image quality, motion artefact and diagnostic confidence using a 5-point scale, five being best. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aorta and IVC were measured. The Wilcoxon rank-sum test, one-way ANOVA with Tukey correction and two-tailed t tests were utilized for statistical analyses. RESULTS All scans were diagnostic and assessed with high confidence (scores ≥ 4). Average scan time for f-FEMRA was 6.27 min (range 3.56 to 10.12 min), with no significant difference between f-FEMRA and GEMRA in diagnostic confidence (4.86 ± 0.24 vs 4.69 ± 0.25, p = 0.13), arterial image quality (4.62 ± 0.57 vs 4.65 ± 0.49, p = 0.78) and motion artefact score (4.58 ± 0.49 vs 4.58 ± 0.28, p > 0.99). f-FEMRA scored significantly better for venous image quality than GEMRA (4.62 ± 0.42 vs 4.19 ± 0.56, p = 0.04). CNR in the IVC was significantly higher for steady-state f-FEMRA than GEMRA regardless of the enhancement phase (p < 0.05). CONCLUSIONS Comprehensive vascular MR imaging of the thorax, abdomen and pelvis can be completed in as little as 5 min within the magnet bore using f-FEMRA, facilitating acceptance by patients with claustrophobia and streamlining workflow. ADVANCES IN KNOWLEDGE A focused approach to vascular imaging with ferumoxytol can be performed in patients with claustrophobia, limiting time in the magnet bore to 10 min or less, while acquiring fully diagnostic images of the thorax, abdomen and pelvis.
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Affiliation(s)
- Puja Shahrouki
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
| | - Kim-Lien Nguyen
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
| | - John M. Moriarty
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
| | - Adam N. Plotnik
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
| | - Takegawa Yoshida
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
| | - J. Paul Finn
- Department of Radiological Sciences, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, California, United States
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Saito K, Araki Y, Kokubo R, Kurata C, Wakabayashi Y, Suzuki K. Abdominal Organ Enhancement in Dynamic MRI using 1 M Gadobutrol vs 0.5 M Meglumine Gadoterate in Liver of Hemangioma Patients. Curr Med Imaging 2021; 17:662-668. [PMID: 33172380 DOI: 10.2174/1573405616999201109215827] [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: 03/03/2020] [Revised: 08/15/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The utility of gadobutrol (GAD) which is higher r1 value contrast media for evaluating abdominal solid organ have not been fully evaluated. OBJECTIVE To compare the contrast enhancement of abdominal organs on dynamic MRI using 0.1 mmol/kg 1.0 M GAD or 0.5 M meglumine gadoterate (MG) in patients with a liver hemangioma. METHODS A phantom study was performed at different concentrations (0.05, 0.1, 0.3, 0.5, 0.7, 0.9, 1.0, 5.0 and 10 mmol/L) of GAD and MG. Sixty-two patients with a liver hemangioma were enrolled. Contrast media was injected at a rate of 2 mL/s followed by 40 mL of saline. Two arterial phases, a portal phase and an equilibrium phase were obtained. One certified radiologist set regions of interest on the abdominal aorta, liver, pancreas, spleen and the liver hemangioma. The relative enhancement ratio (RER) was calculated. RESULTS In the phantom study the signal intensity of both contrast media was similar at lower concentrations. However, the signal intensity of MG was higher at concentrations of more than 5.0 mmol/L. In the clinical study the RER of the abdominal viscera during the portal and equilibrium phases was higher with GAD. The hemangioma had a higher equilibrium phase enhancement with GAD. The aortic RER was equivalent during all phases and the liver RER during the 2nd arterial phase was higher with GAD. The arterial phase during GAD imaging might have been measured later than was optimal. CONCLUSION When the same injection protocol was used for an abdominal dynamic MRI, arterial phase imaging was late when GAD was used. The higher T1 relaxation value was significantly higher in the abdominal viscera during the portal and equilibrium phases, while the liver hemangioma also had significantly higher contrast enhancement during the equilibrium phase. CLINICAL TRIAL REGISTRATION NUMBER 3186.
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Affiliation(s)
- Kazuhiro Saito
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Yoichi Araki
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Reiji Kokubo
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | - Chishio Kurata
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
| | | | - Kunihito Suzuki
- Department of Radiology, Tokyo Medical University, Tokyo, Japan
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Liu X, Zhang W, Li Z, Fu Y, Ren J, Shen W, Wang J, Xu Y, Song B. Improved display of abdominal contrast-enhanced MRA using gadobutrol: comparison with Gd-DTPA. Clin Radiol 2019; 74:978.e1-978.e7. [PMID: 31551147 DOI: 10.1016/j.crad.2019.08.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 08/20/2019] [Indexed: 02/05/2023]
Abstract
AIM To qualitatively and quantitatively compare gadobutrol with gadopentetate dimeglumine (Gd-DTPA) in abdominal contrast-enhanced magnetic resonance angiography (CE-MRA) and contrast-enhanced magnetic resonance imaging (CE-MRI) during one-stop imaging. MATERIALS AND METHODS This prospective, blinded, multicentre, intra-individual comparison study was approved by the institutional review board. All patients underwent gadobutrol- and Gd-DTPA-enhanced MRA and MRI. Qualitative analysis for vessels was performed using a three-point scale while quantity analysis was performed by signal-to-noise ratio (SNR). Visceral organs enhancements were also analysed. A Wilcoxon matched-pair signed-rank test was used to evaluate the quality and quantity results. RESULTS One hundred and twelve patients were enrolled. Quality analyses results for large vessels and small vessels of gadobutrol and Gd-DTPA were 18.38±1.51 and 6.76±1.58 and 17.87±1.84 and 6.09±1.55, respectively. Wilcoxon signed-rank tests revealed gadobutrol was significantly superior to Gd-DTPA (p=0.036) for small vessels. For large vessel quantity analysis, gadobutrol demonstrated significantly higher signal-to-noise ratios (SNR; p=0.041) than Gd-DTPA, with mean values of 948.156±349.731 and 838.925±248.197. There was no statistically significant in enhancement of liver, spleen, and renal tissue during gadobutrol- and Gd-DTPA-enhanced imaging (p>0.05). One patient reported an adverse event. Dizziness and vomiting occurred after injection of Gd-DTPA. CONCLUSIONS The present study demonstrates gadobutrol-enhanced MRA was superior to that of Gd-DTPA without statistical significance in visceral organ enhancement. It indicates gadobutrol may be more suitable for abdominal one-stop imaging for CE-MRA and CE-MRI by improving depiction of vessels in MRA images.
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Affiliation(s)
- X Liu
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - W Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Z Li
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Y Fu
- Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - J Ren
- Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China
| | - W Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin, Tianjin Province, China
| | - J Wang
- Department of Radiology, The Third Affiliated Hospital of Zhongshan University, Guangzhou, Guangdong Province, China
| | - Y Xu
- Department of Radiology, Nanfang Hospital of Southern Medical University, Guangzhou, Guangdong Province, China
| | - B Song
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Liu X, Li Z, Zhang W, Yang C, Diao Y, Duan T, Fu Y, Ren J, Bin S. Gadobutrol Precedes Gd-DTPA in Abdominal Contrast-Enhanced MRA and MRI: A Prospective, Multicenter, Intraindividual Study. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:9738464. [PMID: 31866800 PMCID: PMC6914877 DOI: 10.1155/2019/9738464] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 09/22/2019] [Accepted: 10/26/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To qualitatively and quantitatively compare the contrast-enhanced magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) in one-stop shop of abdominal imaging with Gadobutrol and Gd-DTPA at equimolar doses of gadolinium. MATERIALS AND METHODS This was a prospective designed, multiple center, intraindividual comparison study. All volunteers underwent Gadobutrol- and Gd-DTPA-enhanced MRA and MRI in one-stop shop. Qualitative analysis for large vessels and small vessels was performed by a three-point scale, while for minute small vessels, by a five-point scale. Quantitative analysis was performed for large vessels by signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Visceral organ enhancements on the equilibrium phase were also analyzed. Wilcoxon matched-pair signed-rank tests were used to evaluate the qualitative and quantitative results. RESULTS 40 volunteers were enrolled. Qualitative analyses results for large vessels, small vessels, and minute small vessels of Gadobutrol and Gd-DTPA were 20.98 ± 2.11, 6.03 ± 1.03, and 3.41 ± 1.18 and 20.01 ± 2.18, 5.28 ± 1.67, and 2.61 ± 1.40, respectively. Wilcoxon signed-rank tests revealed Gadobutrol-enhanced MRA was superior to that of Gd-DTPA significantly for small vessels (p=0.028) and minute small vessels (p=0.007). For quantitative analysis of large vessels, no statistic difference was found. Gadobutrol-enhanced MRI had higher CNR of the liver (p=0.003), spleen (p=0.001), and pancreas (p=0.001) and higher SNR of spleen (p=0.009) than those of Gd-DTPA statistically. CONCLUSION Our study proved Gadobutrol was superior to Gd-DTPA in qualitative analysis of CE-MRA and quantitative analysis of visceral organ enhancement on CE-MRI in abdomen of healthy volunteers. Gadobutrol may be more suitable for abdominal one-stop examination for CE-MRA and CE-MRI.
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Affiliation(s)
- Xijiao Liu
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Zhengyan Li
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Weiwei Zhang
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Caiwei Yang
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yike Diao
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Ting Duan
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yu Fu
- 2Department of Radiology, The First Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jing Ren
- 3Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan Province, China
| | - Song Bin
- 1Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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Toprak N, Unal O, Avcu S. The Efficacy of One Molar Contrast Material in the Evaluation of Breast Lesions with MR Imaging. Pol J Radiol 2015; 80:401-10. [PMID: 26405464 PMCID: PMC4557414 DOI: 10.12659/pjr.894863] [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: 06/01/2015] [Accepted: 06/16/2015] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To investigate the efficacy of 1 molar (containing 1 mol/mL gadobutrol) contrast material in the differentiation of malignant and benign breast lesions with MRI. MATERIAL/METHODS Thirty-seven women (age range: 22-77 years, mean: 43.7 years) with 76 breast lesions were included in this study. Dynamic post-contrast images with 0.2 mL/kg gadobutrol (Gadovist) injection were obtained in all patients. Contrast-to-noise-ratio (CNR) of the lesions, as well as their contrast enhancement patterns (ring, heterogeneous, homogenous), and perilesional increased vascularity were studied. RESULTS Fifty-six benign and 20 malignant lesions were examined histopathologically. In malignant cases, heterogeneous and peripheral enhancements were most commonly determined, whereas homogeneous enhancement was most commonly determined in benign cases. CNR was 450% in malignant lesions, and 60% in benign lesions. CONCLUSIONS Type II/III contrast-time curves, ring/heterogeneous enhancement, prominent increase in CNR, and perilesional vascularity increase are important findings determining malignancy, whereas Type I curves, homogenous enhancement, a slight increase in CNR, and absence of perilesional vascularity increase support findings of benign breast lesions. By increasing CNR and providing increased perilesional vascularity, Gadovist can help in the determination of malignant breast lesions.
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Affiliation(s)
- Nursen Toprak
- Department of Radiology, Yüzüncü Yıl University Medical Faculty, Van, Turkey
| | - Ozkan Unal
- Department of Radiology, Yüzüncü Yıl University Medical Faculty, Van, Turkey
| | - Serhat Avcu
- Department of Radiology, Gazi University Medical Faculty, Ankara, Turkey
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Liang Z, Ma L, Wang D, Huan Y, Li P, Yu J, Yao Z, Chen S, He H, Feng X, Breuer J. Efficacy and Safety of Gadobutrol (1.0 M) versus Gadopentetate Dimeglumine (.5 M) for Enhanced Mri of Cns Lesions: A Phase Iii, Multicenter, Single-blind, Randomized Study in Chinese Patients. MAGNETIC RESONANCE INSIGHTS 2012. [DOI: 10.4137/mri.s9348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The aim of this study was to compare the efficacy and safety of macrocyclic gadobutrol (1.0 M) with linear gadopentetate dimeglumine (0.5 M) for contrast-enhanced magnetic resonance imaging (MRI) of central nervous system (CNS) lesions in Chinese patients (N = 147) with known or suspected CNS lesions, who were enrolled in this single-blind, randomized, parallel-group study. Three blinded independent readers evaluated all efficacy variables. The primary efficacy variable was the difference between the two agents for the change in contrast-to-noise ratio (CNR) between non-enhanced and contrast-enhanced scans of lesions. Secondary outcomes included mean change in number of lesions detected before and after contrast enhancement, diagnostic confidence, and safety and tolerability parameters. Gadobutrol was non-inferior to gadopentetate dimeglumine in respect to the difference in the mean change in CNR (6.94; 95% confidence interval [CI] lower limit: -3.90; predefined maximum 95% CI lower limit: -6.52). The mean change in the number of CNS lesions detected was greater with gadobutrol versus gadopentetate dimeglumine (1.2 vs. 0.2 lesions). Diagnostic confidence was classified as ‘high’ for more patients with gadobutrol versus gadopentetate dimeglumine by the investigators (58.8% vs. 55.4%) and by the three blinded readers (63.6% vs. 55.7%, 23.7% vs. 18.0% and 81.7% vs. 81.0%). Both agents were well tolerated by participating patients. We concluded that in Chinese patients with CNS lesions, gadobutrol (1.0 M) was as effective and well tolerated in contrast-enhanced MRI as gadopentetate dimeglumine (0.5 M). Gadobutrol provided improved visualization of CNS lesions compared with gadopentetate dimeglumine, with a comparable tolerability profile.
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Affiliation(s)
- Zonghui Liang
- Radiology Department, Huashan Hospital, Fudan University, Shanghai, China
- Radiology Department, Shanghai Jing'an District Centre Hospital (Fudan University Huashan Hospital Jing'an Branch), Shanghai, China
| | - Lin Ma
- Radiology Department, Chinese PLA 301st Hospital, Beijing, China
| | - Dehang Wang
- Radiology Department, The People's Hospital of Jiangsu Province, Jiangsu, China
| | - Yi Huan
- Radiology Department, Xijing Hospital, Shanxi, China
| | - Ping Li
- Bayer Healthcare Company Ltd., Beijing, China
| | - Jun Yu
- Radiology Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenwei Yao
- Radiology Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Shuang Chen
- Radiology Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Huijin He
- Radiology Department, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaoyuan Feng
- Radiology Department, Huashan Hospital, Fudan University, Shanghai, China
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Wuesten O, Morelli JN, Miller MW, Tuzun E, Lenox MW, Fossum TW, Trelles M, Cotes C, Krombach GA, Runge VM. MR angiography of carotid artery aneurysms in a porcine model at 3 Tesla: comparison of two different macrocyclic gadolinium chelates and of dynamic and conventional techniques. J Magn Reson Imaging 2012; 36:1203-12. [PMID: 22826184 DOI: 10.1002/jmri.23757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 06/15/2012] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate the differences in image quality of two macrocyclic gadolinium-based contrast agents, gadobutrol and gadoterate meglumine, using time-resolved, contrast-enhanced MR angiography (CE-MRA) in a porcine carotid artery aneurysm model and to compare image quality between dynamic and conventional, single acquisition CE-MRA. MATERIALS AND METHODS Bilateral carotid aneurysms were created surgically in this Institutional Animal Care and Use Committee approved study. Dynamic CE-MRA studies optimized for high temporal resolution were performed at 3 Tesla. Scans using equivalently dosed (on a per mmol basis) gadobutrol and gadoterate meglumine were compared qualitatively and quantitatively in terms of contrast-to-noise ratio (CNR). Higher spatial resolution dynamic and conventional CE-MRA were also compared. RESULTS N = 16 aneurysms were assessed. Qualitative evaluation of dynamic CE-MRA scans demonstrated a preference for gadobutrol over gadoterate meglumine. Significantly higher aneurysm CNR was found with gadobutrol (133 ± 44) versus gadoterate meglumine, the latter at both equivalent and double injection rates (94 ± 35 and 102 ± 38). In a blinded assessment, conventional CE-MRA was preferred qualitatively when compared with dynamic CE-MRA. However, dynamic CE-MRA was generally capable of providing diagnostic image quality. CONCLUSION Gadobutrol is preferred to gadoterate meglumine for high temporal resolution dynamic CE-MRA, a fact with important clinical implications for low dose CE-MRA protocols in patients at risk for nephrogenic systemic fibrosis. Conventional high resolution CE-MRA provides superior image quality when compared with dynamic CE-MRA.
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Affiliation(s)
- Oliver Wuesten
- Department of Radiology, University of Texas Medical Branch (UTMB), 301 University Boulevard, Galveston, Texas, USA.
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Forkert ND, Illies T, Möller D, Handels H, Säring D, Fiehler J. Analysis of the influence of 4D MR angiography temporal resolution on time-to-peak estimation error for different cerebral vessel structures. AJNR Am J Neuroradiol 2012; 33:2103-9. [PMID: 22555588 DOI: 10.3174/ajnr.a3089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND PURPOSE Time-resolved MRA imaging is a promising technique for blood flow evaluation in case of cerebrovascular malformations. Unfortunately, 4D MRA imaging is a trade-off between spatial and temporal resolution. The aim of this study was to investigate the influence of temporal resolution on the error associated with TTP estimation from indicator dilution curves derived from different vascular structures. MATERIALS AND METHODS Monte Carlo simulation was performed to compute indicator dilution curves with known criterion standard TTP at temporal resolutions between 0.1 and 5 seconds. TTPs were estimated directly and by using 4 hemodynamic models for each curve and were compared with criterion standard TTP. Furthermore, clinical evaluation was performed by using 226 indicator dilution curves from different vessel structures obtained from clinical datasets. The temporal resolution was artificially decreased, and TTPs were estimated and compared with those obtained at the original temporal resolutions. The results of the clinical evaluations were further stratified for different vessel structures. RESULTS The results of both evaluations show that the TTP estimation error increases exponentially when one lowers the temporal resolution. TTP estimation by using hemodynamic model curves leads to lower estimation errors compared with direct estimation. A temporal resolution of 1.5 seconds for arteries and 2.5 seconds for venous and arteriovenous malformation vessel structures appears to be reasonable to achieve TTP estimations adequate for clinical application. CONCLUSIONS Different vessel structures require different temporal resolutions to enable comparable TTP estimation errors, which should be considered for achieving a case-optimal temporal and spatial resolution.
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Affiliation(s)
- N D Forkert
- Departments of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Giesel FL, Mehndiratta A, Essig M. High-relaxivity contrast-enhanced magnetic resonance neuroimaging: a review. Eur Radiol 2010; 20:2461-74. [PMID: 20567832 DOI: 10.1007/s00330-010-1805-8] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2009] [Revised: 03/01/2010] [Accepted: 03/04/2010] [Indexed: 11/25/2022]
Abstract
Evaluation of brain lesions using magnetic resonance imaging (MRI) provides information that is critical for accurate diagnosis, prognosis, therapeutic intervention and monitoring response. Conventional contrast-enhanced MR neuroimaging using gadolinium (Gd) contrast agents primarily depicts disruption of the blood-brain barrier, demonstrating location and extent of disease, and also the morphological details at the lesion site. However, conventional imaging results do not always accurately predict tumour aggressiveness. Advanced functional MRI techniques such as dynamic contrast-enhanced perfusion-weighted imaging utilise contrast agents to convey physiological information regarding the haemodynamics and neoangiogenic status of the lesion that is often complementary to anatomical information obtained through conventional imaging. Most of the Gd contrast agents available have similar T1 and T2 relaxivities, and thus their contrast-enhancing capabilities are comparable. Exceptions are gadobenate-dimeglumine, Gd-EOB-DTPA, Gadobutrol and gadofosveset, which, owing to their transient-protein-binding capability, possess almost twice (and more) the T1 and T2 relaxivities as other agents at all magnetic field strengths. Numerous comparative studies have demonstrated the advantages of the increased relaxivity in terms of enhanced image contrast, image quality and diagnostic confidence. Here we summarise the benefits of higher relaxivity for the most common neuroimaging applications including MRI, perfusion-weighted imaging and MRA for evaluation of brain tumours, cerebrovascular disease and other CNS lesions.
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Affiliation(s)
- Frederik L Giesel
- Department of Radiology E010, German Cancer Research Centre (DKFZ), 69120, Heidelberg, Germany
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Contrast Material for Abdominal Dynamic Contrast-Enhanced 3D MR Angiography With Parallel Imaging: Intraindividual Equimolar Comparison of a Macrocyclic 1.0 M Gadolinium Chelate and a Linear Ionic 0.5 M Gadolinium Chelate. AJR Am J Roentgenol 2010; 194:821-9. [DOI: 10.2214/ajr.09.3306] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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12
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Seeger A, Kramer U, Fenchel M, Grimm F, Bretschneider C, Döring J, Klumpp B, Tepe G, Rittig K, Seidensticker PR, Claussen CD, Miller S. Comparison between a linear versus a macrocyclic contrast agent for whole body MR angiography in a clinical routine setting. J Cardiovasc Magn Reson 2008; 10:63. [PMID: 19116027 PMCID: PMC2633332 DOI: 10.1186/1532-429x-10-63] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2008] [Accepted: 12/30/2008] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Previous experiences of whole body MR angiography are predominantly available in linear 0.5 M gadolinium-containing contrast agents. The aim of this study was to compare image quality on a four-point scale (range 1-4) and diagnostic accuracy of a 1.0 M macrocyclic contrast agent (gadobutrol, n = 80 patients) with a 0.5 M linear contrast agent (gadopentetate dimeglumine, n = 85 patients) on a 1.5 T whole body MR system. Digital subtraction angiography served as standard of reference. RESULTS All examinations yielded diagnostic image quality. There was no significant difference in image quality (3.76 +/- 0.3 versus 3.78 +/- 0.3, p = n.s.) and diagnostic accuracy observed. Sensitivity and specificity of the detection of hemodynamically relevant stenoses was 93%/95% in the gadopentetate dimeglumine group and 94%/94% in the gadobutrol group, respectively. CONCLUSION The high diagnostic accuracy of gadobutrol in the clinical routine setting is of high interest as medical authorities (e.g. the European Agency for the Evaluation of Medicinal Products) recommend macrocyclic contrast agents especially to be used in patients with renal failure or dialysis.
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Affiliation(s)
- Achim Seeger
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Ulrich Kramer
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Michael Fenchel
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Florian Grimm
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Christiane Bretschneider
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Jörg Döring
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Bernhard Klumpp
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Gunnar Tepe
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Kilian Rittig
- Department of Internal Medicine IV, Eberhard-Karls-University Tuebingen, Otfried-Müller-Str. 10, 72076 Tuebingen, Germany
| | | | - Claus D Claussen
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
| | - Stephan Miller
- Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany
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Bayrak IK, Ozmen Z, Nural MS, Danaci M, Diren B. A comparison of low-dose and normal-dose gadobutrol in MR renography and renal angiography. Korean J Radiol 2008; 9:250-7. [PMID: 18525228 PMCID: PMC2627262 DOI: 10.3348/kjr.2008.9.3.250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective It has been advocated that a reduced injection volume with highly concentrated (1 M) contrast material can produce a sharper bolus peak and an increased intravascular first-pass gadolinium concentration when compared with the use of a lower concentration (0.5 M). A higher concentration would also cause a reduction in dose. The purpose of our study was to test the use of a low dose (0.05 mmol/kg) of gadobutrol in magnetic resonance renography and angiography and compare the findings with a dose of 0.1 mmol/kg. Materials and Methods One-hundred-thirty-four patients referred for magnetic resonance angiography for suspected renovascular disease participated in the study. Contrast enhanced MR renography and angiography were performed after administration of a bolus of 0.1 mmol/kg or 0.05 mmol/kg gadobutrol in randomized patients. The relative signal intensity-time curves of the aorta, peripheral cortex and parenchyma, were obtained. Two radiologists evaluated the angiographic images and evaluated the quality of angiography. Results The signal intensity with a low dose of gadobutrol was significantly lower in early phases, in the peripheral cortex (for 36, 54, 72 and 90 seconds), the parenchyma (for 36, 54, 72 seconds) and the aorta (for 18, 36, 54, 72 seconds). The decreases in the early phase obtained with a low dose of gadobutrol caused blunter time intensity curves. The difference in the quality scores of the readers for the angiographic images for the use of the two different doses was not statistically significant (p > 0.05). Conclusion A lower dose of gadobutrol can be used for MR renal angiography, but for MR renography the normal dose should be used.
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Affiliation(s)
- Ilkay Koray Bayrak
- Department of Radiology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey.
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Szucs-Farkas Z, Froehlich JM, Ulrich M, Wuersten HU, Guignard D, Wyss S, Braunschweig M. 1.0-M gadobutrol versus 0.5-M gadoterate for peripheral magnetic resonance angiography: A prospective randomized controlled clinical trial. J Magn Reson Imaging 2008; 27:1399-405. [DOI: 10.1002/jmri.21351] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Stalder AF, Elverfeldt DV, Paul D, Hennig J, Markl M. Variable echo time imaging: signal characteristics of 1-M gadobutrol contrast agent at 1.5 and 3T. Magn Reson Med 2008; 59:113-23. [PMID: 18058940 DOI: 10.1002/mrm.21345] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Gadobutrol (Gd-Bt; Gadovist(R), Schering AG) is a 1-M Gadolinium (Gd)-based contrast agent. Its higher Gd concentration allows for reduction of injection volumes in first pass contrast-enhanced MR angiography (CE-MRA) and should increase bolus sharpness and image quality. However, ambivalent results were reported. In order to explore the performance of 1-M contrast agents such as Gd-Bt and its dependence on molecular environment and temperature, signal characteristics were analyzed for a series of increasing Gd-Bt concentrations for different temperature-controlled samples in water and human blood plasma. Relaxation times, relaxivities, and signal-concentration curves were assessed for several Gd-Bt concentrations in water at 20 degrees C and 37 degrees C and in plasma at 37 degrees C for 1.5T and 3T. Gd-Bt concentration influence on signal intensity (SI) could be effectively simulated and compared with experimental measurements as well as simulations with other contrast agents at realistic in vivo concentrations. Particular attention was given to T(2)- and T(*) (2)-induced losses at high concentrations, which annihilate benefits from T(1) shortening. Based on these findings, variable echo time (VTE) approaches with readout bandwidth varying with k-space position were explored in order to enhance the signal to noise performance of gradient echo imaging at high contrast agent concentrations. Results indicate the potential of VTE for imaging with increased SNR at high contrast agent concentrations.
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Affiliation(s)
- A F Stalder
- Department of Diagnostic Radiology, Medical Physics, University Hospital Freiburg, Freiburg, Germany.
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Kim YK, Lee YH, Kim CS, Han YM, Hwang SB. Double-dose 1.0-M gadobutrol versus standard-dose 0.5-M gadopentetate dimeglumine in revealing small hypervascular hepatocellular carcinomas. Eur Radiol 2007; 18:70-7. [PMID: 17404740 DOI: 10.1007/s00330-007-0630-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2006] [Revised: 01/08/2007] [Accepted: 03/08/2007] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to compare the diagnostic efficacy of double-dose 1.0-M gadobutrol with that of standard-dose 0.5-M gadopentetate dimeglumine for revealing small hypervascular hepatocellular carcinomas (HCCs). Twenty-three patients with 37 HCCs (mean size: 1.2 cm) that were diagnosed by histology (n = 13) or imaging findings (n = 10) underwent two separate 3D dynamic MRIs with 0.2 mmol/kg of gadobutrol and 0.1 mmol/kg of gadopentetate dimeglumine. Three observers interpreted both MRIs in terms of lesion detection using the alternative-free response receiver operating characteristic method and lesion-to-liver contrast using matched pairs analysis. The two MRIs were also compared quantitatively by measuring the signal-to-noise ratio (SNR) of the liver and lesion as well as the lesion-liver contrast-to-noise ratio (CNR). The SNR of the liver and lesion and lesion-liver CNR with gadobutrol were better than those with gadopentetate dimeglumine (p < 0.01). However, in terms of the diagnostic accuracy (mean Az for gadobutrol: 0.878, and mean Az for gadopentate dimeglumine: 0.873), the sensitivity (92.8%), positive predictive value (92.8% vs. 93.7%) and lesion-liver contrast, the two dynamic MRIs were equivalent. Gadobutrol showed a superior degree of enhancement for hypervascular HCC than did gadopentetate dimeglumine, but the diagnostic capabilities of the two agents for revealing HCCs were equivalent.
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Affiliation(s)
- Young Kon Kim
- Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, South Korea.
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17
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Schaefer FKW, Schaefer PJ, Altjohann C, Bourne M, Decobelli F, Goyen M, Griffiths PD, Kopka L, Kreitner KF, Link J, Oberholzer K, Pering C, Poeckler-Schoeninger C, Ruehm SG, Sachoran MR, Schulte-Altedorneburg G, Springer OS, Steiner P, Wall A, Winterer J, Tombach B. A multicenter, site-independent, blinded study to compare the diagnostic accuracy of contrast-enhanced magnetic resonance angiography using 1.0M gadobutrol (Gadovist™) to intraarterial digital subtraction angiography in body arteries. Eur J Radiol 2007; 61:315-23. [PMID: 17074459 DOI: 10.1016/j.ejrad.2006.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Revised: 09/02/2006] [Accepted: 09/08/2006] [Indexed: 11/23/2022]
Abstract
PURPOSE Prospective evaluation of diagnostic accuracy of single field-of-view contrast-enhanced MR Angiography (ceMRA) with 1.0M gadobutrol compared to intraarterial DSA in body arteries. MATERIALS AND METHODS In an European multicenter study 179 patients underwent ceMRA and DSA. For each indication five prospectively defined vessel segments were evaluated by local investigators onsite and by three site-independent blinded readers (BR) independently. RESULTS The agreement between ceMRA and DSA diagnosis was statistically significant in the onsite (96.6%) and blinded reader (86.6-90.2%) evaluation. Sensitivity, specificity, accuracy, positive (PPV) and negative predictive values (NPV) for detection of relevant stenosis (>50%) were calculated for the right and left internal carotid arteries, and common and external iliac arteries: Sensitivity was 95-98% (onsite) and 76-96% (BR), specificity 94-96% (onsite) and 86-94% (BR), accuracy 96% (onsite) and 87-93% (BR), NPV 98-99% (onsite) and 84-98% (BR), and PPV 79-93% (onsite) and 44-91% (BR), respectively. CONCLUSION CeMRA of body arteries using 1.0M gadobutrol provides diagnostic information comparable to intraarterial DSA.
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Affiliation(s)
- Fritz K W Schaefer
- Department of Diagnostic Radiology, University Hospital Schleswig-Holstein Campus Kiel, Arnold-Heller-Strasse 9, 24105 Kiel, Germany.
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Michaely HJ, Dietrich O, Nael K, Weckbach S, Reiser MF, Schoenberg SO. MRA of abdominal vessels: technical advances. Eur Radiol 2006; 16:1637-50. [PMID: 16721552 DOI: 10.1007/s00330-006-0240-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2005] [Revised: 02/20/2006] [Accepted: 03/06/2006] [Indexed: 11/26/2022]
Abstract
Magnetic resonance angiography (MRA) in general and MRA of the abdominal vessels in particular have undergone substantial improvements in the past 5 years triggered by the introduction and application of parallel imaging (PI), new sequence techniques such as centric k-space trajectories and undersampling, dedicated contrast agents and clinical high-field scanners. All of these techniques have the potential to improve image quality and resolution or decrease the image acquisition time. However, each of them has its own specific advantages and drawbacks. This review describes the main technical innovations and focuses on the impact these developments may have on abdominal MRA. Special consideration is given to the interaction of these various technical advances. The clinical value of advanced MRA techniques is discussed and illustrated by characteristic cases.
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Affiliation(s)
- Henrik J Michaely
- Department of Clinical Radiology, University Hospitals - Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr.15, 81377 Munich, Germany.
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