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Kanal E, Maki JH, Schramm P, Marti-Bonmati L. Evolving Characteristics of Gadolinium-Based Contrast Agents for MR Imaging: A Systematic Review of the Importance of Relaxivity. J Magn Reson Imaging 2024. [PMID: 38699938 DOI: 10.1002/jmri.29367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 05/05/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are widely and routinely used to enhance the diagnostic performance of magnetic resonance imaging and magnetic resonance angiography examinations. T1 relaxivity (r1) is the measure of their ability to increase signal intensity in tissues and blood on T1-weighted images at a given dose. Pharmaceutical companies have invested in the design and development of GBCAs with higher and higher T1 relaxivity values, and "high relaxivity" is a claim frequently used to promote GBCAs, with no clear definition of what "high relaxivity" means, or general concurrence about its clinical benefit. To understand whether higher relaxivity values translate into a material clinical benefit, well-designed, and properly powered clinical studies are necessary, while mere in vitro measurements may be misleading. This systematic review of relevant peer-reviewed literature provides high-quality clinical evidence showing that a difference in relaxivity of at least 40% between two GBCAs results in superior diagnostic efficacy for the higher-relaxivity agent when this is used at the same equimolar gadolinium dose as the lower-relaxivity agent, or similar imaging performance when used at a lower dose. Either outcome clearly implies a relevant clinical benefit. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Emanuel Kanal
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Division of Emergency Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jeffrey H Maki
- Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Peter Schramm
- Department of Neuroradiology, University Luebeck and Universitaetsklinikum Schleswig-Holstein Campus Luebeck, Luebeck, Germany
| | - Luis Marti-Bonmati
- Department of Radiology and GIBI230 Research Group on Biomedical Imaging, Hospital Universitario y Politécnico de La Fe and Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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2
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Clinical impact of assessing thrombus age using magnetic resonance venography prior to catheter-directed thrombolysis. Eur Radiol 2022; 32:4555-4564. [PMID: 35347362 PMCID: PMC9213279 DOI: 10.1007/s00330-022-08599-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/15/2022]
Abstract
Objectives Magnetic resonance venography (MRV) is underutilized in the evaluation of thrombus properties prior to endovascular treatment but may improve procedural outcomes. We therefore investigated the clinical impact of using a dedicated MRV scoring system to assess thrombus characteristics prior to endovascular intervention for iliofemoral deep vein thrombosis (DVT). Methods This is a post hoc analysis of data from the CAVA trial (Clinicaltrials.gov:NCT00970619). MRV studies of patients receiving ultrasound-accelerated catheter-directed thrombolysis (CDT) for iliofemoral DVT were reviewed. Thrombus age-related imaging characteristics were scored and translated into an overall score (acute, subacute, or old). MRV scores were compared to patient-reported complaints. MRV-scored groups were compared for CDT duration and success rate. Results Fifty-six patients (29 men; age 50.8 ± 16.4 years) were included. Using MRV, 27 thrombi were classified acute, 17 subacute, and 12 old. Based on patient-reported complaints, 11 (91.7%) of these old thrombi would have been categorized acute or subacute, and one (3.7%) of the acute thrombi as old. Average duration of CDT to > 90% restored patency differed significantly between groups (p < 0.0001): average duration was 23 h for acute thromboses (range: 19–25), 43 h for subacute (range: 41–62), and 85 h for old thromboses (range: 74–96). CDT was almost eleven times more successful in thromboses characterized as acute and subacute compared to old thromboses (OR: 10.7; 95% CI 2.1–55.5). Conclusion A dedicated MRV scoring system can safely discriminate between acute, subacute, and old thromboses. MRV-based selection is predictive of procedural duration and success rate and can help avoid unnecessary complications. Key Points • Thrombus age, characterized by MRV as acute, subacute, and old, can predict CDT duration and probability of success. • Accurate pre-interventional MRV-based thrombus aging has the potential to facilitate identification of eligible patients and may thus prevent CDT-related complications.
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Mehri-Kakavand G, Hasanzadeh H, Jahanbakhsh R, Abdollahi M, Nasr R, Bitarafan-Rajabi A, Jadidi M, Darbandi-Azar A, Emadi A. Gd n 3+@CNTs-PEG versus Gadovist®: In Vitro Assay. Oman Med J 2019; 34:147-155. [PMID: 30918609 PMCID: PMC6425045 DOI: 10.5001/omj.2019.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives Carbon nanotubes (CNTs) are allotropes of carbon with a length-to-diameter ratio greater than 106 with the potential uses as medical diagnostic or therapeutic agents. In vitro studies have revealed that gadolinium (Gd) nanoparticle-catalyzed single-walled carbon nanotubes (SWCNTs) possess superparamagnetic properties, which enable them to be used as contrast agents in magnetic resonance imaging (MRI). Our study synthesized Gd-CNT for use as MRI contrast agents. Methods To reduce the toxicity and solubility of CNTs, it was functionalized, and after loading with Gd was coated with polyethylene glycols (PEG). We then synthesized different concentrations of Gdn3+@CNTs-PEG and Gadovist® to be evaluated as MRI contrast agents. Results The analysis showed that the Gd concentration in Gadovist® was 12.18% higher than synthesized Gdn3+@CNTs-PEG, but the mean signal intensity of the Gdn3+@CNTs-PEG was approximately 3.3% times higher than Gadovist®. Conclusions Our findings indicate that synthesized Gdn3+@CNTs-PEG has the potential to be used as an MRI contrast agent in vitro, but in vivo assessment is necessary to determine the bio-distribution, kinetic, and signal enhancement characteristics.
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Affiliation(s)
| | - Hadi Hasanzadeh
- Cancer Research Center and Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran
| | - Rouzbeh Jahanbakhsh
- Arak Zist Darou Co, Health Technology Incubator Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Abdollahi
- Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran
| | - Reza Nasr
- Biotechnology Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Ahmad Bitarafan-Rajabi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Jadidi
- Department of Medical Physics, Semnan University of Medical Sciences, Semnan, Iran
| | - Amir Darbandi-Azar
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Emadi
- Deputy of Research and Technology, Semnan University of Medical Sciences, Semnan, Iran
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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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Roditi G, Christie A, Chandramohan S. Lower-limb magnetic resonance angiography: performance of extracellular contrast agents versus blood pool contrast agent for both dynamic and high spatial resolution imaging in extended phase. Clin Radiol 2016; 71:1296-1303. [PMID: 27629349 DOI: 10.1016/j.crad.2016.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Revised: 07/06/2016] [Accepted: 08/01/2016] [Indexed: 01/05/2023]
Abstract
AIM To prospectively compare the performance of extracellular space contrast agents (ECSCAs) versus a blood-pool contrast agent (BPCA) for a comprehensive lower-limb magnetic resonance angiography (MRA) protocol in patients with either claudication or critical ischaemia. MATERIALS AND METHODS Thirty patients with claudication underwent lower-limb magnetic resonance angiography (MRA) (dynamic crural, three-station bolus chase, and infra-inguinal high resolution) using a triphasic injection method with both a ECSCA and BPCA to allow intra-individual comparison, and 30 patients with critical ischaemia were scanned with either a ECSCA or BPCA. The dynamic, bolus chase, and high-resolution images were scored for quality on a Likert scale (from 1-5). Signal- and contrast-to-noise ratios were analysed and statistical analysis performed. RESULTS Overall, there was no statistically significant difference between the ECSCAs and BPCA for arteriographic dynamic imaging, bolus chase MRA, or the high spatial resolution imaging. Venous image quality was rated higher quality for BPCA scans than for ECSCA images for calf veins (not significantly for thigh veins). Venous imaging signal intensity measures were higher for BPCA imaging. CONCLUSION Extended-phase imaging using an ECSCA with this protocol provides arteriographic image quality equal to imaging with a BPCA. Venous depiction is good using ECSCAs with this approach, although better with BPCA.
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Affiliation(s)
- G Roditi
- Department of Radiology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G63 9SJ, UK.
| | - A Christie
- Department of Radiology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G63 9SJ, UK
| | - S Chandramohan
- Department of Radiology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G63 9SJ, UK
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Finn JP, Nguyen KL, Han F, Zhou Z, Salusky I, Ayad I, Hu P. Cardiovascular MRI with ferumoxytol. Clin Radiol 2016; 71:796-806. [PMID: 27221526 DOI: 10.1016/j.crad.2016.03.020] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 03/21/2016] [Accepted: 03/24/2016] [Indexed: 11/28/2022]
Abstract
The practice of contrast-enhanced magnetic resonance angiography (CEMRA) has changed significantly in the span of a decade. Concerns regarding gadolinium (Gd)-associated nephrogenic systemic fibrosis in those with severely impaired renal function spurred developments in low-dose CEMRA and non-contrast MRA as well as efforts to seek alternative MR contrast agents. Originally developed for MR imaging use, ferumoxytol (an ultra-small superparamagnetic iron oxide nanoparticle), is currently approved by the US Food and Drug Administration for the treatment of iron deficiency anaemia in adults with renal disease. Since its clinical availability in 2009, there has been rising interest in the scientific and clinical use of ferumoxytol as an MR contrast agent. The unique physicochemical and pharmacokinetic properties of ferumoxytol, including its long intravascular half-life and high r1 relaxivity, support a spectrum of MRI applications beyond the scope of Gd-based contrast agents. Moreover, whereas Gd is not found in biological systems, iron is essential for normal metabolism, and nutritional iron deficiency poses major public health challenges worldwide. Once the carbohydrate shell of ferumoxytol is degraded, the elemental iron at its core is incorporated into the reticuloendothelial system. These considerations position ferumoxytol as a potential game changer in the field of CEMRA and MRI. In this paper, we aim to summarise our experience with the cardiovascular applications of ferumoxytol and provide a brief synopsis of ongoing investigations on ferumoxytol-enhanced MR applications.
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Affiliation(s)
- J P Finn
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - K-L Nguyen
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Cardiology, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - F Han
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Z Zhou
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - I Salusky
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Division of Pediatric Nephrology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - I Ayad
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - P Hu
- Diagnostic Cardiovascular Imaging Laboratory, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Nagpal P, Maller V, Garg G, Hedgire S, Khandelwal A, Kalva S, Steigner ML, Saboo SS. Upper Extremity Runoff: Pearls and Pitfalls in Computed Tomography Angiography and Magnetic Resonance Angiography. Curr Probl Diagn Radiol 2016; 46:115-129. [PMID: 26949062 DOI: 10.1067/j.cpradiol.2016.01.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/25/2016] [Indexed: 12/13/2022]
Abstract
Upper extremity vasculature can be affected by various traumatic and nontraumatic pathologies; however, the evaluation of these arteries can be challenging for the radiologists as well as for the clinicians. After an accurate history and clinical examination, imaging plays a vital role in the diagnosis and treatment planning of these patients. Depending on the urgency and the indication, upper extremity arteries may be evaluated by ultrasonography with color Doppler, computed tomography (CT), magnetic resonance imaging (MRI), or digital subtraction angiography. This review article discusses relevant imaging anatomy of the upper extremity arteries, presents CT and MRI protocols, briefly describes the state-of-the-art CT and MRI of various pathologies affecting the upper extremity arteries, and summarizes the important pearls needed for busy practicing radiologist.
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Affiliation(s)
- Prashant Nagpal
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, IA; Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA.
| | - Vinod Maller
- Division of Interventional Radiology, Department of Radiology, University of Tennessee Health Science Center, Memphis, TN
| | - Gunjan Garg
- Department of Nuclear Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Yeshiva University, New York, NY
| | - Sandeep Hedgire
- Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Ashish Khandelwal
- Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Sanjeeva Kalva
- Division of Interventional Radiology, Department of Radiology, UT Southwestern Medical Center, Dallas, TX
| | - Michael L Steigner
- Department of Radiology, Brigham and Women׳s Hospital, Harvard Medical School, Boston, MA
| | - Sachin S Saboo
- Division of Cardiothoracic Imaging, Department of Radiology, UT Southwestern Medical Center, Dallas, TX
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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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Mirsharifi SR, Noparast M, Khazravi M, Ghanaati H, Shakiba M, Sharifi A. Gadolinium Enhanced MR-angiography Results in Patients With Peripheral Arterial Disease: Positive Predictive Value Compared to Surgery. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 16:e26033. [PMID: 25763247 PMCID: PMC4341249 DOI: 10.5812/ircmj.26033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 12/23/2014] [Accepted: 12/27/2014] [Indexed: 11/16/2022]
Abstract
Background: Peripheral arterial disease (PAD) represents systematic atherosclerosis of great vessels. PAD affects approximately 10-20 % of patients older than 60 years and is associated with high mortality and morbidity rate debilitating individuals’ life. Objectives: To compare the results of Gadolinium enhanced MR-Angiography and surgery in patients suspected to have peripheral arterial disease. Materials and Methods: In this prospective cohort study, 30 consecutive patients matching the inclusion criteria were enrolled and MR-Angiography was performed prior to surgery for each one. Results: 22 patients were male (73.3%) and the mean age was 60.3 ± 10.6 years in our study group. The most common artery for cut off and run off was superior femoral artery in both assessments. Proximal section of each artery was the most common anatomical section for cut off and run off. There was a same report of cut off artery by MR-Angiography and surgery (kappa coefficient of agreement was 0.96, P value < 0.001) and positive predictive value was 0.97 (95% CI: 0.83-0.99). Conclusions: According to our findings MR-angiography is an appropriate alternative imaging modality for patients suspected to have peripheral arterial disease and it facilitates the early diagnosis proposed by the clinical findings. Also beneficial characteristics of this method such as low exposure to ionizing radiation, repeatability, and low risk of contrast agent-induced nephropathy make it a modality of choice in patients with renal impairment.
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Affiliation(s)
- Seyed Rasool Mirsharifi
- Department of General Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Morteza Noparast
- Department of General Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding Author: Morteza Noparast, Department of General Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2166581657, Fax: +98-2161191609, E-mail:
| | - Mona Khazravi
- Department of General Surgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Hossein Ghanaati
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, IR Iran
| | - Majid Shakiba
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, IR Iran
| | - Amirsina Sharifi
- Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, IR Iran
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Kirchin MA, Lorusso V, Pirovano G. Compensatory biliary and urinary excretion of gadobenate ion after administration of gadobenate dimeglumine (MultiHance(®)) in cases of impaired hepatic or renal function: a mechanism that may aid in the prevention of nephrogenic systemic fibrosis? Br J Radiol 2015; 88:20140526. [PMID: 25651409 PMCID: PMC4651256 DOI: 10.1259/bjr.20140526] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Objective: To determine whether increased elimination of gadobenate ion via the hepatobiliary pathway might compensate for reduced/absent elimination via the urinary pathway in the event of compromised renal function, as a possible protective mechanism against nephrogenic systemic fibrosis (NSF). Methods: 15 male Crl:CD® R(SD)Br rats (Charles River Italia, Como, Italy) randomized to three treatment groups: (1) animals with occluded bile ducts, (2) animals with occluded renal vessels and (3) control animals, each received 0.25 mmol kg−1 of bodyweight of gadobenate dimeglumine (MultiHance®; Bracco Imaging SpA, Milan, Italy). Urine and bile were collected from 0−30, 30−60, 60−120, 120−240 and 240−480 min after gadobenate dimeglumine administration prior to exsanguination. Determinations of gadobenate ion in blood, bile and urine were performed by high-performance liquid chromatography. Gadolinium (Gd3+) levels in excised liver and kidneys were determined by X-ray fluorescence. Results: The recovery of gadobenate ion in the urine of rats with bile duct occlusion was significantly higher than that in the urine of normal rats (89.1 ± 4.2% vs 60.6 ± 2.8%; p < 0.0001). Conversely, mean recovery in the bile of rats with renal vessel occlusion was significantly higher than that in the bile of normal rats (96.16 ± 0.55% vs 33.5 ± 4.7%; p < 0.0001). Gadobenate ion was not quantifiable in any group 8 h post-injection. Conclusion: Compensatory elimination may be an effective means to overcome compromised renal or hepatobiliary elimination. Advances in knowledge: The absence of NSF in at-risk patients administered with gadobenate dimeglumine may in part reflect greater Gd3+ elimination via the hepatobiliary route.
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Affiliation(s)
- M A Kirchin
- 1 Global Medical and Regulatory Affairs, Bracco Imaging SpA, Milan, Italy
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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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Kanal E, Maravilla K, Rowley HA. Gadolinium contrast agents for CNS imaging: current concepts and clinical evidence. AJNR Am J Neuroradiol 2014; 35:2215-26. [PMID: 24852287 DOI: 10.3174/ajnr.a3917] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARY The aim of this article was to review the properties of the various gadolinium-based contrast agents used for CNS imaging along with the clinical evidence and published data that highlight the impact these different properties can have on diagnostic performance. In addition, approaches to optimizing image acquisition that take into account the different properties of specific gadolinium-based contrast agents and an extensive review of the safety profiles of the various agents are presented.
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Affiliation(s)
- E Kanal
- From Magnetic Resonance Services (E.K.), Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - K Maravilla
- Research Laboratory (K.M.), University of Washington, Seattle, Washington
| | - H A Rowley
- Departments of Radiology, Neurology, and Neurosurgery (H.A.R.), University of Wisconsin, Madison, Wisconsin.
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Doltra A, Skorin A, Hamdan A, Schnackenburg B, Gebker R, Klein C, Nagel E, Fleck E, Kelle S. Comparison of acquisition time and dose for late gadolinium enhancement imaging at 3.0 T in patients with chronic myocardial infarction using Gd-BOPTA. Eur Radiol 2014; 24:2192-200. [DOI: 10.1007/s00330-014-3213-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 03/13/2014] [Accepted: 04/30/2014] [Indexed: 01/15/2023]
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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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