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Li R, Chen Y, Chen P, Ma L, Han H, Li Z, Zhou W, Chen X, Zhao Y. Lesion-Filling Index from Quantitative DSA Correlates with Hemorrhage of Cerebral AVM. AJNR Am J Neuroradiol 2024; 45:712-720. [PMID: 38697788 PMCID: PMC11288585 DOI: 10.3174/ajnr.a8218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/02/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND AND PURPOSE Rupture is the most life-threatening manifestation of cerebral AVMs. This study aimed to explore the hemodynamic mechanism of AVM rupture. We introduced a new quantitative DSA parameter that can reflect the degree of intranidal blood stasis, called the lesion-filling index. MATERIALS AND METHODS This study examined patients with AVMs who had undergone both DSA and MR imaging between 2013 and 2014. Clinical presentations, angioarchitecture, and hemodynamic parameters generated from quantitative DSA were analyzed using univariate and multivariable logistic regression. The lesion-filling index was defined as the arterial diagnostic window divided by the volume of the AVM. To assess the correlation between the lesion-filling index and rupture, we incorporated the lesion-filling index into 2 published prediction models widely recognized for predicting AVM rupture risk, R2eD and VALE. The DeLong test was used to examine whether the addition of the lesion-filling index improved predictive efficacy. RESULTS A total of 180 patients with AVMs were included. The mean lesion-filling index values in the ruptured group were higher compared with the unruptured group (390.27 [SD, 919.81] versus 49.40 [SD, 98.25]), P < .001). A higher lesion-filling index was significantly correlated with AVM rupture in 3 different multivariable logistic models, adjusting for angioarchitecture factors (OR = 1.004, P = .02); hemodynamic factors (OR = 1.005, P = .009); and combined factors (OR = 1.004, P = .03). Both R2eD (area under the curve, 0.601 versus 0.624; P = .15) and VALE (area under the curve, 0.603 versus 0.706; P < .001) predictive models showed improved predictive performance after incorporating the lesion-filling index and conducting 10-fold cross-validation. CONCLUSIONS The lesion-filling index showed a strong correlation with AVM rupture, suggesting that overperfusion is the hemodynamic mechanism leading to AVM rupture.
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Affiliation(s)
- Ruinan Li
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Chen
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.C., X.C., Y.Z.), Beijing, China
- Beijing Neurosurgical Institute (Y.C., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Pingting Chen
- College of Energy and Power Engineering (P.C.), Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Li Ma
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurological Surgery (L.M.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Heze Han
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhipeng Li
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wanting Zhou
- Department of Artificial Intelligence (W.Z.), Beijing University of Posts and Telecommunications, Beijing, China
| | - Xiaolin Chen
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.C., X.C., Y.Z.), Beijing, China
- Beijing Neurosurgical Institute (Y.C., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanli Zhao
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.C., X.C., Y.Z.), Beijing, China
- Beijing Neurosurgical Institute (Y.C., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Panara V, Chiacchiaretta P, Rapino M, Maruotti V, Parenti M, Piccirilli E, Pizzi AD, Caulo M. Dynamic susceptibility MR perfusion imaging of the brain: not a question of contrast agent molarity. Neuroradiology 2021; 64:685-692. [PMID: 34557937 DOI: 10.1007/s00234-021-02807-7] [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: 06/10/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Dynamic susceptibility contrast (DSC) perfusion-weighted MR imaging (PWI) is increasingly used in clinical neuroimaging for a range of conditions. More highly concentrated GBCAs (e.g., gadobutrol) are often preferred for DSC imaging because it is thought that more Gd is present in the volume of interest during first pass for a given equivalent injection rate. However, faster injection of a less viscous GBCA (e.g., gadoteridol) might generate a more compact and narrower contrast bolus thus obviating any perceived benefit of higher Gd concentration. This preliminary study aimed to analyze and compare DSC examinations in the healthy brain hemisphere of patients with brain tumors using gadobutrol and gadoteridol administered at injection rates of 4 and 6 mL/s. METHODS Thirty-nine brain tumor patients studied with DSC-PWI were evaluated. A simplified gamma-variate model function was applied to calculate the mean peak, area under the curve (AUC), and full-width at half-maximum (FHWM) of concentration-time curves derived from ΔR2* signals at four different regions-of-interest (ROIs). Qualitative assessment of the derived CBV maps was also performed independently by 2 neuroradiologists. RESULTS No qualitative or quantitative differences between the two GBCAs were observed when administered at a flow rate of 4 mL/s. At a flow rate of 6 mL/s, gadoteridol showed lower FWHM values. CONCLUSION Gadobutrol and gadoteridol are equivalent for clinical assessment of qualitative CBV maps and quantitative perfusion parameters (FHWM) at a flow rate of 4 mL/s. At 6 mL/s, gadoteridol produces a narrower bolus shape and potentially improves quantitative assessment of perfusion parameters.
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Affiliation(s)
- Valentina Panara
- Department of Radiology, University "G. d'Annunzio" of Chieti, Chieti, Italy. .,ITAB - Institute of Advanced Biomedical Technologies, University "G. D'Annunzio" of Chieti, Via Luigi Polacchi 11, 66100, Chieti, Italy.
| | - Piero Chiacchiaretta
- Department of Psychological, Health and Territory Sciences, University "G. D'Annunzio" of Chieti, Pescara, Italy.,Center for Advanced Studies and Technology (CAST), University "G. D'Annunzio" of Chieti, Pescara, Italy
| | - Matteo Rapino
- Department of Radiology, University "G. d'Annunzio" of Chieti, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Valerio Maruotti
- Department of Radiology, University "G. d'Annunzio" of Chieti, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Matteo Parenti
- ITAB - Institute of Advanced Biomedical Technologies, University "G. D'Annunzio" of Chieti, Via Luigi Polacchi 11, 66100, Chieti, Italy
| | - Eleonora Piccirilli
- Department of Radiology, University "G. d'Annunzio" of Chieti, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Andrea Delli Pizzi
- Department of Radiology, University "G. d'Annunzio" of Chieti, Chieti, Italy.,ITAB - Institute of Advanced Biomedical Technologies, University "G. D'Annunzio" of Chieti, Via Luigi Polacchi 11, 66100, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti, Chieti, Italy
| | - Massimo Caulo
- Department of Radiology, University "G. d'Annunzio" of Chieti, Chieti, Italy.,ITAB - Institute of Advanced Biomedical Technologies, University "G. D'Annunzio" of Chieti, Via Luigi Polacchi 11, 66100, Chieti, Italy.,Department of Neuroscience, Imaging and Clinical Science, University "G. d'Annunzio" of Chieti, Chieti, Italy
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Szomolanyi P, Frenzel T, Noebauer-Huhmann IM, Rohrer M, Trattnig S, Pietsch H, Endrikat J. Impact of concentration and dilution of three macrocyclic gadolinium-based contrast agents on MRI signal intensity at 1.5T and 3T and different pulse sequences: results of a phantom study in human plasma. Acta Radiol 2021; 62:51-57. [PMID: 32290676 DOI: 10.1177/0284185120915674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Many factors influence the increase in signal intensity (SI) provided by magnetic resonance imaging (MRI) contrast media. PURPOSE To assess the impact of different gadolinium concentrations and dilutions of three macrocyclic gadolinium-based contrast agents (GBCA) on SI. MATERIAL AND METHODS This phantom study investigated gadobutrol, gadoteridol, and gadoterate in human plasma of a healthy donor pool at 37 °C. Different molar concentrations served to mimic conditions typically relevant for steady-state imaging; different dilutions served to mimic influence on first-pass bolus imaging. For SI measurement at 1.5T and 3T, we used two Magnetom Scanners (Siemens), applying the T1-weighted sequences Flash 2D/3D and VIBE. Regions of interest were placed on the central slice of the test vials. RESULTS In the concentration series, gadobutrol showed the highest SI of all three GBCAs up to 2 mM, followed by gadoteridol and gadoterate. No major differences were seen between 1.5T and 3T. In the dilution series, gadobutrol showed the highest SI of all three GBCAs up to 10 mL/L. The highest effect was recorded with Flash 3D and VIBE at 3T. CONCLUSION SIs measured in phantoms using three macrocyclic GBCAs strongly depend on their relaxivity and on the local concentration. The latter can be influenced-when comparing dilutions-by their initial concentration in their formulation. Furthermore, the pulse sequences and the chosen parameters have essential influence. At steady-state concentrations (≤2 mM) and first-pass bolus dilutions (up to 10 ml/L), gadobutrol showed highest SIs, followed by gadoterate and gadoteridol.
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Affiliation(s)
- Pavol Szomolanyi
- High field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | | | - Iris M Noebauer-Huhmann
- High field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | | | - Siegfried Trattnig
- High field MR Centre, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Austria
| | | | - Jan Endrikat
- Bayer AG, Berlin, Germany
- Department of Gynecology, Obstetrics and Reproductive Medicine, University Medical School of Saarland, Homburg/Saar, Germany
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Schubert T, Motosugi U, Kinner S, Colgan TJ, Sharma SD, Hetzel S, Wells S, Campo CA, Reeder SB. Crossover comparison of ferumoxytol and gadobenate dimeglumine for abdominal MR-angiography at 3.0 tesla: Effects of contrast bolus length and flip angle. J Magn Reson Imaging 2016; 45:1617-1626. [PMID: 27862577 DOI: 10.1002/jmri.25513] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 10/01/2016] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Ferumoxytol (FE) has gained interest as an alternative to gadolinium-based contrast agents (GBCAs). The purpose of this study was to evaluate and optimize ferumoxytol dose and T1 weighting, in comparison to a conventional GBCA. MATERIALS AND METHODS Twelve healthy volunteers (six women / six men, mean age 44.3 years) were recruited for this study. Scanning was performed on a clinical 3 Tesla (T) MRI system. Gadobenate dimeglumine (GD)-enhanced MRA was performed followed by FE-enhanced MRA 1 month later. Volunteers were randomly assigned to a diluted (n = 6) or undiluted (n = 6) dose of GD (0.1 mmol/kg), and to FE doses of 4 mg/kg (n = 6) or 2 mg/kg (n = 6). First pass and steady-state MRA were performed for GD- and FE-enhanced MRA. Flip-angle optimization was performed after FE administration. Quantitative analysis included relative contrast-to-noise ratio (relCNR) measurements for all acquisitions. First pass GD- and FE-enhanced MRA images were evaluated qualitatively. RESULTS RelCNR was significantly higher with undiluted GD (31.8, 95% confidence interval [CI], 27.7-35.9) compared with diluted GD (16.2; 95% CI, 12.2-20.3; P = 0.001) and both 4 mg/kg FE (12.5; 95% CI, 8.5-16.4; P < 0.001) and 2 mg/kg FE (9.1; 95% CI, 5.1-13.2; P < 0.001) during first pass. Relative CNR did not decrease with FE 5 min postinjection compared with GD. Flip-angle analysis revealed relative CNR-peaks at 30° for FE 4 mg/kg and at 20° for FE 2 mg/kg. Diluted GD (P = 0.013) and FE 4 mg/kg (P = 0.01) revealed significantly higher image quality scores compared with undiluted GD during first pass. CONCLUSION This study shows an equivalent image quality of FE and GD for first pass MRA even though GD showed significantly higher relative CNR. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;45:1617-1626.
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Affiliation(s)
- Tilman Schubert
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Clinic of Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland
| | - Utaroh Motosugi
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Sonja Kinner
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Timothy J Colgan
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Samir D Sharma
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Shane Wells
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Camilo A Campo
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Scott B Reeder
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Emergency Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Interest of HYPR flow dynamic MRA for characterization of cerebral arteriovenous malformations: comparison with TRICKS MRA and catheter DSA. Eur Radiol 2015; 25:3230-7. [DOI: 10.1007/s00330-015-3745-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Revised: 03/04/2015] [Accepted: 03/26/2015] [Indexed: 10/23/2022]
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Haneder S, Kucharczyk W, Schoenberg SO, Michaely HJ. Safety of magnetic resonance contrast media: a review with special focus on nephrogenic systemic fibrosis. Top Magn Reson Imaging 2015; 24:57-65. [PMID: 25654421 DOI: 10.1097/rmr.0b013e3182a14e79] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Stefan Haneder
- From the *Department of Radiology, University Hospital of Cologne, Cologne, Germany; University Medical Center Mannheim, Heidelberg University, Mannheim, Germany; and †University of Toronto, Toronto, Canada
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Kinner S, Eggebrecht H, Maderwald S, Barkhausen J, Ladd SC, Quick HH, Hunold P, Vogt FM. Dynamic MR angiography in acute aortic dissection. J Magn Reson Imaging 2014; 42:505-14. [PMID: 25430957 DOI: 10.1002/jmri.24788] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 10/14/2014] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To evaluate the benefit (additional flow information), image quality, and diagnostic accuracy of a dynamic magnetic resonance angiography (MRA) combining high spatial and temporal resolution for the preinterventional assessment of acute aortic dissection. METHODS Nineteen patients (12 men, 7 women; aged 32-78 years) with acute aortic dissection underwent contrast-enhanced four-dimensional (4D) MRA and 3D conventional high-resolution MRA (3D MRA) within one examination on a 1.5 Tesla MR system. Both MRA datasets for each patient were evaluated and compared for image quality and visualization of vascular details on a 5-point scale (5 = excellent image quality, 1 = nondiagnostic image quality). In addition, presence and relevance of additional hemodynamic information (flow direction and organ perfusion delay) gained by dynamic MRA were assessed. RESULTS Conventional 3D MRA provided significantly higher values for image quality of the aorta and aortic side branches compared with dynamic MRA (aorta: 4.3 versus 3.3; P = 0.006 side branches: 4.2 versus 3.3; P = 0.02). However, in 10 of the 19 patients (53%) the additionally available information on flow dynamics due to dynamic MRA (e.g., delayed perfusion of parenchymal organs) led to a change in therapy planning and realization. CONCLUSION Dynamic MRA is a technique that combines functional flow and morphological information. Thus, the combination of 3D and dynamic MRA provides all requested information for treatment planning in patients suffering from acute aortic dissection.
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Affiliation(s)
- Sonja Kinner
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | | | - Stefan Maderwald
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Jörg Barkhausen
- Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck / Germany
| | - Susanne C Ladd
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Harald H Quick
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Peter Hunold
- Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck / Germany
| | - Florian M Vogt
- Clinic for Radiology and Nuclear Medicine, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck / Germany
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Kramer JH, Arnoldi E, François CJ, Wentland AL, Nikolaou K, Wintersperger BJ, Grist TM. Dynamic and static magnetic resonance angiography of the supra-aortic vessels at 3.0 T: intraindividual comparison of gadobutrol, gadobenate dimeglumine, and gadoterate meglumine at equimolar dose. Invest Radiol 2013; 48:121-8. [PMID: 23211552 PMCID: PMC3818529 DOI: 10.1097/rli.0b013e31827752b4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was the intraindividual comparison of a 1.0 M and two 0.5 M gadolinium-based contrast agents (GBCA) using equimolar dosing in dynamic and static magnetic resonance angiography (MRA) of the supra-aortic vessels. MATERIALS AND METHODS In this institutional review board-approved study, a total of 20 healthy volunteers (mean ± SD age, 29 ± 6 years) underwent 3 consecutive supra-aortic MRA examinations on a 3.0 T magnetic resonance system. The order of GBCA (Gadobutrol, Gadobenate dimeglumine, and Gadoterate meglumine) was randomized with a minimum interval of 48 hours between the examinations. Before each examination and 45 minutes after each examination, circulatory parameters were recorded. Total GBCA dose per MRA examination was 0.1 mmol/kg with a 0.03 mmol/kg and 0.07 mmol/kg split for dynamic and static MRA, respectively, injected at a rate of 2 mL/s. Two blinded readers qualitatively assessed static MRA data sets independently using pairwise rankings (superior, inferior, and equal). In addition, quantitative analysis was performed with signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) evaluation as well as vessel sharpness analysis of static MRA using an in-house-developed semiautomated tool. Dynamic MRA was evaluated for maximal SNR. Statistical analysis was performed using the Cohen κ, the Wilcoxon rank sum tests, and mixed effects models. RESULTS No significant differences of hemodynamic parameters were observed. In static MRA, Gadobutrol was rated superior to Gadoterate meglumine (P < 0.05) and equal to Gadobenate dimeglumine (P = 0.06) with good to excellent reader agreement (κ, 0.66-0.83). In static MRA, SNR was significantly higher using 1.0 M Gadobutrol as compared with either 0.5 M agent (P < 0.05 and P < 0.05) and CNR was significantly higher as compared with Gadoterate meglumine (P < 0.05), whereas CNR values of Gadobutrol data sets were not significantly different as compared with Gadobenate dimeglumine (P = 0.13). Differences in CNR between Gadobenate dimeglumine and Gadoterate meglumine were not significant (P = 0.78). Differences in vessel sharpness between the different GBCAs were also not significant (P > 0.05). Maximal SNR in dynamic MRA using Gadobutrol was significantly higher than both comparators at the level of the proximal and distal internal carotid artery (P < 0.05 and P < 0.05; P < 0.05 and P < 0.05). CONCLUSIONS At equimolar doses, 1.0 M Gadobutrol demonstrates higher SNR/CNR than do Gadobenate dimeglumine and Gadoterate meglumine, with superior image quality as compared with Gadoterate meglumine for dynamic and static carotid MRA. Despite the shortened bolus with Gadobutrol, no blurring of vessel edges was observed.
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Affiliation(s)
- Jens Harald Kramer
- Institute for Clinical Radiology, Ludwig Maximilians University Hospital Munich, Munich, Germany.
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Contrast Dose, Temporal Footprint, and Spatial Resolution Tradeoffs in Dynamic Contrast-Enhanced MRA Performed in a Porcine Model of a Carotid Aneurysm. J Comput Assist Tomogr 2013; 37:105-10. [DOI: 10.1097/rct.0b013e318276fc92] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Magnetic resonance evaluation of renal artery stenosis in a swine model: performance of low-dose gadobutrol versus gadoterate meglumine in comparison with digital subtraction intra-arterial catheter angiography. Invest Radiol 2012; 47:376-82. [PMID: 22543971 DOI: 10.1097/rli.0b013e3182539554] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to compare low-dose imaging with gadobutrol and gadoterate meglumine (Gd-DOTA) for evaluation of renal artery stenosis with 3-T magnetic resonance angiography (MRA) in a swine model. METHOD AND MATERIALS A total of 12 experimental animals were evaluated using equivalently dosed gadobutrol and Gd-DOTA for time-resolved and static imaging. For time-resolved imaging, the time-resolved imaging with stochastic trajectories (TWIST) technique (temporal footprint, 4.4 seconds) was used; a dose of 1 mL of gadobutrol was injected at 2 mL/s and a dose of 2 mL of Gd-DOTA was injected at both 2 and 4 mL/s. For a separate static acquisition, doses were doubled. The static scans were used for stenosis gradation and the time-resolved scans for comparison of enhancement dynamics, signal-to-noise ratio (SNR), and qualitative assessments. RESULTS The average magnitude of difference in the stenosis measurements with static gadobutrol scans relative to digital subtraction intra-arterial catheter angiography (mean [SD], 7.4% [5.6%]) was less than with both the 2 mL/s (10.6% [6.2%]) and 4 mL/s (11.5% [7.8%]) Gd-DOTA MRA protocols. On time-resolved scans, peak signal-to-noise ratio was greatest with the gadobutrol protocol (P < 0.05), and the gadobutrol TWIST scan was preferred to the TWIST Gd-DOTA scan in terms of image quality and stenosis visualization in every case for every reader. CONCLUSION Low-dose gadobutrol (~0.05 mmoL/kg) contrast-enhanced MRA results in improved accuracy of renal artery stenosis assessments relative to equivalently dosed Gd-DOTA at 3 T.
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Lois C, Bezrukov I, Schmidt H, Schwenzer N, Werner MK, Kupferschläger J, Beyer T. Effect of MR contrast agents on quantitative accuracy of PET in combined whole-body PET/MR imaging. Eur J Nucl Med Mol Imaging 2012; 39:1756-66. [PMID: 22890801 DOI: 10.1007/s00259-012-2190-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/02/2012] [Indexed: 11/28/2022]
Abstract
PURPOSE Clinical PET/MR acquisition protocols entail the use of MR contrast agents (MRCA) that could potentially affect PET quantification following MR-based attenuation correction (AC). We assessed the effect of oral and intravenous (IV) MRCA on PET quantification in PET/MR imaging. METHODS We employed two MRCA: Lumirem (oral) and Gadovist (IV). First, we determined their reference PET attenuation values using a PET transmission scan (ECAT-EXACT HR+, Siemens) and a CT scan (PET/CT Biograph 16 HI-REZ, Siemens). Second, we evaluated the attenuation of PET signals in the presence of MRCA. Phantoms were filled with clinically relevant concentrations of MRCA in a background of water and (18)F-fluoride, and imaged using a PET/CT scanner (Biograph 16 HI-REZ, Siemens) and a PET/MR scanner (Biograph mMR, Siemens). Third, we investigated the effect of clinically relevant volumes of MRCA on MR-based AC using human pilot data: a patient study employing Gadovist (IV) and a volunteer study employing two different oral MRCA (Lumirem and pineapple juice). MR-based attenuation maps were calculated following Dixon-based fat-water segmentation and an external atlas-based and pattern recognition (AT&PR) algorithm. RESULTS IV and oral MRCA in clinically relevant concentrations were found to have PET attenuation values similar to those of water. The phantom experiments showed that under clinical conditions IV and oral MRCA did not yield additional attenuation of PET emission signals. Patient scans showed that PET attenuation maps are not biased after the administration of IV MRCA but may be biased, however, after ingestion of iron oxide-based oral MRCA when segmentation-based AC algorithms are used. Alternative AC algorithms, such as AT&PR, or alternative oral contrast agents, such as pineapple juice, can yield unbiased attenuation maps. CONCLUSION In clinical PET/MR scenarios MRCA are not expected to lead to markedly increased attenuation of the PET emission signals. MR-based attenuation maps may be biased by oral iron oxide-based MRCA unless advanced AC algorithms are used.
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Affiliation(s)
- Cristina Lois
- Department of Particle Physics, University of Santiago de Compostela, Campus Vida S/N, 15782 Santiago de Compostela, Spain.
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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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Morelli JN, Ai F, Runge VM, Zhang W, Li X, Schmitt P, McNeal G, Michaely HJ, Schoenberg SO, Miller M, Gerdes CM, Sincleair ST, Spratt H, Attenberger UI. Time-resolved MR angiography of renal artery stenosis in a swine model at 3 Tesla using gadobutrol with digital subtraction angiography correlation. J Magn Reson Imaging 2012; 36:704-13. [PMID: 22645046 DOI: 10.1002/jmri.23696] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 04/09/2012] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To establish the minimum dose required for detection of renal artery stenosis using high temporal resolution, contrast enhanced MR angiography (MRA) in a porcine model. MATERIALS AND METHODS Surgically created renal artery stenoses were imaged with 3 Tesla MR and digital subtraction angiography (DSA) in 12 swine in this IACUC approved protocol. Gadobutrol was injected intravenously at doses of 0.5, 1, 2, and 4 mL for time-resolved MRA (1.5 × 1.5 mm(2) spatial resolution). Region of interest analysis was performed together with stenosis assessment and qualitative evaluation by two blinded readers. RESULTS Mean signal to noise ratio (SNR) and contrast to noise ratio (CNR) values were statistically significantly less with the 0.5-mL protocol (P < 0.001). There were no statistically significant differences among the other evaluated doses. Both readers found 10/12 cases with the 0.5-mL protocol to be of inadequate diagnostic quality (κ = 1.0). All other scans were found to be adequate for diagnosis. Accuracies in distinguishing between mild/insignificant (<50%) and higher grade stenoses (>50%) were comparable among the higher-dose protocols (sensitivities 73-93%, specificities 62-100%). CONCLUSION Renal artery stenosis can be assessed with very low doses (~0.025 mmol/kg bodyweight) of a high concentration, high relaxivity gadolinium chelate formulation in a swine model, results which are promising with respect to limiting exposure to gadolinium based contrast agents.
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Affiliation(s)
- John N Morelli
- Scott and White Clinic and Hospital and Department of Radiology, Texas A&M University Health Science Center, Temple, TX, USA
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Hadizadeh DR, Kukuk GM, Steck DT, Gieseke J, Urbach H, Tschampa HJ, Greschus S, Kovàcs A, Möhlenbruch M, Bostroem A, Schild HH, Willinek WA. Noninvasive evaluation of cerebral arteriovenous malformations by 4D-MRA for preoperative planning and postoperative follow-up in 56 patients: comparison with DSA and intraoperative findings. AJNR Am J Neuroradiol 2012; 33:1095-101. [PMID: 22300925 DOI: 10.3174/ajnr.a2921] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 4D-MRA is a promising technique in the diagnosis and follow-up of cAVMs. The purpose of this study was to compare 4D-MRA in the pre- and postoperative evaluation of cAVMs with DSA or intraoperative findings as the standards of reference regarding qualitative and quantitative parameters. MATERIALS AND METHODS Fifty-six consecutive patients with cAVMs (30 women) underwent both 4D-MRA and DSA. Preoperative 4D-MRA was excluded from analysis in 1 patient (movement artifacts). Twenty-five patients underwent surgery on cAVMs and underwent both imaging modalities pre- and postoperatively. 4D-MRA was performed with either 0.5-mol/L gadolinium-diethylene-triamine pentaacetic acid (group 1: voxel size, 1.1 × 1.1 × 1.4 mm(3); 608 ms/dynamic frame; 19 patients) or 1.0-mol/L gadobutrol (group 2: voxel size, 1.1 × 1.1 × 1.1 mm(3); 572 ms/dynamic frame; additional alternating view sharing; 37 patients). Two readers independently reviewed 4D-MRA and DSA regarding the Spetzler-Martin classification, arterial feeders, and postoperative residual filling. Vessel sharpness, vessel diameter, and VBC of 4D-MRA were quantified. RESULTS Preoperative Spetzler-Martin classification 4D-MRA and DSA ratings matched in 55/55 patients (Spetzler-Martin grades: I, 12; II, 22; III, 15; IV, 5; V, 1), and 93/100 arterial feeders were correctly identified by preoperative 4D-MRA (7 additional arterial feeders identified by DSA only: group 1, 3/19; group 2, 4/36). Postoperative 4D-MRA and DSA matched in 25/25 patients (residual filling, 1/25). Vessel sharpness and diameters did not differ substantially between the 2 groups. VBC was significantly higher in group 2 (P < .005). CONCLUSIONS 4D-MRA is a reliable tool that allows predicting Spetzler-Martin classification and postoperative residual filling; it hence allows substituting DSA in the pre- and postoperative evaluation of patients with cerebral AVMs.
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Affiliation(s)
- D R Hadizadeh
- Departments of Radiology and Neurosurgery, University of Bonn, Bonn, Germany; and Philips Healthcare, Best, the Netherlands
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Lee YJ, Laub G, Jung SL, Yoo WJ, Kim YJ, Ahn KJ, Kim BS. Low-dose 3D time-resolved magnetic resonance angiography (MRA) of the supraaortic arteries: Correlation with high spatial resolution 3D contrast-enhanced MRA. J Magn Reson Imaging 2010; 33:71-6. [PMID: 21182123 DOI: 10.1002/jmri.22396] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Youn-Joo Lee
- Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Raoult H, Ferré JC, Morandi X, Carsin-Nicol B, Carsin M, Cuggia M, Law M, Gauvrit JY. Quality-evaluation scheme for cerebral time-resolved 3D contrast-enhanced MR angiography techniques. AJNR Am J Neuroradiol 2010; 31:1480-7. [PMID: 20448014 DOI: 10.3174/ajnr.a2093] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE No practical tool has been reported in the literature to evaluate the quality of cerebral TR-3D-CE-MRA techniques. Our study assessed a large list of parameters used to propose a quality-evaluation scheme for TR-3D-CE-MRA. MATERIALS AND METHODS A large list of visual and quantitative parameters used to study the quality of images was collected from the literature and evaluated in 19 healthy patients and 11 patients with arteriovenous shunts who had undergone both CENTRA keyhole TR-3D-CE-MRA at 3T and CCA. Several observers evaluated the visual parameters, such as the diagnostic confidence index, artifacts, maximum vascular signal intensity, arterial-to-venous separation, and visibility of 17 arteries and 7 veins; and quantitative parameters, such as maximum arterial SI, arteriovenous transit time, arteriovenous contrast curve, and ADW. A statistical analysis was used to determine interobserver reproducibility of the visual parameters, to calculate the sensitivity of TR-3D-CE-MRA for detecting each vessel (with CCA as standard of reference), and to compare the results of the visual and quantitative evaluations. RESULTS Diagnostic confidence index, artifacts, arterial-to-venous separation, and 4 vessels-the PICA, ophthalmic and occipital arteries, and the ISS-demonstrated high reproducibility and sensitivity. The ADW was the most reliable dynamic quantitative parameter and was correlated with arterial-to-venous separation. CONCLUSIONS The image quality of TR-3D-CE-MRA can be effectively evaluated with a scheme of 1 quantitative and 7 visual parameters.
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Affiliation(s)
- H Raoult
- Department of Neuroradiology, Pontchaillou University Hospital, Rennes, France
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Kramer U, Fenchel M, Laub G, Seeger A, Klumpp B, Bretschneider C, Finn JP, Claussen CD, Miller S. Low-dose, time-resolved, contrast-enhanced 3D MR angiography in the assessment of the abdominal aorta and its major branches at 3 Tesla. Acad Radiol 2010; 17:564-76. [PMID: 20171907 DOI: 10.1016/j.acra.2009.12.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 12/08/2009] [Accepted: 12/09/2009] [Indexed: 10/19/2022]
Abstract
RATIONALE AND OBJECTIVES The aims of this study were to evaluate the effectiveness of low-dose, contrast-enhanced (CE), time-resolved, three-dimensional magnetic resonance angiography (MRA) in the assessment of the abdominal aorta and its major branches at 3 T and to compare the results with those of high-spatial resolution CE MRA. MATERIALS AND METHODS Twenty-two consecutive patients (eight men, 14 women; mean age, 43.9 +/- 17.9 years) underwent CE time-resolved three-dimensional MRA and high-spatial resolution three-dimensional MRA. Studies were performed using a 3-T magnetic resonance system; gadolinium-based contrast medium was administered at a dose of 3 to 5 mL for time-resolved MRA, followed by 0.1 mmol/kg gadopentetate dimeglumine for single-phase CE MRA. For analysis purposes, the abdominal arterial system was divided into 11 arterial segments, and image quality as well as the presence and degree of vascular pathology were evaluated by two independent magnetic resonance radiologists. RESULTS A total of 242 arterial segments were visualized with good image quality. Time-resolved MRA was able to visualize the majority of arterial segments with good definition in the diagnostic range. Vascular pathologies (stenosis, occlusion) or abnormal vascular anatomy was detected in 19 arterial segments, with good interobserver agreement (kappa = 0.78). All image findings were detected with time-resolved CE MRA by both observers and were confirmed by correlative imaging. CONCLUSION Low-dose, time-resolved MRA at 3 T yields rapid and important anatomic and functional information in the evaluation of the abdominal vasculature. Because of its limited spatial resolution, time-resolved MRA is inferior to CE MRA in demonstrating fine vascular details.
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Comparative Evaluation of Lesion Enhancement Using 1 M Gadobutrol vs. 2 Conventional Gadolinium Chelates, All at a Dose of 0.1 mmol/kg, in a Rat Brain Tumor Model at 3 T. Invest Radiol 2009; 44:251-6. [DOI: 10.1097/rli.0b013e31819ba711] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Peripheral Magnetic Resonance Angiography (MRA) With Continuous Table Movement at 3.0 T. Invest Radiol 2008; 43:627-34. [PMID: 18708856 DOI: 10.1097/rli.0b013e31817e90e9] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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