Albumin-binding MR blood pool contrast agent improves diagnostic performance in human brain tumour: comparison of two contrast agents for glioblastoma

• Published in: European radiology 2013-04, Vol.23 (4), p.1093-1101
• Main Authors: Puig, Josep, Blasco, Gerard, Essig, Marco, Daunis-i-Estadella, Josep, Laguillo, Gemma, Quiles, Ana María, Remollo, Sebastián, Bergmann, Karsten, Joly, Carme, Bernado, Lluis, Sánchez-González, Javier, Pedraza, Salvador
• Format: Article
• Language: English
• Subjects: Albumins - metabolism; Brain cancer; Brain Neoplasms - metabolism; Brain Neoplasms - pathology; Contrast agents; Contrast Media - pharmacokinetics; Diagnostic Radiology; Female; Gadolinium - pharmacokinetics; Glioblastoma - metabolism; Glioblastoma - pathology; Hospitals; Humans; Image Enhancement - methods; Imaging; Internal Medicine; Interventional Radiology; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Neuro; Neuroradiology; Organometallic Compounds - pharmacokinetics; Proteins; Radiology; Reproducibility of Results; Sensitivity and Specificity; Tumors; Ultrasound
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-012-2678-9

Objective We qualitatively and quantitatively compared MRI enhancement obtained with gadofosveset, an albumin-binding blood-pool contrast agent, and with gadobutrol, an extracellular contrast agent, in patients with glioblastoma. Methods Thirty-five patients (25 men; 64 ± 14 years) with histologically proven glioblastoma underwent MRI including pre- and post-contrast T1-weighted SE images acquired 5 min after gadobutrol (0.1 mmol/kg) and, 48 h later, images acquired with identical parameters 5 min and 3, 6, and 24 h after gadofosveset (0.03 mmol/kg). Lesion extent, delineation, internal morphology, multifocality, and global diagnostic preference were evaluated quantitatively for the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast enhancement (CE). Results Mean values of SNR, CNR, and tumour CE were highest 6 h after gadofosveset. Multifocality was seen in 17 (48.6 %) patients; additional lesions had stronger enhancement 6 h after gadofosveset in 12 patients (70.6 %). In 21 (60 %) patients, radiologists’ global preference was highest in images acquired 6 h after gadofosveset (kappa = 0.764). In 22 patients (62.8 %), all qualitative endpoints were better at 5 min after gadobutrol than in images acquired 5 min after gadofosveset injection. Conclusions Gadobutrol gives significant tumour enhancement in early postcontrast imaging. However, images acquired 6 h after gadofosveset injection have significantly better diagnostic information endpoints and contrast enhancement. Key Points • We compared MRI enhancement with gadofosveset and gadobutrol in patients with glioblastoma. • Gadobutrol provides better enhancement in early enhanced imaging at 5 min. • Gadofosveset at 6 h post-injection provides optimal enhancement and diagnostic information endpoints. • Gadofosveset is feasible for diagnostic quality contrast-enhanced MRI in glioblastoma. • The contrast medium dose can be reduced without disminishing the image quality using gadofosveset.