Contrast-enhanced MR angiography: does a higher relaxivity MR contrast agent permit a reduction of the dose administered for routine vascular imaging applications?

• Published in: Radiologia medica 2015-02, Vol.120 (2), p.239-250
• Main Authors: Xing, Xiaoying, Zeng, Xiangzhu, Li, Xuan, Zhao, Qiang, Kirchin, Miles A., Pirovano, Gianpaolo, Wang, Xiaoying, Li, Yuan, Iezzi, Roberto, De Cobelli, Francesco
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Arterial Occlusive Diseases - diagnosis; Contrast Media - administration & dosage; Cross-Over Studies; Diagnostic Radiology; Female; Gadolinium DTPA - administration & dosage; Humans; Imaging; Interventional Radiology; Magnetic Resonance Angiography - methods; Magnetic Resonance Imaging; Male; Medicine; Medicine & Public Health; Meglumine - administration & dosage; Meglumine - analogs & derivatives; Middle Aged; Neuroradiology; Organometallic Compounds - administration & dosage; Prospective Studies; Radiology; Ultrasound; Young Adult
• ISSN: 0033-8362; 1826-6983
• DOI: 10.1007/s11547-014-0434-8

Purpose The authors prospectively compared single dose (0.1 mmol/kg bodyweight) gadobenate dimeglumine with double dose (0.2 mmol/kg bodyweight) gadopentetate dimeglumine for contrast-enhanced magnetic resonance angiography (CE-MRA) in patients with suspected or known steno-occlusive disease of the carotid, renal or peripheral vasculature using an intra-individual crossover study design. Materials and methods Twenty-eight patients with suspected or known steno-occlusive disease of the carotid ( n  = 16), renal ( n  = 5) or peripheral arteries ( n  = 7) were randomised to receive either 0.1 mmol/kg gadobenate dimeglumine or 0.2 mmol/kg gadopentetate dimeglumine for a first CE-MRA procedure. After 3–5 days all patients underwent a second identical CE-MRA procedure with the other contrast agent. Three blinded readers assessed images for vessel anatomical delineation, disease detection/exclusion, and global preference. Diagnostic performance for detection of ≥51 % stenosis was determined for 20/28 patients who also underwent digital subtraction angiography (DSA). Non-inferiority was assessed using the Wilcoxon signed rank, McNemar and Wald tests. Quantitative (signal-to-noise and contrast-to-noise ratio) enhancement based on 3D maximum intensity projection reconstructions was compared. Results No differences were noted for any qualitative parameter. Equivalence was reported for all diagnostic preference end-points. Superiority for gadobenate dimeglumine was reported by all readers for sensitivity for disease detection (80.8–86.5 vs. 75.0–82.7 %). Quantitative enhancement was similar for single dose gadobenate dimeglumine and double dose gadopentetate dimeglumine. Conclusions Under identical examination conditions a single 0.1 mmol/kg body weight dose of gadobenate dimeglumine can fully replace a double 0.2 mmol/kg body weight dose of gadopentetate dimeglumine for routine CE-MRA procedures.