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Signal quality of single dose gadobenate dimeglumine pulmonary MRA examinations exceeds quality of MRA performed with double dose gadopentetate dimeglumine

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Abstract

During a recent multi-center trial assessing gadolinium (Gd)-enhanced magnetic resonance angiography (MRA) for diagnosis of acute pulmonary embolism (PE), the Food and Drug Administration announced a risk of nephrogenic sclerosing fibrosis in patients with renal insufficiency who had received intravenous Gd-based MR contrast agents. Although no patients in this trial had renal insufficiency, in cautious response to this announcement, the trial protocol was changed from an intravenous administration of 0.2 mmol/Kg of a conventional Gd-based MR contrast agent to 0.1 mmol/Kg of gadobenate dimeglumine. The study described herein compares the signal quality of pulmonary MRA performed with double dose conventional agent to single dose gadobenate dimeglumine. This study is a retrospective analysis of data from a prospective, multicenter study in men and women ≥18 years with documented presence or absence of PE. The study was approved by the Institutional Review Board at all participating centers, and all patients provided written indication of informed consent. We performed both objective and subjective analysis of pulmonary artery image quality. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the main pulmonary artery were assessed in single and double dose protocols and compared. SNR and CNR of the main PA were correlated with subjective quality assessment of main/lobar, segmental and subsegmental pulmonary arteries. Although there were individual outliers, both SNR (P = 0.01) and CNR (P = 0.008) were higher in all quartiles for examinations using gadobenate dimeglumine than with gadopentetate dimeglumine. Subjective quality of vascular signal intensity at each vessel order was significantly better for gadobenate dimeglumine (P < 0.0001), and correlated well with SNR and CNR at each order (<0.001). Because of agent high relaxivity, a single dose of gadobenate dimeglumine provides better pulmonary MRA signal quality than double dose of a conventional Gd-based MR contrast agent.

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Acknowledgments

This study was supported by Grants HL081593, HL177150, HL077149, HL077151, HL077154, HL081594, HL077358, HL077155, and HL077153 from the U.S. Department of Health and Human Services, Public Health Services, National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Conflict of interest

Dr. Woodard received research support from GE Healthcare and Siemens Medical Systems. None of the other authors has paid speaking, grant support, equity or patents with any company that makes products relevant to this investigation.

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Authors and Affiliations

  1. Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., St. Louis, MO, 63110, USA

    Pamela K. Woodard & Vamsidhar Narra

  2. Department of Radiology, University of Michigan, Ann Arbor, MI, USA

    Thomas L. Chenevert, Frank J. Londy & John G. Weg

  3. Office of the Dean and Department of Radiology, Weill Cornell Medical College and Methodist Hospital, Houston, TX, USA

    H. Dirk Sostman

  4. The Biostatistics Center, George Washington University, Rockville, ML, USA

    Kathleen A. Jablonski

  5. Department of Internal Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA

    Paul D. Stein

  6. Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA

    Lawrence R. Goodman

  7. Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Charles A. Hales

  8. Department of Medicine, University of Calgary, Calgary, AB, Canada

    Russell D. Hull

  9. Department of Medicine, Duke University, Durham, NC, USA

    Victor F. Tapson

Authors
  1. Pamela K. Woodard
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  2. Thomas L. Chenevert
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  3. H. Dirk Sostman
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  4. Kathleen A. Jablonski
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  5. Paul D. Stein
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  6. Lawrence R. Goodman
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  7. Frank J. Londy
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  8. Vamsidhar Narra
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  9. Charles A. Hales
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  10. Russell D. Hull
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  11. Victor F. Tapson
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  12. John G. Weg
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Corresponding author

Correspondence to Pamela K. Woodard.

Additional information

ClinicalTrials.gov Identifier: NCT00241826.

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Woodard, P.K., Chenevert, T.L., Dirk Sostman, H. et al. Signal quality of single dose gadobenate dimeglumine pulmonary MRA examinations exceeds quality of MRA performed with double dose gadopentetate dimeglumine. Int J Cardiovasc Imaging 28, 295–301 (2012). https://doi.org/10.1007/s10554-011-9821-6

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  • DOI: https://doi.org/10.1007/s10554-011-9821-6

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