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Dynamic contrast-enhanced MR imaging of the prostate: intraindividual comparison of gadoterate meglumine and gadobutrol

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Abstract

Objectives

To intraindividually compare the signal-enhancing effect of 0.5 M gadoterate meglumine and 1.0 M gadobutrol in dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging of the prostate.

Methods

Fifty patients who underwent two 3-T MR examinations of the prostate were included in this IRB-approved retrospective uncontrolled, unrandomized study. All received two scans (mean time interval, 20.5 months) including T1-weighted DCE-MR imaging, one with 0.5 M gadoterate meglumine and one with 1.0 M gadobutrol. Equimolar doses of gadolinium (0.1 mmol/kg body weight) were administered with identical injection speed (2 mL/s), resulting in differing gadolinium delivery rate. An identical region of interest (ROItz) within a BPH-node was identified on both scans. The area under the time-enhancement curve of each ROItz from 0 to 180 s post contrast arrival and pharmacokinetic parameters were calculated. Relative enhancement and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios in the delayed phase at about 180 s were compared between both agents.

Results

There was a significantly larger area under the time-enhancement curve (5.53 vs 4.97 p = 0.0007) and higher relative enhancement of BPH nodules (2.23 vs 1.96 p < 0.0001) with gadobutrol compared with gadoterate meglumine. There were no significant differences in SNR (44.55 vs 37.63 p = 0.12), CNR (31.22 vs 26.39 p = 0.18), and pharmacokinetic parameters Ktrans (0.31 vs 0.32 p = 0.86), Ve (1.36 vs 0.98 p = 0.13), and Kep (0.34 vs 0.36 p = 0.12).

Conclusions

At equimolar doses, increased gadolinium delivery over time using gadobutrol provides higher relative enhancement parameters in BPH nodules compared with gadoterate meglumine, but does not translate into improved SNR or CNR.

Key Points

• At equal injection rate and equimolar total dose, gadobutrol compared with gadoterate meglumine provides a significantly greater relative enhancement in DCE-MR imaging of BPH over the first 180 s.

• There are no significant differences in SNRs, CNRs, and pharmacokinetic parameters between the two GBCAs.

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Abbreviations

AUCenh :

Area under the RE-t curve from contrast agent arrival time to 180 s after arrival

BPH:

Benign prostatic hyperplasia

CNR:

Contrast-to-noise ratio

DCE-MR:

Dynamic contrast-enhanced magnetic resonance

GBCA:

Gadolinium-based contrast agent

GRAPPA:

GeneRalized Autocalibrating Partial Parallel Acquisition

IRB:

Institutional Review Board

Kep:

Flux rate constant

Ktrans:

Volume transfer constant reflecting the efflux rate of gadolinium contrast from blood plasma into the interstitial space

MR:

Magnetic resonance

RE:

Relative enhancement

RE-t:

Relative enhancement over time

ROItz :

Region of interest corresponding to a BPH nodule in the transition zone

SNR:

Signal-to-noise ratio

t 180 :

Time point closest to 180 s after first DCE-MR acquisition

TE:

Echo time

TR:

Repetition time

Ve:

Extravascular extracellular space corresponding to the interstitial space

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Acknowledgements

The authors would like to thank Ms. Bettina Herwig for language editing of the manuscript.

Funding

The authors state that this work was partially-funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) – SFB 1340/1 2018.

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Authors and Affiliations

  1. Department of Radiology, Charité– Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany

    Chau Hung Lee, Matthias Taupitz, Bernd Hamm & Patrick Asbach

  2. Department of Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Chau Hung Lee

  3. Department of Radiation Oncology, National University Cancer Institute, National University Health System, Singapore, Singapore

    Balamurugan Vellayappan

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  1. Chau Hung Lee
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Correspondence to Chau Hung Lee.

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Lee, C.H., Vellayappan, B., Taupitz, M. et al. Dynamic contrast-enhanced MR imaging of the prostate: intraindividual comparison of gadoterate meglumine and gadobutrol. Eur Radiol 29, 6982–6990 (2019). https://doi.org/10.1007/s00330-019-06321-6

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