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Evaluation of liver MRI examinations with two dosages of gadobenate dimeglumine: a blinded intra-individual study

  • Hepatobiliary
  • Published:
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Abstract

Purpose

There is discrepancy in the literature regarding the optimal dose of gadobenate for liver MRI. We evaluated the quality of liver MRIs performed in the same individual using two dosages.

Methods

With ethics approval, this retrospective study evaluated sixty patients who underwent liver MRIs between July 2015 and May 2017 (low dose, 0.06 mmol/kg) and May 2017 and September 2018 (standard dose, 0.10 mmol/kg). Regions of interest were drawn over the aorta, portal veins, and liver on unenhanced and post-contrast phases; relative enhancement values were compared (paired t-tests). Two blinded radiologists graded the arterial and portal venous sequences of each MRI from 1 to 4 (1 = suboptimal, 2 = adequate, 3 = good, 4 = excellent); grades were compared overall and in cirrhotic and non-cirrhotic subgroups (Wilcoxon signed-rank test). Radiologists graded each MRI pair from 1 to 5 (1 = substantially inferior, 2 = slightly inferior, 3 = equivalent, 4 = slightly improved, 5 = substantially improved). Inter-reader agreement was assessed (kappa statistic).

Results

Relative enhancement increased significantly with the standard dose for all structures on all phases (p < 0.05). For both radiologists and both post-contrast phases, individual grades of the low- and standard-dose MRIs were similar, including the cirrhotic and non-cirrhotic subgroups (p > 0.05). Compared to the low-dose MRIs, the number of standard-dose MRIs graded 1–5 were 9, 31, 97, 88, and 11 for all patients, and 6, 13, 26, 45, and 6 in cirrhotics. Inter-observer agreement was fair-moderate (Κ range 0.23–0.45).

Conclusions

Although the standard dose of gadobenate yields greater relative enhancement, there is overall little improvement in subjective imaging quality. A trend towards better image quality is observed in cirrhotics.

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Abbreviations

GBCA:

Gadolinium-based contrast agent

ROIs:

Regions of interest

RE:

Relative enhancement

CNR:

Contrast-to-noise ratio

SI:

Signal intensity

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Acknowledgements

The authors thank Pearl Duffy, departmental manager of MRI, and James MacEachern, lead MRI technologist, for their assistance in this study.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Victoria General Building, 3rd Floor, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada

    Mahsa Kamali, Sharon E. Clarke & Andreu F. Costa

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  1. Mahsa Kamali
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  2. Sharon E. Clarke
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Correspondence to Andreu F. Costa.

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Dr. Sharon Clarke has a research agreement with GE Healthcare, however, this did not impact our study in any way. The other two co-authors have no disclosures.

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IRB statement: IRB approval was obtained for this work.

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Kamali, M., Clarke, S.E. & Costa, A.F. Evaluation of liver MRI examinations with two dosages of gadobenate dimeglumine: a blinded intra-individual study. Abdom Radiol 45, 36–44 (2020). https://doi.org/10.1007/s00261-019-02158-1

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