Biliary excretion of gadobenate dimeglumine causing degradation of magnetic resonance cholangiopancreatography (MRCP)

Abstract

Purpose

To assess the effect of gadobenate dimeglumine on magnetic resonance cholangiopancreatography (MRCP) and determine an appropriate time frame for performing MRCP sequences.

Materials and methods

2D MRCP sequences obtained after intravenous administration of gadobenate dimeglumine or gadobutrol over 14 months were reviewed retrospectively in randomized order by five abdominal radiologists, using a 3-point scale to rate biliary and pancreatic duct clarity (1 = no-, 2 = limited-, 3 = good visualization). Intraclass correlation coefficients were computed and mean scores were compared for both agents. For gadobenate dimeglumine exams, time delays between arterial phase and MRCP acquisition times were analyzed concerning duct clarity. For gadobutrol, only exams with delays ≥ 15 min were included.

Results

134 exams (107 gadobenate dimeglumine, 27 gadobutrol) were included. Moderate reliability for pancreatic duct visualization and excellent reliability for visualization of intrahepatic bile ducts and upper and lower extrahepatic bile ducts were noted. No difference in mean scores was noted for pancreatic duct visualization (p = 0.66). Bile duct segment scores were lower with gadobenate dimeglumine (mean: 2.1–2.6) compared with gadobutrol (mean: 2.8–2.9) (p ≤ 0.006). For gadobenate dimeglumine, visualization scores varied depending on the delay between the arterial phase and MRCP acquisition (p ≤ 0.047). Good visualization for all bile duct segments was noted with delays of 7.2–9.4 min (95% confidence interval; mean 8.3 min).

Conclusion

Bile duct clarity degraded on MRCP images with an increasing delay following gadobenate dimeglumine injection. 2D MRCP, thus, should be performed within 7.2 min after obtaining the arterial phase sequence to ensure good visualization of the entire biliary system.

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Availability of data and material

The raw data generated and analyzed for this project have been stored and are available.

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Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by LMT and JKD. The first draft of the manuscript was written by LMT, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lukas M. Trunz.

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Conflict of interest

Research support/grant from Lantheus Medical Imaging, GE Healthcare, and Philips (JKD).

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Trunz, L.M., Guglielmo, F.F., Selvarajan, S.K. et al. Biliary excretion of gadobenate dimeglumine causing degradation of magnetic resonance cholangiopancreatography (MRCP). Abdom Radiol (2020). https://doi.org/10.1007/s00261-020-02686-1

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Keywords

  • Gadolinium
  • Gadobenate dimeglumine
  • Gadobutrol
  • MR cholangiopancreatography
  • Image quality
  • Imaging protocol