Academic Radiology
Volume 13, Issue 6 , Pages 744-751, June 2006

Enhancing Lesions of the Brain:

Intraindividual Crossover Comparison of Contrast Enhancement After Gadobenate Dimeglumine Versus Established Gadolinium Comparators

  • Marco Essig, MD

      Affiliations

    • German Cancer Research Center, Department of Radiology, INF 280, 69120 Heidelberg, Germany
    • Institute for Biological Sciences, Universita’ “G.D. Annunzio” of Chieti-Pescara, Chieti, Italy
    • Istituto di Radiologia, Policlinico A. Gemelli, Roma, Italy
    • Worldwide Medical Affairs, Bracco Diagnostics Inc. Princeton, NJ, USA
    • Worldwide Medical Affairs, Bracco Imaging SpA, Milano, Italy
    • Corresponding Author InformationAddress correspondence to M.E.
    • ,
  • Armando Tartaro, MD

      Affiliations

    • German Cancer Research Center, Department of Radiology, INF 280, 69120 Heidelberg, Germany
    • Institute for Biological Sciences, Universita’ “G.D. Annunzio” of Chieti-Pescara, Chieti, Italy
    • Istituto di Radiologia, Policlinico A. Gemelli, Roma, Italy
    • Worldwide Medical Affairs, Bracco Diagnostics Inc. Princeton, NJ, USA
    • Worldwide Medical Affairs, Bracco Imaging SpA, Milano, Italy
    • ,
  • Tomasso Tartaglione, MD

      Affiliations

    • German Cancer Research Center, Department of Radiology, INF 280, 69120 Heidelberg, Germany
    • Institute for Biological Sciences, Universita’ “G.D. Annunzio” of Chieti-Pescara, Chieti, Italy
    • Istituto di Radiologia, Policlinico A. Gemelli, Roma, Italy
    • Worldwide Medical Affairs, Bracco Diagnostics Inc. Princeton, NJ, USA
    • Worldwide Medical Affairs, Bracco Imaging SpA, Milano, Italy
    • ,
  • Gianpaolo Pirovano, MD

      Affiliations

    • German Cancer Research Center, Department of Radiology, INF 280, 69120 Heidelberg, Germany
    • Institute for Biological Sciences, Universita’ “G.D. Annunzio” of Chieti-Pescara, Chieti, Italy
    • Istituto di Radiologia, Policlinico A. Gemelli, Roma, Italy
    • Worldwide Medical Affairs, Bracco Diagnostics Inc. Princeton, NJ, USA
    • Worldwide Medical Affairs, Bracco Imaging SpA, Milano, Italy
    • ,
  • Miles A. Kirchin, PhD

      Affiliations

    • German Cancer Research Center, Department of Radiology, INF 280, 69120 Heidelberg, Germany
    • Institute for Biological Sciences, Universita’ “G.D. Annunzio” of Chieti-Pescara, Chieti, Italy
    • Istituto di Radiologia, Policlinico A. Gemelli, Roma, Italy
    • Worldwide Medical Affairs, Bracco Diagnostics Inc. Princeton, NJ, USA
    • Worldwide Medical Affairs, Bracco Imaging SpA, Milano, Italy
    • ,
  • Alberto Spinazzi, MD

      Affiliations

    • German Cancer Research Center, Department of Radiology, INF 280, 69120 Heidelberg, Germany
    • Institute for Biological Sciences, Universita’ “G.D. Annunzio” of Chieti-Pescara, Chieti, Italy
    • Istituto di Radiologia, Policlinico A. Gemelli, Roma, Italy
    • Worldwide Medical Affairs, Bracco Diagnostics Inc. Princeton, NJ, USA
    • Worldwide Medical Affairs, Bracco Imaging SpA, Milano, Italy

Received 28 February 2005; received in revised form 28 February 2005; accepted 28 February 2005.

Rationale and Objectives

Gadobenate dimeglumine (Gd-BOPTA) possesses a two-fold higher T1 relaxivity compared to other available gadolinium contrast agents. The study was conducted to evaluate the benefits of this increased relaxivity for MR imaging of intracranial enhancing brain lesions.

Materials and Methods

Forty-five patients (31 males, 14 females) with suspected glioma or cerebral metastases were evaluated. Patients received Gd-BOPTA and either Gd-DTPA (n = 23) or Gd-DOTA (n = 22) in fully randomized order at 0.1 mmol/kg body weight and at a flow rate of 2 ml/s. The second agent was administered 1–14 days after the first agent. Images were acquired precontrast (T1wSE, T2wFSE sequences) and at sequential postcontrast time-points (T1wSE sequences at 0, 2, 4, 6, and 8 and 15 min and a T1wSE-MT sequence at 12 min) at 1.0 or 1.5 T using a head coil. Determination of contrast enhancement was performed quantitatively (lesion-to-brain ratio, contrast-to-noise ratio, and percent enhancement) and qualitatively (border delineation, internal morphology, contrast enhancement, and diagnostic preference) by two independent, fully blinded readers.

Results

Images from 43/45 patients were available for quantitative assessment. After correction for precontrast values, significantly greater lesion-to-brain ratio (P < .003), contrast-to-noise ratio (P < .03), and percent enhancement (P < .0001) was noted by both readers for Gd-BOPTA-enhanced images at all time-points from 2 min postcontrast. Qualitative assessment of all patients similarly revealed significant preference for Gd-BOPTA for lesion border delineation (P < .004), lesion internal morphology (P < .008), contrast enhancement (P < .0001), and diagnostic preference (P < .0005).

Conclusions

The greater T1 relaxivity of Gd-BOPTA permits improved visualization of intracranial enhancing lesions compared to conventional gadolinium agents.

Key Words:  Gadobenate dimeglumine , MultiHance , Gd-BOPTA , MR imaging , brain tumors , crossover comparisons

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PII: S1076-6332(06)00168-1

doi:10.1016/j.acra.2006.02.056

Academic Radiology
Volume 13, Issue 6 , Pages 744-751, June 2006

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