Optimizing dose and administration regimen of a high-relaxivity contrast agent for myocardial MRI late gadolinium enhancement

Università degli Studi di Milano, Dipartimento di Scienze Medico-Chirurgiche, Milan, Italy.
European journal of radiology (Impact Factor: 2.16). 10/2011; 80(1):96-102. DOI: 10.1016/j.ejrad.2010.06.040
Source: PubMed

ABSTRACT To investigate the time-course of late gadolinium enhancement of infarcted myocardium using gadobenate dimeglumine at different dosages and administration regimens.
After institutional review board approval and informed consent, we studied 13 patients (aged 63±11 years) with chronic myocardial infarction. They underwent two gadobenate dimeglumine-enhanced MR examinations (interval 24-48 h) using short-axis inversion-recovery gradient-echo sequences, with the following two different protocols, in randomized order: 0.05 mmol/kg and imaging at the 2.5th, 5th, 7.5th and 10th minute plus 0.05 mmol/kg and imaging at the 12.5th, 15th, 17.5th and 20th minute; the same as before but using 0.1 mmol/kg for both contrast injections. Contrast-to-noise ratios (CNRs) between infarcted myocardium, non-infarcted myocardium and left ventricle cavity were calculated for each time-point (2.5-min steps). Friedman ANOVA was used for comparing the CNR time-course; Wilcoxon test for comparing CNR at the 10th and the 20th minute.
The CNR between infarcted and non-infarcted myocardium obtained at the 20th minute with 0.05 plus 0.05 mmol/kg resulted significantly higher than that obtained at the 10th minute with 0.05 mmol/kg (P=0.033) while not significantly different from that obtained at the 10th (0.1mm/kg) or at the 20th minute with 0.1 plus 0.1 mmol/kg. The CNR between infarcted myocardium and the left ventricle cavity obtained at the 20th minute with 0.05 plus 0.05 mmol/kg resulted significantly higher than all other measured values (P≤0.017).
Using gadobenate dimeglumine, 0.05 plus 0.05 mmol/kg allows for a higher CNR between infarcted myocardium and the left ventricle cavity allowing for reliable assessment of the sub-endocardial infarctions.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This article reviews the magnetic resonance imaging (MRI) and angiography (MRA) techniques, imaging findings, and evidence for evaluating patients with acute chest pain due to acute pulmonary embolus (PE), aortic dissection (AD), and myocardial infarction (MI). When computed tomographic angiography (CTA) is contraindicated, MRI and MRA are important alternative imaging modalities for diagnosis and management of patients with acute PE, AD, and MI. Familiarity with the techniques, imaging findings, and evidence is critical to safely and appropriately managing patients presenting with acute chest pain. J. Magn. Reson. Imaging 2013;00:000-000. © 2013 Wiley Periodicals, Inc.
    Journal of Magnetic Resonance Imaging 06/2013; 37(6). DOI:10.1002/jmri.24173 · 2.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives The aim of this study was to compare the contrast-to-noise ratio (CNR) values of infarct and remote myocardium as well as infarct and blood after application of 0.1 mmol/kg gadobutrol and 0.1 mmol/kg gadobenate dimeglumine on late gadolinium enhancement magnetic resonance (MR) images. Material and Methods The study was a prospective randomized controlled clinical study. After informed consent was obtained, 20 patients (12 men, 8 women; mean age, 67 ± 11 years) with known chronic myocardial infarction were included for an intraindividual comparison of a single-dose gadobutrol and a single-dose gadobenate dimeglumine. Two MR imaging examinations were performed within a period of 28 days in a crossover design. Late gadolinium enhancement imaging was performed 10 minutes after gadolinium administration using a 2-dimensional phase-sensitive inversion recovery gradient echo sequence at 3 T. Infarct size, signal intensities (SIs), signal-to-noise ratio, and CNR were determined on phase-sensitive MR images. Values for CNR were calculated as CNRinfarct/myocardium = (SIinfarct − SImyocardium)/SDnoise and CNRinfarct/blood = (SIinfarct − SIblood)/SDnoise. In addition, the areas of myocardial infarction were determined on single slices. The entire infarct volumes were calculated by adding the areas with hyperenhancement multiplied by the slice thickness. Results Late gadolinium enhancement was present in all patients. Median values of the infarct area, infarct volume, and transmurality for gadobutrol and gadobenate dimeglumine showed good to excellent concordance (rc = 0.85, rc = 0.95, and rc = 0.71, respectively). The mean signal-to-noise ratio values for infarct, remote myocardium, and ventricular blood were 18.6 ± 6.5, 4.1 ± 3.7, and 14.6 ± 7.5, respectively, for gadobutrol and 18.8 ± 8.9, 4.9 ± 4.5, and 17.8 ± 10.1, respectively, for gadobenate dimeglumine (P = 0.93, P = 0.48, and P = 0.149, respectively). The mean values of CNRinfarct/myocardium and CNRinfarct/blood were 14.5 ± 5.9 and 4.0 ± 4.6, respectively, for gadobutrol and 13.9 ± 6.1 and 0.9 ± 4.5, respectively, for gadobenate dimeglumine (P = 0.69 and P = 0.02, respectively). Conclusion Both gadobutrol and gadobenate dimeglumine allow for successful late gadolinium enhancement imaging of chronic myocardial infarction after a single-dose application (0.1 mmol/kg) at 3 T. Gadobutrol provides a higher CNR between infarct and blood. The CNRs between infarct and normal myocardium, infarct size, and transmural extent were similar for both contrast agents.
    Investigative Radiology 05/2014; 49(11). DOI:10.1097/RLI.0000000000000076 · 4.45 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A unique biomineralization approach was developed to synthesize gadolinium-based hybrid (GH) nanoparticles for effective blood pool contrast agents. This approach is bioinspired, environmentally benign, and straightforward. As-prepared GH nanoparticles are biocompatible and well stable in serum. They exhibit much higher longitudinal relaxivity and transverse relaxivity in water (r1 and r2 values of 15.0 and 19.7 s−1 per mM of Gd3+, respectively) than those measured for Gd–DTPA solution (r1 and r2 values of 3.7 and 4.6 s−1 per mM of Gd3+, respectively). In vivo T1-weighted magnetic resonance imaging (MRI) in living mice shows that the GH nanoparticles have an intravascular half-life up to 1 h, much longer than that of Gd–DTPA (about 10 min). As the GH nanoparticles were found to be cleared gradually via hepatobiliary (HB) processing, they can also serve as ideal candidates for liver specific MR contrast agents. In particular, these GH nanoparticles are bioinspired and environmentally benign, therefore promising for medical imaging applications.
    Journal of Materials Chemistry 07/2012; 22(29):14494-14501. DOI:10.1039/C2JM30629H · 6.63 Impact Factor


Available from
Dec 31, 2014