Delineation of gliomas with various doses of MR contrast material (original) (raw)
Related papers
Journal of Magnetic Resonance Imaging, 2016
Purpose: To determine whether half of the approved dose of gadobenate dimeglumine (MultiHance) is as effective as a full dose of gadoterate meglumine (Dotarem) for qualitative and quantitative cerebral blood volume (CBV) perfusion evaluation at 3T in patients with brain gliomas. Materials and Methods: We enrolled 65 adult patients in an interindividual comparative study. Patients were randomized to one of two study arms: 33 patients received 0.1 mmol/kg body weight (bw) of gadoterate, 32 patients received 0.05 mmol/kg bw of gadobenate. The patients underwent identical examinations at 3T. Arterial input function (AIF), tissue function (TF), and the maximum tumor CBV (CBV_T) were obtained from each patient. The quality of the CBV maps were independently reviewed by two neuroradiologists blinded to the administered contrast agent. Results: The administration of a half dose of gadobenate led to a roughly 40% reduction in signal drop compared to that achieved with a full dose of gadoterate (P values for AIF and TF maximum and integral were <0.01); quantitative and qualitative assessment of CBV maps revealed no difference between contrast agents (P values for CBV_T of highand low-grade gliomas, image quality evaluation were 0.87, 0.48, >0.65, respectively) Conclusion: The CBV maps obtained with a half dose gadobenate (0.05 mmol/kg bw) are of comparable diagnostic quality as the corresponding images acquired with a full dose of gadoterate (0.1 mmol/kg bw).
Experience with high-dose gadolinium MR imaging in the evaluation of brain metastases
AJNR. American journal of neuroradiology
To assess the effectiveness and safety of higher doses of gadoteridol in the MR evaluation of patients with brain metastases. Thirty-one patients with a clinical suspicion of brain metastases were studied prospectively with gadoteridol, a new, nonionic, low-osmolality contrast agent. Each patient received an initial injection of 0.1 mmol/kg and an additional dose of 0.2 mmol/kg 30 minutes later. Images were obtained before, immediately after, and 10 and 20 minutes after the initial dose. Images also were acquired immediately after the additional dose of gadoteridol. No adverse effects were attributed to the injection of gadoteridol. Four patients' examinations were excluded from analysis because of machine malfunction (two patients) and excessive motion artifact (two patients). Four patients had no detectable metastases. After the additional dose of gadoteridol, there was a marked qualitative improvement in lesion conspicuity and detection. The conspicuity of 80 of 81 lesions wa...
Journal of Computer Assisted Tomography, 2017
Objective The aim of this study was to evaluate the arterial input function (AIF) and tissue enhancement time curve (tissue function [TF]) obtained after the administration of a half-dose gadobenate dimeglumine (0.05-mmol/kg body weight [bw]) compared with a full dose (0.1-mmol/kg bw) of a standard-relaxivity contrast agent. Methods We enrolled 40 adult patients with glioblastoma in an interindividual comparative study. Patients were randomized to 1 of the 2 study arms: 20 patients received 0.1-mmol/kg bw of gadoterate; the other 20 patients received 0.05-mmol/kg bw of gadobenate. The patients underwent dynamic contrast-enhanced magnetic resonance imaging examinations. Arterial input function, tissue enhancement time curve (TF), tumor transfer rate (Ktrans), and tumor extracellular-extravascular volume fraction (Ve) were calculated for each patients. Averaged AIF, TF, Ktrans, and Ve of both groups were compared. Results A significant difference (P = 0.001) between the peak AIF value...
European Radiology, 2013
Objective We qualitatively and quantitatively compared MRI enhancement obtained with gadofosveset, an albumin-binding blood-pool contrast agent, and with gadobutrol, an extracellular contrast agent, in patients with glioblastoma. Methods Thirty-five patients (25 men; 64±14 years) with histologically proven glioblastoma underwent MRI including pre-and post-contrast T1-weighted SE images acquired 5 min after gadobutrol (0.1 mmol/kg) and, 48 h later, images acquired with identical parameters 5 min and 3, 6, and 24 h after gadofosveset (0.03 mmol/kg). Lesion extent, delineation, internal morphology, multifocality, and global diagnostic preference were evaluated quantitatively for the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast enhancement (CE).
Journal of Magnetic Resonance Imaging, 2001
T 1 -weighted magnetic resonance imaging (MRI) was used to evaluate the potential interest of a new Gd-based contrast agent, termed P760, to characterize brain tumor heterogeneity and vascularization and to delineate regions containing permeable vessels. The C6 rat glioma model was used as a model of high-grade glioblastoma. The signal enhancement was measured as a function of time in the vascular compartment and in different regions of interest (ROIs) within the tumor after the injection of 0.02 mmol kg -1 of P760. The results were compared to those obtained after the injection of 0.1 mmol kg -1 of Gd-DOTA. We showed that P760, in spite of a Gd concentration five times smaller, produces an enhancement in the blood pool similar to that produced by Gd-DOTA. It was shown that P760 makes possible an excellent delineation of regions containing vessels with a damaged blood-brain barrier (BBB). Images acquired 5-10 minutes after P760 injection showed the location of permeable vessels more accurately than Gd-DOTA-enhanced images. The enhancement produced in the tumor by P760 was, however, less than that produced by Gd-DOTA. The extravasation and/or diffusion rate of P760 in the interstitial medium were found to be strongly reduced, compared to those found with Gd-DOTA. This study suggests that the new contrast agent has promising capabilities in clinical imaging of brain tumors. J. Magn. Reson. Imaging 2001;14:97-105.
Journal of Magnetic Resonance Imaging, 2009
Purpose-To prospectively compare 0.1 mmol/kg doses of gadobenate dimeglumine and gadopentetate dimeglumine for contrast-enhanced MRI of brain lesions at 3 Tesla (T). Materials and Methods-Forty-six randomized patients underwent a first examination with gadobenate dimeglumine (n = 23) or gadopentetate dimeglumine (n = 23) and then, after 2-7 days, a second examination with the other agent. Contrast administration (volume, rate), sequence parameters (T1wSE; T1wGRE), and interval between injection and image acquisition were identical for examinations in each patient. Three blinded neuroradiologists evaluated images qualitatively (lesion delineation, lesion enhancement, global preference) and quantitatively (lesion-to-brain ratio [LBR], contrast-to-noise ratio [CNR],%lesion enhancement). Differences were assessed using Wilcoxon's signed-rank test. Reader agreement was determined using kappa (κ) statistics. Results-There were no demographic differences between groups. The three readers preferred gadobenate dimeglumine globally in 22 (53.7%), 21 (51.2%), and 27 (65.9%) patients, respectively, compared with 0, 1, and 0 patients for gadopentetate dimeglumine. Similar significant (P < 0.001) preference was expressed for lesion border delineation and enhancement. Reader agreement was consistently good (κ = 0.48-0.64). Significantly (P < 0.05) higher LBR (+43.5-61.2%), CNR (+51.3-147.6%), and % lesion enhancement (+45.9-49.5%) was noted with gadobenate dimeglumine. Conclusion-Brain lesion depiction at 3T is significantly improved with 0.1 mmol/kg gadobenate dimeglumine.
American Journal of Neuroradiology, 2017
BACKGROUND AND PURPOSE: Effective management of patients with brain tumors depends on accurate detection and characterization of lesions. This study aimed to demonstrate the noninferiority of gadoterate meglumine versus gadobutrol for overall visualization and characterization of primary brain tumors. MATERIALS AND METHODS: This multicenter, double-blind, randomized, controlled intraindividual, crossover, noninferiority study included 279 patients. Both contrast agents (dose ϭ 0.1 mmol/kg of body weight) were assessed with 2 identical MRIs at a time interval of 2-14 days. The primary end point was overall lesion visualization and characterization, scored independently by 3 off-site readers on a 4-point scale, ranging from "poor" to "excellent." Secondary end points were qualitative assessments (lesion border delineation, internal morphology, degree of contrast enhancement, diagnostic confidence), quantitative measurements (signal intensity), and safety (adverse events). All qualitative assessments were also performed on-site. RESULTS: For all 3 readers, images of most patients (Ͼ90%) were scored good or excellent for overall lesion visualization and characterization with either contrast agent; and the noninferiority of gadoterate meglumine versus gadobutrol was statistically demonstrated. No significant differences were observed between the 2 contrast agents regarding qualitative end points despite quantitative mean lesion percentage enhancement being higher with gadobutrol (P Ͻ .001). Diagnostic confidence was high/excellent for all readers in Ͼ81% of the patients with both contrast agents. Similar percentages of patients with adverse events related to the contrast agents were observed with gadoterate meglumine (7.8%) and gadobutrol (7.3%), mainly injection site pain. CONCLUSIONS: The noninferiority of gadoterate meglumine versus gadobutrol for overall visualization and characterization of primary brain tumors was demonstrated. ABBREVIATIONS: AE ϭ adverse event; CNR ϭ contrast-to-noise ratio; GBCA ϭ gadolinium-based contrast agent; LS ϭ least-squares; r1 ϭ relaxivity G adolinium-based contrast agents (GBCAs) have led to improvement in the diagnostic accuracy and sensitivity of MR imaging. GBCAs can be classified into linear or macrocyclic agents according to their chemical structure, with macrocyclic GBCAs showing a higher kinetic stability. Gadoterate meglumine is an ionic macrocyclic GBCA with a measured T1 relaxivity (r1) range in plasma at 37°C of 3.4-3.8 L ϫ mmol Ϫ1 ϫ s Ϫ1 at 1.5T and 3.3-3.7 L ϫ mmol Ϫ1 ϫ s Ϫ1 at 3T. 1 Gadobutrol is a nonionic macrocyclic GBCA with a higher r1 range of 4.9-5.5 L ϫ mmol Ϫ1 ϫ s Ϫ1 at 1.5T and 4.7-5.3 L ϫ mmol Ϫ1 ϫ s Ϫ1 at 3T in plasma at 37°C. 1 Gadobutrol is the only GBCA formulated at a concentration of 1 mmol/mL, while gadoterate meglumine is formulated at 0.5 mmol/mL, as are all other commercially available GBCAs approved for CNS imaging. Both are administered intravenously at a dose of 0.1 mmol/kg of body weight; thus, gadobutrol is administered at half the volume of gadoterate meglumine. However,
MRI in treatment of adult gliomas
The Lancet Oncology, 2005
The introduction of MRI into clinical practice has been among the most important of all advances in the care of patients with brain tumours. The crucial roles of neuroimaging in neuro-oncology include refinement of preoperative differential diagnosis, precise anatomical localisation for operative planning (figure 1), detection of response to treatment and of tumour progression, and recognition of side-effects that are treatment related. However, there are many unsolved difficulties in the use of MRI in neuro-oncology. New techniques that allow analysis of the chemical composition of tumour tissue, capillary density, and the diffusion of water, have great potential but are not yet well validated. The specialty of molecular imaging is expanding rapidly, although only in the preclinical setting. Here we review the status of these techniques and other issues in neuro-oncology. Correlation between imaging appearance and histological features of gliomas
Magnetic Resonance Imaging of Gliomas
Advances in the Biology, Imaging and Therapies for Glioblastoma, 2011
Brain cancer is a life threatening neurological disorder in which malignant cells, grow, proliferate and invade the original cerebral structures of the host, hampering seriously adequate brain function. Malignant cells generate eventually a dedifferentiated tumoral mass that interferes with vital brain functions as sensory and motor activations, memory and perception and neuroendocrine regulation, among others. The fully developed tumoral mass consumes a significant part of cerebral volume resulting in cerebral compression and serious neurological impairments, such as vision or hearing disturbances and eventually lethal cerebrovascular complications. Most brain tumors remain asymptomatic during early development, revealing their symptoms and lethal nature only at later stages. Therapy is facilitated many times by an early finding, a circumstance making the neuroimaging approaches particularly useful in the detection and handling of these lesions. In the last decades, Magnetic Resonance Imaging (MRI) approaches have evolved into the most powerful and versatile imaging tool for brain tumor diagnosis, prognosis, therapy evaluation, monitoring of disease progression and planning of neurosurgical strategies. MRI methods enable the non invasive assessment of glioma morphology and functionality providing a point of likeness into histopathological grading of the tumor and helping in this way a more successful patient management. This impressive evolution is based not only for the high resolution and quality of the anatomical images obtained, but on the additional possibilities to achieve quantitative functional information on tumoral physiopathology and its repercussions in the sensorial, motor and integrative functions through the brain. The use of conventional paramagnetic or superparamagnetic contrast media allows for the identification of areas with blood-brain barrier (BBB) disruption and the recent molecular imaging approaches enable researchers to visualize molecular events associated to tumor proliferation and invasion, bringing the potentials of diagnostic imaging to the cellular and molecular aspects of tumor biology. Moreover, functional MRI approaches as performed in the clinic are endowed with the potential to detect and characterize the earliest neoangiogenic, metabolic and hemodynamic alterations induced by the neoplasm. Several advanced magnetic resonance (MR) methodologies have been proposed in the last years to assess the functional competence in healthy and pathologic brain tissue. Diffusion and perfusion MRI are probably the two main approaches that have reached a relevant clinical role