Dynamic contrast‐enhanced magnetic resonance imaging of abdominal solid organ and major vessel: Comparison of enhancement effect between Gd‐EOB‐DTPA and Gd‐DTPA

Abstract

Purpose:To evaluate the differences in enhancement of the abdominal solid organ and the major vessel on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) obtained with gadolinium ethoxybenzyldiethylenetriamine pentaacetic acid (Gd-EOB-DTPA: EOB) and gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) in the same patients. Materials and Methods:A total of 13 healthy volunteers underwent repeat assessments of abdominal MR examinations with DCE-MRI using either Gd-DTPA at a dose of 0.1 mmol/kg body weight or EOB at a dose of 0.025 mmol/kg body weight. DCE images were obtained at precontrast injection and in the arterial phase (AP: 25 seconds), portal phase (PP: 70 seconds), and equilibrium phase (EP: 3 minutes). The signal intensities (SIs) of liver at AP, PP, and EP; the SIs of spleen, renal cortex, renal medulla, pancreas, adrenal gland, aorta at AP; and the SIs of portal vein and inferior vena cava (IVC) at PP were defined using region-ofinterest measurements, and were used for calculation of signal intensity ratio (SIR). There was no significant difference in mean SIR of liver at PP between EOB (0.529 Ϯ 0.124) and Gd-DTPA (0.564 Ϯ 0.139). Conversely, the mean SIR of liver at EP was significantly higher with EOB (0.576 Ϯ 0.167) than with Gd-DTPA (0.396 Ϯ 0.093) (P Ͻ 0.001). Results Conclusion:Lower arterial vascular and parenchymal enhancement with Gd-EOB, as compared with Gd-DTPA, may require reassessment of its dose, despite the higher late venous phase liver parenchymal enhancement.

Comparison of Dynamic Phase Enhancement of Hepatocellular Carcinoma Using Gadoxetate Disodium vs Gadobenate Dimeglumine

“…When compared to Gd-BOPTA, at standard doses Gd-EOB-DTPA demonstrates lower enhancement in normal vasculature and solid abdominal organs [9] and lower dynamic enhancement of the liver vasculature [10]. Frydrychowicz et al compared dynamic post contrast hepatic vasculature signal to noise ratio (SNR) with the higher (non-FDA approved) Gd-EOB-DTPA dose of 0.05 mmol/kg to the standard dose of Gd-BOPTA.…”

Transient Severe Respiratory Motion Artifacts After Application of Gadoxetate Disodium: What We Currently Know

“…This is only a quarter of the dose of conventional extracellular contrast agents (0.1 mmol/ kg) [18,19]. The weight-adjusted contrast volume of gadoxetate disodium (concentration: 0.25mol) results in half the volume of other extracellular contrast agents (concentration: 0.5mol) [20].…”

“…The smaller volume shortens the duration of arterial enhancement and reduces signal intensity [21]. Therefore, some institutions use higher doses of 0.05 mmol/kg [18,22,23]. Other institutions use a fixed dose of 10 ml equaling the package size, resulting in varying concentrations of gadoxetate disodium, depending on the patient's body weight [6, 8 -10, 12, 14].…”

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

“…Contrast enhancement of the vessels is lower on the arterial phase for gadoxetic acid-enhanced images than for extracellular GBCAs. 9 The T 1 -shortening eŠect of gadoxetic acid is much larger than that of extracellular GBCAs, but that can result in equivalent or even greater contrast enhancements in the aorta. 10 A recent study revealed that use of a slow injection rate (one mL/s) can facilitate equivalent arterial enhancements between gadoxetic acid and extracellular GBCAs.…”

“…64,65 Several studies have shown that gadoxetic acid-enhanced MR imaging is useful in diagnosing conventional HCCs and, in fact, may sometimes be more reliable than dynamic contrast-enhanced 16-to 64-slice multidetector-row CT for this purpose. 9,36,66,67 When using an extracellular GBCA, sensitivity and specicity of MR imaging are excellent even for small HCCs. 68 However, some researchers suggest that the hepatocyte phase of gadoxetic acid might have added value to detect more HCCs than dynamic phases especially for less-experienced observers.…”