Prospective, randomized comparison of gadopentetate and gadobutrol to assess chronic myocardial infarction applying cardiovascular magnetic resonance

Abstract

BackgroundWe hypothesized that the contrast medium gadobutrol is not inferior compared to Gd-DTPA in identifying and quantifying ischemic late gadolinium enhancement (LGE), even by using a lower dose.MethodsWe prospectively enrolled 30 patients with chronic myocardial infarction as visualized by LGE during clinical routine scan at 1.5 T with 0.20 mmol/kg Gd-DTPA. Participants were randomized to either 0.15 mmol/kg gadobutrol (group A) or 0.10 mmol/kg gadobutrol (group B). CMR protocol was identical in both exams.LGE was quantified using a semiautomatic approach. Signal intensities of scar, remote myocardium, blood and air were measured. Signal to noise (SNR) and contrast to noise ratios (CNR) were calculated.ResultsSignal intensities were not different between Gd-DTPA and gadobutrol in group A, whereas significant differences were detected in group B. SNR of injured myocardium (53.5+/−21.4 vs. 30.1+/−10.4, p = 0.0001) and CNR between injured and remote myocardium (50.3+/−20.3 vs. 27.3+/−9.3, p < 0.0001) were lower in gadobutrol. Infarct size was lower in both gadobutrol groups compared to Gd-DTPA (group A: 16.8+/−10.2 g vs. 12.8+/−6.8 g, p = 0.03; group B: 18.6+/−12.0 g vs. 14.0+/−9.9 g, p = 0.0016).ConclusionsTaking application of 0.2 mmol/kg Gd-DTPA as the reference, the delineation of infarct scar was similar with 0.15 mmol/kg gadobutrol, whereas the use 0.10 mmol/kg gadobutrol led to reduced tissue contrast.Trial registrationThe study had been registered under EudraCT Number: 2010-020775-22. Registration date: 2010.08.10

Quantitative analysis of late gadolinium enhancement in hypertrophic cardiomyopathy: comparison of diagnostic performance in myocardial fibrosis between gadobutrol and gadopentetate dimeglumine

“…In our study, two contrast agents were used for two tests to verify the accuracy of different measurement methods. A recent study by Rudolph et al [28] reported that applying 0.2 mmol/kg Gd-DTPA as the reference, the delineation of scar size was similar with 0.15 mmol/kg gadobutrol, whereas the use 0.10 mmol/kg gadobutrol led to reduced tissue contrast.…”

“…While the application of gadobutrol in cardiac late imaging is limited, there are still some published studies about use of gadobutrol in other DCE CMRI studies [26][27][28][29] . In our study, the usage of gadobutrol with corrected relaxation dosage and gadopentetate dimeglumine with standard dosage was more advantageous in cardiac delayed imaging.…”

Clinical use of 4D flow MRI for quantification of aortic regurgitation

“…Image acquisition begins simultaneously with the injection of 0.15 mmol/kg of contrast agent followed immediately by saline flush. The dose of the contrast agent is based on current recommendations of the Society for Cardiovascular Magnetic Resonance 21…”

Tissue characterisation and myocardial mechanics using cardiac MRI in children with hypertrophic cardiomyopathy

“…While some studies suggest that late gadolinium enhancement is more apparent with Gadovist than Magnevist, others suggest similar images for the two contrast agents. [29][30][31] Though there are minimal available data comparing extracellular volume values with Gadovist and Magnevist, the extracellular volume appears to be relatively contrast independent, with no significant difference or differences of questionable clinical significance between contrast agents. [32][33][34]…”