Sequence optimization in mangafodipir trisodium-enhanced liver and pancreas MRI

Wang, Chen; Johansson, Lars; Western, A; Fagertun, H.; Åhlström, Håkan

doi:10.1002/(sici)1522-2586(199902)9:2<280::aid-jmri19>3.0.co;2-h

Cited by 18 publications

(7 citation statements)

References 10 publications

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“…Moreover, MnDPDPenhanced MRI showed significantly better quality of delineation of the lesion and lesion conspicuity with respect to spiral CT images (p < 0.001). The superiority of MRI, however, was manifest only with use of T1-weighted GRE sequences, which outperformed T1-weighted SE sequences in both pre-contrast and contrast-enhanced studies, as reported previously [17].…”

Section: Discussionsupporting

confidence: 73%

MnDPDP-enhanced MRI vs dual-phase spiral CT in the detection of hepatocellular carcinoma in cirrhosis

et al. 2000

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The objectives of this study were twofold: (a) to assess safety and tolerability of the hepatobiliary MR contrast agent MnDPDP; and (b) to investigate the sensitivity of MnDPDP-enhanced MRI, in comparison with dual-phase spiral CT, in the detection of hepatocellular carcinoma (HCC) in cirrhosis. Fifty patients with liver cirrhosis and histologically proven HCC were enrolled in a prospective phase-IIIB clinical trial. All patients underwent evaluation with dual-phase spiral CT and pre-contrast and post-contrast MRI at 1.5 T. The MR examination protocol included spin-echo (SE) and gradient-recalled-echo (GRE) T1-weighted images acquired before and 60-120 min after administration of 0.5 micromol/kg (0.5 ml/kg) MnDPDP (Teslascan, Nycomed Amersham, Oslo, Norway); and fast T2-weighted SE images obtained solely before contrast injection. Gold standard was provided by findings at Lipiodol CT in combination with follow-up spiral CT studies, which were repeated at 4-month intervals over a 10- to 27-month (mean +/- SD 20.1 +/- 5.1 months) follow-up period. No serious adverse event occurred. Eighty tumors ranging 0.8-9.1 cm in diameter (mean +/- SD 3.2 +/- 2.4 cm) were detected by Lipiodol CT or confirmed as cancerous foci by follow-up CT studies. Pre-contrast MRI detected 38 of 80 lesions (48%); MnDPDP-enhanced MRI, 65 of 80 lesions (81%); pre-contrast plus post-contrast MRI, 69 of 80 lesions (86%); and dual-phase spiral CT, 64 of 80 lesions (80%). The difference between unenhanced and MnDPDP-enhanced MRI was statistically significant (p < 0.001). The difference between MRI (pre-contrast plus post-contrast) and dual-phase spiral CT was not statistically significant (p = 0.33). The confidence in the final diagnosis, however, was significantly higher for MRI as compared with spiral CT (p<0.001). MnDPDP is a safe and well-tolerated hepatobiliary MR contrast agent. Magnetic resonance imaging with use of MnDPDP is significantly more sensitive than unenhanced MRI and as good as dual-phase spiral CT for detection of HCC in cirrhosis.

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Section: Discussionsupporting

confidence: 73%

MnDPDP-enhanced MRI vs dual-phase spiral CT in the detection of hepatocellular carcinoma in cirrhosis

et al. 2000

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“…Liver MRI is known to provide useful information for detecting and characterizing liver tumors (18, 19), and Mn‐DPDP has been shown to be useful for improving hepatic tumor detection (20). In our study, however, postcontrast delayed MR images were not useful for hepatic lesion detection because no new hepatic lesion was detected on postcontrast delayed images in a lesion‐by‐lesion analysis.…”

Section: Discussionmentioning

confidence: 99%

Mangafodipir trisodium‐enhanced MRI for the detection and characterization of focal hepatic lesions: Is delayed imaging useful?

Chung

Kim

2006

Magnetic Resonance Imaging

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Purpose:To investigate the usefulness of early and delayed hepatic MRI after mangafodipir trisodium (Mn-DPDP) administration for the detection and characterization of focal hepatic lesions. Materials and Methods:Forty-five patients (31 males and 14 females, mean age ϭ 61 years) with a total of 113 hepatic lesions (mean size ϭ 3.5 cm) were included in this study (15 with hepatocellular carcinoma (HCC, N ϭ 35), 20 with hepatic metastasis (N ϭ 63), five with hemangioma (N ϭ 10), three with cholangiocarcinoma (CC, N ϭ 3), and two with liver abscess (N ϭ 2)). T1-weighted gradient-echo MR images were obtained before and after Mn-DPDP administration, with a mean 18-hour delayed imaging. A qualitative analysis (including the size and signal intensity (SI)) and quantitative analysis (including enhancement and lesionliver contrast-to-noise ratio (CNR)) were performed on preand postcontrast early and delayed MR images.Results: Compared to postcontrast early imaging, 17 (48.6%) of 35 HCCs showed higher SI, 16 (45.7%) showed no SI change, and two (5.7%) showed lower SI on delayed imaging. All 63 metastases, 10 hemangiomas, three CCs, and two abscesses showed no SI change. On delayed imaging, ring enhancement was noted in 53 metastases (84.1%), three hemangiomas (30.0%), and one abscess (50.0%), but was not seen in HCCs or CCs. Eight metastases (12.7%) also showed ring enhancement on postcontrast early imaging. No newly detected hepatic lesions were revealed on postcontrast delayed MR images compared to postcontrast early images. Regarding CNR, the HCCs showed a significant increase in CNR from postcontrast early to delayed images after administration of Mn-DPDP (P Ͻ 0.01). However, none of the metastases, hemangiomas, CCs, and abscesses showed a significant increase of CNR from postcontrast early to delayed images. Conclusion:Postcontrast delayed MR images after Mn-DPDP administration were helpful in distinguishing hepatocellular from nonhepatocellular lesions, but were not useful for lesion detection and had limited utility for lesion characterization, since benign and malignant hepatic lesions looked the same.

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“…For the gadolinium chelates, stability of the complex in vivo is of the utmost importance. The dechelation of mangafodipir trisodium accounts for the high incidence of flushing, as well as the enhancement of intestinal mucosa and pancreas (62, 63). DPDP, the ligand, does not facilitate transport of manganese into any organ, except the kidney.…”

Section: Other Metal Chelatesmentioning

confidence: 99%

Safety of approved MR contrast media for intravenous injection

Runge

2000

J. Magn. Reson. Imaging

244

110

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In the last 10 years, the use of intravenous contrast media in magnetic resonance (MR) has become well‐established clinical practice. Contrast media provide critical additional diagnostic information in many instances. The gadolinium chelates constitute the largest group of MR contrast media and are considered to be very safe. These agents are thought to be safer than nonionic iodinated contrast agents. Unlike x‐ray agents, the gadolinium chelates are not nephrotoxic. Minor adverse reactions, including nausea (1%–2% for all agents) and hives (<1% for all agents), occur in a very low percent of cases. Health care personnel should be aware of the (extremely uncommon) potential for severe anaphylactoid reactions in association with the use of MR contrast media and be prepared should complications arise. The four gadolinium chelates currently available worldwide, gadopentetate dimeglumine, gadoteridol, gadodiamide, and gadoterate meglumine, cannot be differentiated on the basis of adverse reactions. Far fewer patients have been examined to date with the two other agents that have widespread approval, mangafodipir trisodium and ferumoxides. These latter two agents are considered to be very safe but have a higher percentage of associated adverse reactions (7%–17% with mangafodipir trisodium and 15% with ferumoxides). This review discusses the safety issues involved with administration of intravenous contrast media in MR imaging, focusing on the six agents (four gadolinium chelates, one manganese chelate, and the last a large iron particle) with widespread use world‐wide. J. Magn. Reson. Imaging 2000;12:205–213. © 2000 Wiley‐Liss, Inc.

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Sequence optimization in mangafodipir trisodium-enhanced liver and pancreas MRI

Cited by 18 publications

References 10 publications

MnDPDP-enhanced MRI vs dual-phase spiral CT in the detection of hepatocellular carcinoma in cirrhosis

MnDPDP-enhanced MRI vs dual-phase spiral CT in the detection of hepatocellular carcinoma in cirrhosis

Mangafodipir trisodium‐enhanced MRI for the detection and characterization of focal hepatic lesions: Is delayed imaging useful?

Safety of approved MR contrast media for intravenous injection

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