The Pattern of Use, Effectiveness, and Safety of Gadoteric Acid (Clariscan) in Patients Undergoing Contrast-Enhanced Magnetic Resonance Imaging: A Prospective, Multicenter, Observational Study

Abstract

Objective. Contrast-enhanced MR (CE-MR) imaging is often required to improve lesion detection and characterization and to increase diagnostic confidence. This study aimed to evaluate the safety and effectiveness, as well as the use pattern, of the macrocyclic gadolinium-based contrast agent Clariscan in real-world clinical practice in Korea. Materials and Methods. This was a prospective, multicenter, observational study of patients undergoing CE-MR as part of routine clinical care at 6 university hospitals in Korea. Effectiveness was evaluated by determining diagnostic confidence and image quality; safety evaluation included the adverse event (AE) expression rate. Subgroup analyses were conducted by body regions of diagnosis (musculoskeletal, nervous system, others) and in pediatric patients (aged ≤7 years). Results. From October 2019 to September 2020, 1,376 subjects were included in the study. The mean volume of Clariscan used was 0.26 mL/kg (0.13 mmol/kg). In the overall study population and in each subgroup, diagnostic confidence increased after contrast enhancement with Clariscan. Overall, image quality was excellent in 72.5% of subjects and good-to-adequate in 27.2%. Clariscan was well tolerated (14 AEs occurred in 10 subjects); all AEs were of mild severity. Subgroup analyses showed that the mean dose of Clariscan used was ≥0.1 mmol/kg for nervous system-related diagnoses (e.g., brain) and ≤0.1 mmol/kg for musculoskeletal and pediatric-related diagnoses. All musculoskeletal and pediatric examinations were provided with a smaller package of 5 mL Clariscan. By body region of MR examination, the most common region was the nervous system in 69.0%, musculoskeletal system in 13.6%, and reproductive system in 4.9%. Conclusions. This study confirmed the use pattern of Clariscan and its excellent effectiveness and safety in the real-world clinical environment in Korea. The small-dose package indicated the possibility of increasing the convenience and efficiency of drug use.

MRI Case Report of Perianal Fistula with T2 TSE SPIR Sequence

“…The usage of pelvic MRI protocol of perianal fistula examination of perianal fistulas at the Mayapada Hospital consist of pre contrast media -sagittal T2 TSE, sagittal T2 TSE SPIR, sagittal T1 TSE, axial oblique T2 TSE, axial oblique T2 TSE SPIR, coronal oblique T2 TSE, Coronal oblique T2 TSE SPIR, Contrast media -Sagittal T1 TSE SPIR, axial oblique T1 TSE SPIR, and coronal oblique T1 TSE SPIR. Focus on MRI Pelvis perianal fistula, namely the presence of fluid, then use the T2 sequence to visualize the fluid image to become hyper-intense so that you can see fluid in the perianal abscess and perianal fistula Figure 4 The contrast media used in Pelvic MRI examination of perianal fistulas at the Radiology Department of Mayapada Hospital, South Jakarta, is contrast media with a gadoteric acid concentration of 0.5 mmol/ml (Braun et al, 2020;GE Health Care, 2017;Moon et al, 2021). The standard volume of contrast media used to visualize perianal abscesses and fistulas properly is around 10 ml, using an injector or manually assisted by a radiologist to inject contrast media.…”

Role of Contrast-Enhanced MRI in Diagnosing Brain Metastases in Patients With Lung Cancer

“…Метод магнитно резонансной томографии (МРТ) в настоящее время является одним из методов обнаружения метастазов головного мозга любой локализации, планирования лучевой терапии и мониторинга ответа на лечение. Однако МРТ на сегодняшний день менее доступна, чем КТ [2,3].…”