Lesion detection and assessment of extrahepatic findings in abdominal MRI using hepatocyte specific contrast agents – comparison of Gd-EOB-DTPA and Gd-BOPTA

BMC Medical Imaging

Elmar M Merkle¹  Rajan T Gupta²  Mustafa R Bashir²  Daniela B Husarik²  Daniel T Boll²  Kristina I Ringe² 

[1] University Hospital Basel, Radiology and Nuclear Medicine, Petersgraben 4, Basel, CH-4031, Switzerland;Department of Radiology, Duke University Medical Center, Box 3808, Durham, North Carolina, 27710, USA

关键词: Extrahepatic;    Gd-BOPTA;    Gadoxetate disodium;    Gd-EOB-DTPA;   

Others  :  1091267
DOI  :  10.1186/1471-2342-13-10

 received in 2012-12-06, accepted in 2013-02-19,  发布年份 2013

【 摘 要 】

Background

To evaluate the contrast agent performance of Gd-EOB-DTPA and Gd-BOPTA for detection and assessment of extrahepatic findings, semi-quantitatively and qualitatively.

Methods

13 patients with 19 extrahepatic lesions underwent liver MRI with Gd-EOB-DTPA and Gd-BOPTA. Quantitative and relative SNR measurements were performed in each dataset in the arterial and portalvenous phase within the extrahepatic lesion, aorta, inferior vena cava, portal vein, spleen, pancreas and renal cortex. Further, relative CNR measurements were performed. Three readers assessed contrast quality using a five-point scale and choosing the preferred image dataset. Statistical analysis consisted of a Student’s t-test with p < 0.05 deemed significant, a weighted kappa statistic for assessment of interobserver variability and an ROC analysis.

Results

Mean SNR after injection of Gd-BOPTA was significantly higher compared with Gd-EOB-DTPA for all measurements (p < 0.05). Mean relative SNR was also higher for Gd-BOPTA, but without being statistically significant. There was no significant difference in relative CNR. Interobserver agreement for selection of image preference was moderate (mean weighted kappa 0.485). The area under the curve for the ROC-analysis regarding contrast agent performance was 0.464.

Conclusion

Even though mean SNR is significantly higher after injection of Gd-BOPTA compared with Gd-EOB-DTPA, there is no significant difference in relative CNR with extrahepatic lesions being assessed equally well. Visual impression may differ after injection of Gd-EOB-DTPA, but does not influence image interpretation. Extrahepatic findings can be assessed similarly to MRI after injection of Gd-BOPTA.

【 授权许可】

   
2013 Ringe et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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【 参考文献 】

• [1]Schuhmann-Giampieri G, Schmitt-Willich H, Press WR, Negishi C, Weinmann HJ, Speck U: Preclinical evaluation of Gd-EOB-DTPA as a contrast agent in MR imaging of the hepatobiliary system. Radiology 1992, 183:59-64.
• [2]Hamm B, Staks T, Mühler A, Bollow M, Taupitz M, Frenzel T, Wolf KJ, Weinmann HJ, Lange L: Phase I clinical evaluation of Gd-EOB-DTPA as a hepatobiliary contrast agent: safety, pharmacokinetics, and MR imaging. Radiology 1995, 195:785-792.
• [3]Kirchin MA, Pirovano GP, Spinazzi A: Gadobenate dimeglumine (Gd-BOPTA) - An overview. Invest Radiol 1998, 33:798-809.
• [4]Reimer P, Rummeny EJ, Shamsi K, Balzer T, Baldrup HE, Tombach B, Hesse T, Berns T, Peters PE: Phase II clinical evaluation of Gd-EOB-DTPA: dose, safety aspects, and pulse sequence. Radiology 1996, 199:177-183.
• [5]Ringe KI, Husarik DB, Sirlin CB, Merkle EM: Gadoxetate-disodium enhanced MRI of the liver: Part 1, Protocol optimization and lesion appearance in the non-cirrhotic liver. AJR Am J Roentgenol 2010, 195:13-28.
• [6]Cruite I, Schröder M, Merkle EM, Sirlin CB: Gadoxetate-disodium enhanced MRI of the liver: Part 2, Protocol optimization and lesion appearance in the cirrhotic liver. AJR Am J Roentgenol 2010, 195:29-41.
• [7]Brismar TB, Dahlstrom N, Edsborg N, Persson A, Smedby O, Albiin N: Liver vessel enhancement by Gd-BOPTA and Gd-EOB-DTPA: a comparison in healthy volunteers. Acta Radiol 2009, 50:709-715.
• [8]Tamada T, Ito K, Sone T, Yoshida K, Kakuba K, Tanimoto D, Higashi H, Yamashita T: Dynamic contrast-enhanced magnetic resonance imaging of abdominal solid organ and major vessel: comparison of enhancement effect between Gd-EOB-DTPA and Gd-DTPA. J Magn Reson Imaging 2009, 29:636-640.
• [9]Goodwin MD, Dobson JE, Sirlin CB, Lim BG, Stella DL: Diagnostic pitfalls and challenges in MR imaging with hepatocyte-specific contrast agents. Radiographics 2011, 31:1547-1568.
• [10]Lim JS, Kim MJ, Myoung S, Park MS, Choi JY, Choi JS, Kim SI: MR cholangiography for evaluation of hilar branching anatomy in transplantation on the right hepatic lobe from a living donor. AJR Am J Roentgenol 2008, 191:537-545.
• [11]Kuhn JP, Hegenscheid K, Siegmund W, Froehlich CP, Hosten N, Puls R: Normal dynamic MRI enhancement patterns of the upper abdominal organs: gadoxetic acid compared with gadobutrol. AJR Am J Roentgenol 2009, 193:1318-1323.
• [12]Zizka J, Kizo L, Ferda J, Mrklovsky M, Bukac J: Dynamic and delayed contrast enhancement in upper abdominal MRI studies: comparison of gadoxetic acid and gadobutrol. Eur J Radiol 2007, 62:186-191.
• [13]Huppertz A, Franiel T, Wagner M, Püttcher O, Wagner J, Rief M, Schwenke C, Hamm B, Strassburg J: Whole-body MRI with assessment of hepatic and extraabdominal enhancement after administration of gadoxetic acid for staging of rectal carcinoma. Acta Radiol 2010, 52:842-850.