Marc Saake1, Soenke Langner2, Carsten Schwenke3, Marina Weibart4, Olav Jansen5, Norbert Hosten2, Arnd Doerfler4. 1. Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany. Marc.Saake@uk-erlangen.de. 2. Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany. 3. SCO:SSiS, Statistical Consulting, Berlin, Germany. 4. Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany. 5. Department of Radiology and Neuroradiology, University of Kiel, Kiel, Germany.
Abstract
OBJECTIVES: To compare contrast effects of gadobutrol with gadoterate meglumine for brain MRI in multiple sclerosis (MS) in a multicentre, randomized, prospective, intraindividual study at 3 T. METHODS: Institutional review board approval was obtained. Patients with known or suspected active MS lesions were included. Two identical MRIs were performed using randomized contrast agent order. Four post-contrast T1 sequences were acquired (start time points 0, 3, 6 and 9 min). If no enhancing lesion was present in first MRI, second MRI was cancelled. Quantitative (number and signal intensity of enhancing lesions) and qualitative parameters (time points of first and all lesions enhancing; subjective preference regarding contrast enhancement and lesion delineation; global preference) were evaluated blinded. RESULTS:Seventy-four patients (male, 26; mean age, 35 years) were enrolled in three centres. In 45 patients enhancing lesions were found. Number of enhancing lesions increased over time for both contrast agents without significant difference (median 2 for both). Lesions signal intensity was significantly higher for gadobutrol (p < 0.05 at time points 3, 6 and 9 min). Subjective preference rating showed non-significant tendency in favour of gadobutrol. CONCLUSION: Both gadobutrol and gadoterate meglumine can be used for imaging of acute inflammatory MS lesions. However, gadobutrol generates higher lesion SI. KEY POINTS: Contrast-enhanced MRI plays a key role in the management of multiple sclerosis. Different gadolinium-based contrast agents are available. Number of visibly enhancing lesions increases over time after contrast injection. Gadobutrol and gadoterate meglumine do not differ in number of visible lesions. Gadobutrol generates higher signal intensity than gadoterate meglumine.
RCT Entities:
OBJECTIVES: To compare contrast effects of gadobutrol with gadoterate meglumine for brain MRI in multiple sclerosis (MS) in a multicentre, randomized, prospective, intraindividual study at 3 T. METHODS: Institutional review board approval was obtained. Patients with known or suspected active MS lesions were included. Two identical MRIs were performed using randomized contrast agent order. Four post-contrast T1 sequences were acquired (start time points 0, 3, 6 and 9 min). If no enhancing lesion was present in first MRI, second MRI was cancelled. Quantitative (number and signal intensity of enhancing lesions) and qualitative parameters (time points of first and all lesions enhancing; subjective preference regarding contrast enhancement and lesion delineation; global preference) were evaluated blinded. RESULTS: Seventy-four patients (male, 26; mean age, 35 years) were enrolled in three centres. In 45 patients enhancing lesions were found. Number of enhancing lesions increased over time for both contrast agents without significant difference (median 2 for both). Lesions signal intensity was significantly higher for gadobutrol (p < 0.05 at time points 3, 6 and 9 min). Subjective preference rating showed non-significant tendency in favour of gadobutrol. CONCLUSION: Both gadobutrol and gadoterate meglumine can be used for imaging of acute inflammatory MS lesions. However, gadobutrol generates higher lesion SI. KEY POINTS: Contrast-enhanced MRI plays a key role in the management of multiple sclerosis. Different gadolinium-based contrast agents are available. Number of visibly enhancing lesions increases over time after contrast injection. Gadobutrol and gadoterate meglumine do not differ in number of visible lesions. Gadobutrol generates higher signal intensity than gadoterate meglumine.
Entities:
Keywords:
Gadolinium-based contrast agent; Inflammation; Magnetic resonance imaging; Multiple sclerosis; Signal intensity
Authors: J H Simon; D Li; A Traboulsee; P K Coyle; D L Arnold; F Barkhof; J A Frank; R Grossman; D W Paty; E W Radue; J S Wolinsky Journal: AJNR Am J Neuroradiol Date: 2006-02 Impact factor: 3.825
Authors: James M Stankiewicz; Bonnie I Glanz; Brian C Healy; Ashish Arora; Mohit Neema; Ralph H B Benedict; Zachary D Guss; Shahamat Tauhid; Guy J Buckle; Maria K Houtchens; Samia J Khoury; Howard L Weiner; Charles R G Guttmann; Rohit Bakshi Journal: J Neuroimaging Date: 2011-04 Impact factor: 2.486
Authors: Chris H Polman; Stephen C Reingold; Brenda Banwell; Michel Clanet; Jeffrey A Cohen; Massimo Filippi; Kazuo Fujihara; Eva Havrdova; Michael Hutchinson; Ludwig Kappos; Fred D Lublin; Xavier Montalban; Paul O'Connor; Magnhild Sandberg-Wollheim; Alan J Thompson; Emmanuelle Waubant; Brian Weinshenker; Jerry S Wolinsky Journal: Ann Neurol Date: 2011-02 Impact factor: 10.422
Authors: Philip Hoelter; Stefan Lang; Marina Weibart; Manuel Schmidt; Michael F X Knott; Tobias Engelhorn; Marco Essig; Stephan Kloska; Arnd Doerfler Journal: Neuroradiology Date: 2017-09-14 Impact factor: 2.804
Authors: Mathieu D Santin; Michel E Vandenberghe; Anne-Sophie Herard; Laurent Pradier; Caroline Cohen; Thomas Debeir; Thierry Delzescaux; Thomas Rooney; Marc Dhenain Journal: Front Aging Neurosci Date: 2016-03-22 Impact factor: 5.750
Authors: Henrik J Michaely; Manuela Aschauer; Hannes Deutschmann; Georg Bongartz; Matthias Gutberlet; Ramona Woitek; Birgit Ertl-Wagner; Walter Kucharczyk; Renate Hammerstingl; Francesco De Cobelli; Martin Rosenberg; Thomas Balzer; Jan Endrikat Journal: Invest Radiol Date: 2017-01 Impact factor: 6.016