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Contrast Enhancement of Central Nervous System Lesions: Multicenter Intraindividual Crossover Comparative Study of Two MR Contrast Agents¹

¹ From the Neuroradiology and MR Research Laboratory, University of Washington, Box 357115, 1959 NE Pacific St, Seattle, WA 98195 (K.R.M.); Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC (J.A.M.); Neuroradiology Research, University of Florida, Gainesville, Fla (I.M.S.); Department of Radiology, Southern Illinois University School of Medicine, Springfield, Ill (M.J.K.); Department of Radiology, University of Miami School of Medicine, Miami, Fla (B.C.B.); Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Mo (F.J.W.); Department of Radiology, Scott and White Memorial Hospital, Temple, Tex (V.M.R.); Department of Radiology, Ohio State University-University Hospitals, Columbus, Ohio (M.V.K.); Department of Neuroradiology, Centre Hospitalier et Universitaire de Neuroradiologie, Nancy, France (S.K.); Department of Radiology, University Hospital, Newark, NJ (L.J.W.); Department of Neuroradiology, San Raffaele Hospital, Milan, Italy (N.A.); German Cancer Research Institute, Heidelberg, Germany (M.E.); and Department of Neuroradiology, Sahlgrenska University Hospital, Gothenburg, Sweden (L.G.). Received July 28, 2005; revision requested September 30; revision received November 10; accepted December 8; final version accepted February 6, 2006. K.R.M. and V.M.R. received partial support and consulted for Bracco Diagnostics. L.J.W. received support from Berlex and Bracco Diagnostics. Address correspondence to K.R.M. (e-mail: kmarav{at}u.washington.edu).

Purpose: To prospectively compare gadobenate dimeglumine with gadopentetate dimeglumine (0.1 mmol per kilogram body weight) for enhanced magnetic resonance (MR) imaging of central nervous system (CNS) lesions.

Materials and Methods: This study was HIPAA-compliant at U.S. centers and was conducted at all centers according to the Good Clinical Practice standard. Institutional review board and regulatory approval were granted; written informed consent was obtained. Seventy-nine men and 78 women (mean age, 50.5 years ± 14.4 [standard deviation]) were randomized to group A (n = 78) or B (n = 79). Patients underwent two temporally separated 1.5-T MR imaging examinations. In randomized order, gadobenate followed by gadopentetate was administered in group A; order of administration was reversed in group B. Contrast agent administration (volume, speed of injection), imaging parameters before and after injection, and time between injections and postinjection acquisitions were identical for both examinations. Three blinded neuroradiologists evaluated images by using objective image interpretation criteria for diagnostic information end points (lesion border delineation, definition of disease extent, visualization of internal morphologic features of the lesion, enhancement of the lesion) and quantitative parameters (percentage of lesion enhancement, contrast-to-noise ratio [CNR]). Overall diagnostic preference in terms of lesion conspicuity, detectability, and diagnostic confidence was assessed. Between-group comparisons were performed with Wilcoxon signed rank test.

Results: Readers 1, 2, and 3 demonstrated overall preference for gadobenate in 75, 89, and 103 patients, compared with that for gadopentetate in seven, 10, and six patients, respectively (P < .0001). Significant (P < .0001) preference for gadobenate was demonstrated for diagnostic information end points, percentage of lesion enhancement, and CNR. Superiority of gadobenate was significant (P < .001) in patients with intraaxial and extraaxial lesions.

Conclusion: Gadobenate compared with gadopentetate at an equivalent dose provides significantly better enhancement and diagnostic information for CNS MR imaging.

© RSNA, 2006

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