Abstract:
HTML
Purpose: Contrast-enhanced MRI has high sensitivity for detecting blood
brain barrier (BBB) defects inherent to acute inflammatory lesions of Multiple
Sclerosis (MS). Diagnostic protocols for MR imaging of "active
lesions" in cases of acute relapse typically envisage contrast agent doses
of up to 0.3 mmol/kg bw. The aim of this study was to compare the efficacy of
single and double doses of Gd-BOPTA (MultiHance(r), Bracco Imaging SpA, Italy)
for the detection of lesions in patients with symptoms of new or relapsing MS.
Methods and Materials: MR imaging was performed in 60 patients within 3 weeks
of the onset of symptoms. PDw, FSE T2w, FLAIR and FSE T1w images were acquired
pre-contrast followed by FSE T1w images at 5 and 15 min after a first injection
of 0.1 mmol/kg bw Gd-BOPTA. A second injection of 0.1 mmol/kg bw Gd-BOPTA was
then performed at 20 min after the first injection, followed, after 5 min, by
the further acquisition of FSE T1w images. Preliminary on-site within patient
comparisons were performed for the number and size of enhancing lesions on each
post-contrast image set compared to pre-contrast. Safety assessments were
performed before contrast administration, at 1 hour after administration and by
interview at 24 hours after administration.
Results: Although good visualization of lesions was noted on images acquired at
5 min after the first injection of 0.1 mmol/kg Gd-BOPTA, images acquired at 15
min post-contrast revealed a greater number of lesions and better lesion
conspicuity. Images acquired at 5 min after the second 0.1 mmol/kg dose
(cumulative 0.2 mmol/kg dose) did not reveal further improvement either in
terms of lesion detection or lesion conspicuity. No serious or unexpected
adverse events were reported.
Conclusion: Imaging at 5 min after a cumulative dose of 0.2 mmol/kg Gd-BOPTA
does not appear to provide any additional information beyond that obtained at
15 min after a single dose of 0.1 mmol/kg Gd-BOPTA for MR imaging of acute MS.
The apparent requirement for only a single dose of Gd-BOPTA can be attributed
to the high (9.7 mmol-1s-1) relaxivity of this agent compared to other
gadolinium agents.
(P.C. is an employee of Bracco Imaging SpA.)
Splendiani MD, A,
Monitoring Multiple Sclerosis on MRI: Preliminary Results of a Multicenter Comparison of Early and Late Enhancement with 0.1 mmol/kg Gd-BOPTA versus Early Enhancement with 0.2 mmol/kg Gd-BOPTA. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3106892.html
