Eun Soo Kim, Presenter: Nothing to Disclose

Seung-Koo Lee MD, PhD, Abstract Co-Author: Nothing to Disclose

Jinna Kim, Abstract Co-Author: Nothing to Disclose

Hyun Seok Choi MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to compare the diagnostic efficacy of gadobutrol (1.0 molar Gd-compound) in detection of brain metastasis comparing with Gd-DTPA (0.5-molar Gd-compound).

IRB waived retrospective analysis of two consecutive contrast enhanced 3D-T1-gradient echo images from 27 patients, screening MRI using double-dose (DD) Gd-DTPA and localization MRI for gamma-knife surgery using double-dose gadobutrol. Same geometric and pulse parameters were used for two difference scans. All images were obtained from 1.5T scanner after injection of 0.2mmol/kg of Gd-DTPA or gadobutrol. Two expertise neuroradiologists reviewed enhanced MR images and counted the number of enhancing lesions with agreement. Difference in lesion detection between Gd-DTPA and gadobutrol was evaluated by McNemar test. Lesion-brain contrast to noise ratio (CNR) was measured by ROI method from measurable 45 lesions and paired t-test analysis was performed between DD Gd-DTPA and gadobutrol enhancing lesions.  

On DD Gd-DTPA enhanced images, total 130 lesions were detected visually. With DD gadobutrol, 25 additional lesions were detected on localization MRI. There was no missing lesion on gadobutrol MRI (McNemar test, p<0.00001, infinite odds ratio). Mean CNR was higher on DD gadobutrol MRI (2.17±0.19 vs. 1.90±0.26, p=0.00011, paired t-test, two-tailed. The lesion-brain CNR with gadobutrol were better than those with Gd-DTPA (p<0.0001). Only two cases showed lower CNR on DD gadobutrol images, which were hemorrhagic metastasis from renal cell carcinoma and the patient started steroid treatment after the first MRI scan.

1.0 M Gd-compound, gadobutrol is much more efficient in detection of brain metastasis and provides higher CNR for enhancing lesions.  

1.0M Gd-contrast agent is much better for lesion detection, CNR and provides higher safety.  Extended application in CNS disease is expected.

Kim, E, Lee, S, Kim, J, Choi, H, Diagnostic Yield of Double-dose Gadobutrol in Detection of Brain Metastasis: Intra-individual Comparison with Double-dose Gd-DTPA.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8010802.html