Tim Leiner MD, PhD, Presenter: Nothing to Disclose

Stephan Miller MD, Abstract Co-Author: Nothing to Disclose

Siegfried Thurner MD, Abstract Co-Author: Nothing to Disclose

Angelo Vanzulli MD, Abstract Co-Author: Nothing to Disclose

Josef Vymazal MD, PhD, Abstract Co-Author: Consultant, EPIX Pharmaceuticals, Inc, Boston, MA Consultant, NovoCure Ltd, Haifa, Israel

Martin N. Wasser MD, Abstract Co-Author: Nothing to Disclose

John R. Parker, Abstract Co-Author: Employee, Bracco Group

To compare diagnostic performance of equivalent 0.1 mmol/kg doses of gadobenate dimeglumine (Gd-BOPTA; MultiHance) and gadopentetate dimeglumine (Gd-DTPA; Magnevist) in patients with peripheral arterial vascular disease (PAOD) undergoing contrast-enhanced MR angiography (CE-MRA).

Adult subjects (N=96) with suspected moderate-to-severe PAOD were enrolled at 7 investigational sites. All patients underwent 2 identical 1.5-T, 3-station, CE-MRA examinations from the aortic bifurcation to the lower leg. Patients received both 0.1 mmol/kg bodyweight doses of gadobenate dimeglumine and gadopentetate dimeglumine in random order. Diagnostic performance (sensitivity, specificity, accuracy, positive predictive value [PPV], negative predictive value [NPV]) was determined in a subset (n=31) of patients that also underwent conventional DSA. The presence and extent of stenoocclusive disease on DSA images was determined on a segmental basis using a 4-point scale (1=stenosis <25%; 2=stenosis >25% to <51% 3=stenosis ≥51–99%; and 4=occlusion). Statistical analyses were performed using the Wilcoxon Signed Rank, McNemar, and Wald tests.

A total of 397 segments were evaluated by DSA. Of these 397 segments, 270 (68.0%) were determined to have stenoses of <51% while 127 (32.0%) were considered to have significant stenoses of ≥51%. Each of the 3 blinded readers reported significantly (p≤0.0017) better diagnostic performance with gadobenate dimeglumine compared to gadopentetate dimeglumine, with increases of 11.0–18.1% in sensitivity, 4.4–9.3% in specificity, and 7.8–10.1% in overall accuracy across the 3 blinded readers. Each reader also reported significantly (p≤0.0028) higher PPV and NPV with gadobenate dimeglumine, with differences ranging from 12.7–19.3% for PPV and 5.5–7.9% for NPV across the 3 readers.

In patients with suspected PAOD referred for CE-MRA, significantly better diagnostic performance is achieved with 0.1 mmol/kg bodyweight gadobenate dimeglumine than with an equivalent dose of gadopentetate dimeglumine.

Use of a higher-relaxivity contrast agent provides better diagnostic performance than an equal dose of a conventional agent gadolinium agent relative to DSA for evaluation of peripheral vessels.

Leiner, T, Miller, S, Thurner, S, Vanzulli, A, Vymazal, J, Wasser, M, Parker, J, MRA of the Peripheral Arteries: Comparison of Two Gadolinium Agents with Digital Subtraction Angiography.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012498.html