Josep Puig Alcantara MD, Presenter: Nothing to Disclose

Gerard Blasco RT, Abstract Co-Author: Nothing to Disclose

Josep Daunis-i-Estadella, Abstract Co-Author: Nothing to Disclose

Marco Essig MD, Abstract Co-Author: Consultant, Bayer AG Consultant, Bracco Group

Karsten Bergmann, Abstract Co-Author: Employee, Bayer AG

Gemma Laguillo MD, Abstract Co-Author: Nothing to Disclose

Ana Maria Quiles, Abstract Co-Author: Nothing to Disclose

Sebastian Remollo MD, Abstract Co-Author: Nothing to Disclose

Roser Garcia-Armengol, Abstract Co-Author: Nothing to Disclose

Salvador Pedraza MD, Abstract Co-Author: Research Consultant, H. Lundbeck A/S

Gadofosveset, a blood-pool agent, has a longer intravascular half-life and higher relaxivity than extracellular contrast agents (ECM), so it is potentially advantageous for MRI. We compared the qualitative and quantitative enhancement with gadobutrol, an ECM, versus gadofosveset within individual patients with glioblastoma.

On a 1.5T scanner we acquired anatomic T1-weighted spin-echo (SE), T2-weighted fast SE, FLAIR images,  and T1-weighted SE images 5 min after gadobutrol (0.1 mmol/kg) injection, and 48h later, T1-weighted SE images with identical imaging parameters 1 min, 3h, 6h, and 24h after gadofosveset (0.03 mmol/kg) injection. Two blinded readers evaluated images qualitatively for enhancement, lesion extent, delineation, morphology, multifocality, and global preference and quantitatively for signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and tumor contrast enhancement (CE) using region of interest analysis.

We enrolled 28 consecutive patients (10 women; age, 64±13y) with histologically proven glioblastoma. Readers had global preference for gadofosveset at 6h in 20 (71.3%) patients (p<0.005) with excellent agreement (kappa≥0.80). Multifocality was seen in 6 (21.4%) cases, and gadofosveset at 6h detected more additional lesions (p<0.005). A highly significant preference for gadobutrol was found for all qualitative endpoints (p<0.0001, all readers) and for CNR and CE compared with gadofosveset at 5 min (137.8±72.4 vs 90.6±40.9; p=0.028 and 172.5±129.6 vs 89.1±35.3; p=0.017, respectively). Overall, the highest SNR and CNR values were found 6h after gadofosveset injection (p<0.005). The highest CE was seen with gadobutrol (172.5±129.6) followed by gadofosveset at 6 hours (152.3±66.3) (p=0.001).

Gadobutrol gives significant tumor enhancement in early postcontrast imaging. However, significantly greater diagnostic information and lesion enhancement are achieved with gadofosveset at 6h.

The protein-binding contrast agent gadofosveset is feasible for diagnostic quality contrast-enhanced MRI in glioblastoma and may improve patient management.

Puig Alcantara, J, Blasco, G, Daunis-i-Estadella, J, Essig, M, Bergmann, K, Laguillo, G, Quiles, A, Remollo, S, Garcia-Armengol, R, Pedraza, S, Comparison of Gadobutrol vs Gadofosveset for Contrast-enhanced MRI in Glioblastoma: Initial Experience.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11014959.html