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前列腺动态对比增强磁共振成像:钆特酸葡甲胺与钆布醇的个体内比较。

Dynamic contrast-enhanced MR imaging of the prostate: intraindividual comparison of gadoterate meglumine and gadobutrol.

机构信息

Department of Radiology, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.

Department of Radiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.

出版信息

Eur Radiol. 2019 Dec;29(12):6982-6990. doi: 10.1007/s00330-019-06321-6. Epub 2019 Jul 1.

Abstract

OBJECTIVES

To intraindividually compare the signal-enhancing effect of 0.5 M gadoterate meglumine and 1.0 M gadobutrol in dynamic contrast-enhanced magnetic resonance (DCE-MR) imaging of the prostate.

METHODS

Fifty patients who underwent two 3-T MR examinations of the prostate were included in this IRB-approved retrospective uncontrolled, unrandomized study. All received two scans (mean time interval, 20.5 months) including T1-weighted DCE-MR imaging, one with 0.5 M gadoterate meglumine and one with 1.0 M gadobutrol. Equimolar doses of gadolinium (0.1 mmol/kg body weight) were administered with identical injection speed (2 mL/s), resulting in differing gadolinium delivery rate. An identical region of interest (ROI) within a BPH-node was identified on both scans. The area under the time-enhancement curve of each ROI from 0 to 180 s post contrast arrival and pharmacokinetic parameters were calculated. Relative enhancement and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios in the delayed phase at about 180 s were compared between both agents.

RESULTS

There was a significantly larger area under the time-enhancement curve (5.53 vs 4.97 p = 0.0007) and higher relative enhancement of BPH nodules (2.23 vs 1.96 p < 0.0001) with gadobutrol compared with gadoterate meglumine. There were no significant differences in SNR (44.55 vs 37.63 p = 0.12), CNR (31.22 vs 26.39 p = 0.18), and pharmacokinetic parameters Ktrans (0.31 vs 0.32 p = 0.86), Ve (1.36 vs 0.98 p = 0.13), and Kep (0.34 vs 0.36 p = 0.12).

CONCLUSIONS

At equimolar doses, increased gadolinium delivery over time using gadobutrol provides higher relative enhancement parameters in BPH nodules compared with gadoterate meglumine, but does not translate into improved SNR or CNR.

KEY POINTS

• At equal injection rate and equimolar total dose, gadobutrol compared with gadoterate meglumine provides a significantly greater relative enhancement in DCE-MR imaging of BPH over the first 180 s. • There are no significant differences in SNRs, CNRs, and pharmacokinetic parameters between the two GBCAs.

摘要

目的

在前列腺的动态对比增强磁共振成像(DCE-MR)中,对个体内 0.5 M 钆特酸葡甲胺和 1.0 M 钆布醇的信号增强效果进行比较。

方法

本研究为经机构审查委员会批准的回顾性、非对照、非随机研究,共纳入 50 例在 3T 磁共振检查中接受两次前列腺检查的患者。所有患者均接受两次扫描(平均时间间隔为 20.5 个月),包括 T1 加权 DCE-MR 成像,一次使用 0.5 M 钆特酸葡甲胺,一次使用 1.0 M 钆布醇。以相同的注射速度(2 mL/s)给予等摩尔剂量的钆(0.1 mmol/kg 体重),导致钆输送率不同。在两次扫描中,均在 BPH 结节内识别出相同的感兴趣区域(ROI)。计算每个 ROI 从对比到达后 0 至 180 秒的时间增强曲线下面积和药代动力学参数。比较两种药物在约 180 秒时的延迟期的相对增强、信噪比(SNR)和对比噪声比(CNR)比值。

结果

与钆特酸葡甲胺相比,使用钆布醇的前列腺结节的时间增强曲线下面积(5.53 比 4.97,p=0.0007)和相对增强更高(2.23 比 1.96,p<0.0001)。SNR(44.55 比 37.63,p=0.12)、CNR(31.22 比 26.39,p=0.18)、药代动力学参数 Ktrans(0.31 比 0.32,p=0.86)、Ve(1.36 比 0.98,p=0.13)和 Kep(0.34 比 0.36,p=0.12)无显著差异。

结论

在等摩尔剂量下,使用钆布醇随着时间的推移增加钆的输送量,与钆特酸葡甲胺相比,在 BPH 结节中提供更高的相对增强参数,但不会转化为 SNR 或 CNR 的改善。

关键点

  • 在相等的注射速率和等摩尔总剂量下,与钆特酸葡甲胺相比,钆布醇在前列腺的 DCE-MR 成像中,在最初的 180 秒内提供了显著更大的相对增强。

  • 两种 GBCA 之间的 SNR、CNR 和药代动力学参数没有显著差异。

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