Department of Radiology, Yale Newhaven Health System, Bridgeport Hospital, CT.
Department of Radiology, Mayo Clinic, Rochester, MN.
Medicine (Baltimore). 2022 Aug 26;101(34):e30163. doi: 10.1097/MD.0000000000030163.
Contrast-enhanced MR (CE-MR) imaging is required to improve lesion detection and characterization and to increase diagnostic confidence. This study aims to evaluate the safety, effectiveness, and usage patterns of recently introduced ClariscanTM (gadoterate meglumine) and other macrocyclic gadolinium-based contrast agents (GBCAs) used for magnetic resonance imaging (MRI) of the central nervous system (CNS). Data was obtained from a European multicenter, prospective, observational postmarketing study that included pediatric and adult patients undergoing contrast-enhanced MRI with a GBCA used in routine clinical practice. Safety data was collected by spontaneous patient adverse event (AE) reporting. Effectiveness was assessed via changes in radiological diagnosis, diagnostic confidence, and image quality. 766 patients with CNS-related indications were included from 8 centers across 5 European countries between December 2018 and November 2019. Clariscan (gadoterate meglumine) was used in 66% (503) of exams, Dotarem® (gadoterate meglumine) in 20% (160), Gadovist® (gadobutrol) in 13% (97), and ProHance® (gadoteridol) in 1%. GBCA use increased the diagnostic confidence in 95% (724/766) of patients and a change in radiological diagnosis in 65% (501/766) of patients. The Clariscan-specific data revealed an increase in diagnostic confidence in 94% (472/503) of patients and resulted in a change in radiological diagnosis in 58% (293/503) of patients. Image quality was considered excellent or good in 95% of patients across all GBCAs and in 94% of patients who received Clariscan. No AEs were reported in this cohort including Clariscan. This data demonstrates the excellent safety and efficacy profile of Clariscan and other GBCAs used in MRI examination of the CNS.
对比增强磁共振(CE-MR)成像有助于提高病变检测和特征描述的准确性,并增强诊断信心。本研究旨在评估最近推出的钆特酸葡胺(gadoterate meglumine,Clariscan)和其他大环类钆对比剂(GBCA)在中枢神经系统(CNS)磁共振成像(MRI)中的安全性、有效性和使用模式。该研究数据来自一项欧洲多中心、前瞻性、观察性上市后研究,共纳入了在常规临床实践中接受 GBCA 对比增强 MRI 检查的儿科和成年患者。安全性数据通过自发的患者不良事件(AE)报告收集。有效性通过影像学诊断、诊断信心和图像质量的变化来评估。本研究共纳入了来自欧洲 5 个国家 8 家中心的 766 名具有 CNS 相关适应证的患者,入组时间为 2018 年 12 月至 2019 年 11 月。Clariscan(gadoterate meglumine)在 66%(503/766)的检查中使用,Dotarem(gadoterate meglumine)占 20%(160),Gadovist(gadobutrol)占 13%(97),ProHance(gadoteridol)占 1%(97)。GBCA 的使用使 95%(724/766)的患者诊断信心增强,65%(501/766)的患者影像学诊断发生改变。Clariscan 特定数据显示,94%(472/503)的患者诊断信心增强,58%(293/503)的患者影像学诊断发生改变。所有 GBCA 中,95%的患者和接受 Clariscan 的 94%的患者认为图像质量为优秀或良好。该队列中未报告 Clariscan 相关的不良事件。这些数据表明,Clariscan 和其他 GBCA 在 CNS MRI 检查中具有良好的安全性和有效性。