From the Guerbet Research and Innovation, Guerbet, Roissy CdG, France (G.H., M.W., P.R.); INRAE, CNRS, Université de Tours, PRC, 37380, Nouzilly, France (H.A.); INRAE, Université de Tours, CHU de Tours, PIXANIM, 37380, Nouzilly, France (H.A.); Siemens Healthineers, Courbevoie-La Défense, France (L.A.); and Hôpital Guillaume et René Laennec, Department of Cardiovascular Radiology, Unité d'Imagerie Cardiaque et Vasculaire Diagnostique, Institut du Thorax-Clinique Cardiologique, Nantes, France (J.-M.S.).
Invest Radiol. 2024 Sep 1;59(9):614-621. doi: 10.1097/RLI.0000000000001083. Epub 2024 May 7.
Unexpected accumulations of gadolinium in various organs were reported after the administration of gadolinium-based contrast agents, making desirable to reduce the dose while maintaining equivalent diagnostic performance. The aim of this study was to evaluate the contrast enhancement performance of high relaxivity gadopiclenol compared with gadoterate meglumine in abdominal contrast-enhanced magnetic resonance angiography (CE-MRA).
In a first study in healthy rabbits, axial 3D gradient echo sequences were applied at 4.7 T to study arterial enhancement as a function of gadopiclenol dose (0.025, 0.05, 0.075, and 0.1 mmol Gd/kg) or gadoterate meglumine at 0.1 mmol Gd/kg (n = 5-6/group). The increase in signal-to-noise ratio (ΔSNR) in the aorta at the first pass was measured and compared. In a second, crossover study in 6 healthy pigs, abdominal CE-MRA sequences were acquired at 3 T with gadopiclenol at 0.05 mmol Gd/kg or gadoterate meglumine at 0.1 mmol Gd/kg at a 1-week interval. Quantitatively on the maximum intensity projection (MIP) images, the mean MIP SNR within the aorta of both groups was compared. Qualitatively, a blinded comparison of the angiograms was performed by an experienced radiologist to determine the preferred contrast agent.
In the rabbit, ∆SNR is linearly correlated with the gadopiclenol dose ( P = 0.0010). Compared with gadoterate meglumine 0.1 mmol Gd/kg, an increase in the ∆SNR is observed after 0.05, 0.075, and 0.1 mmol Gd/kg of gadopiclenol (+63% P = 0.0731, +78% P = 0.0081, and +72% P = 0.0773, respectively), whereas at 0.025 mmol Gd/kg, ∆SNR is in the same range as with gadoterate meglumine 0.1 mmol Gd/kg (+15% P > 0.9999). In pigs, contrast enhancement after gadopiclenol at 0.05 mmol/kg is +22% superior to MIP SNR after gadoterate meglumine at 0.1 mmol Gd/kg ( P = 0.3095). Qualitatively, a preference was shown for gadopiclenol images (3/6) over the gadoterate meglumine examinations (1/6), with no preference being shown for the remainder (2/6).
First-pass CE-MRA is feasible with gadopiclenol at 0.05 mmol Gd/kg with at least the same arterial signal enhancement and image quality as gadoterate meglumine at 0.1 mmol Gd/kg.
在给予钆基造影剂后,各种器官中出现了意外的钆蓄积,因此需要在保持等效诊断性能的同时减少剂量。本研究的目的是评估高弛豫率钆喷替酸葡甲胺与钆特酸葡胺在腹部对比增强磁共振血管造影(CE-MRA)中的对比增强性能。
在一项针对健康兔的初步研究中,在 4.7T 下应用轴向 3D 梯度回波序列,研究了钆喷替酸葡甲胺剂量(0.025、0.05、0.075 和 0.1mmol Gd/kg)或 0.1mmol Gd/kg 钆特酸葡胺对动脉增强的影响(n=5-6/组)。测量并比较了主动脉首过信号强度与噪声比(ΔSNR)的增加。在 6 头健康猪的第二项交叉研究中,在 3T 下使用 0.05mmol Gd/kg 的钆喷替酸葡甲胺或 0.1mmol Gd/kg 的钆特酸葡胺进行腹部 CE-MRA 序列采集,间隔 1 周。在最大强度投影(MIP)图像上定量比较两组主动脉内的平均 MIP SNR。对血管造影图像进行了经验丰富的放射科医生的盲法比较,以确定首选造影剂。
在兔中,ΔSNR 与钆喷替酸葡甲胺剂量呈线性相关(P=0.0010)。与 0.1mmol Gd/kg 钆特酸葡胺相比,在给予 0.05、0.075 和 0.1mmol Gd/kg 钆喷替酸葡甲胺后,ΔSNR 分别增加了+63%(P=0.0731)、+78%(P=0.0081)和+72%(P=0.0773),而在 0.025mmol Gd/kg 时,ΔSNR 与 0.1mmol Gd/kg 钆特酸葡胺相似(+15%P>0.9999)。在猪中,给予 0.05mmol Gd/kg 的钆喷替酸葡甲胺后的对比增强比给予 0.1mmol Gd/kg 的钆特酸葡胺后的 MIP SNR 高+22%(P=0.3095)。定性分析显示,3/6 例患者对钆喷替酸葡甲胺图像有偏好,而 1/6 例患者对钆特酸葡胺检查有偏好,其余 2/6 例患者无偏好。
以 0.05mmol Gd/kg 的剂量进行单次通过 CE-MRA 是可行的,其动脉信号增强和图像质量至少与 0.1mmol Gd/kg 的钆特酸葡胺相同。