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Macrocyclic contrast agents for magnetic resonance imaging of chronic myocardial infarction: intraindividual comparison of gadobutrol and gadoterate meglumine

  • Cardiac
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Abstract

Objectives

To compare 0.15 mmol/kg gadobutrol for late gadolinium enhancement (LGE) imaging of chronic myocardial infarction with a relaxivity-adjusted dose of gadoterate meglumine (Gd-DOTA).

Methods

Seventeen patients with suspected chronic myocardial infarction underwent LGE imaging at 1.5 T, acquiring an inversion-recovery-prepared gradient echo sequence 15 min after contrast agent administration. Each patient underwent LGE imaging twice, once after administration of 0.15 mmol/kg gadobutrol (r1 = 5.2 l mmol-1 s-1) and after 0.22 mmol/kg Gd-DOTA (r1 = 3.6 l mmol-1 s-1). Two readers independently determined infarct size and contrast-to-noise ratios of infarcted myocardium to remote myocardium (CNRremote) and to the left ventricular lumen (CNRlumen).

Results

LGE was present in 14 patients. Infarct sizes determined after administration of gadobutrol [23.4 ml; 95 % CI (14.4; 32.5)] and Gd-DOTA [22.1 ml; 95 % CI (13.0; 31.1)] were not statistically different (P = 0.22). The CNRremote of LGE in infarcted myocardium on gadobutrol- and Gd-DOTA-enhanced images was 44.1 [95 % CI (31.0; 57.1)] and 45.2 [95 % CI (32.2; 58.3)], respectively (P = 0.73). CNRlumen was significantly higher on gadobutrol-enhanced LGE images [12.7; 95 % CI (2.5; 23.0) versus 6.8; 95 % CI (-3.5; 17.0); P = 0.02].

Conclusion

At relaxivity-adjusted doses, gadobutrol and Gd-DOTA yielded similar infarct sizes with superior contrast between infarcted myocardium and left ventricular lumen on gadobutrol-enhanced images.

Key points

• Contrast-enhanced magnetic resonance imaging is increasingly used to assess the myocardium

• Macrocyclic Gd-based contrast agents are considered to be safer than linear agents

• Myocardial infarction MRI can be performed using either gadobutrol or gadoterate meglumine

• Contrast between infarcted myocardium and the left ventricular lumen was greater using gadobutrol

• The minimum macrocyclic dose needed for reliable LGE imaging requires further evaluation

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Authors and Affiliations

  1. Department of Radiology, Charité–Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany

    Moritz Wagner, Rene Schilling, Patrick Doeblin, Alexander Huppertz, Reny Luhur, Martin Maurer, Bernd Hamm, Matthias Taupitz & Tahir Durmus

  2. Imaging Science Institute Charité, Berlin, Germany

    Alexander Huppertz

  3. SCO:SSiS Statistical Consulting, Berlin, Germany

    Carsten Schwenke

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  1. Moritz Wagner
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  2. Rene Schilling
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Correspondence to Moritz Wagner.

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Wagner, M., Schilling, R., Doeblin, P. et al. Macrocyclic contrast agents for magnetic resonance imaging of chronic myocardial infarction: intraindividual comparison of gadobutrol and gadoterate meglumine. Eur Radiol 23, 108–114 (2013). https://doi.org/10.1007/s00330-012-2563-6

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  • DOI: https://doi.org/10.1007/s00330-012-2563-6

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