Cardiac Magnetic Resonance Angiography using Blood-Pool Contrast Agents: Comparison of Citrate-Coated Very Small Superparamagnetic Iron Oxide Particles with Gadofosveset Trisodium in Pigs

 

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Abstract

Purpose: To compare citrate-coated very small superparamagnetic iron oxide particles (VSOP) with gadofosveset trisodium as blood pool contrast agents for cardiac magnetic resonance angiography (CMRA) in pigs.

Materials and Methods: Animal experiments were approved by the responsible authority. 10 CMRA-like examinations were performed at 1.5 T after administration of VSOP (0.06 mmol Fe/kg; 5 examinations) and gadofosveset trisodium (0.03 mmol Gd/kg; 5 examinations). The CMRA protocol included ECG-gated inversion-recovery-prepared T1-weighted gradient echo imaging (IR-GRE; one slice) and ECG-gated inversion recovery prepared steady state free precession imaging (IR SSFP; one slice) before and 1, 3, 5, 10, 15, 20, 25, 30, 40, 50, and 60 min after injection. At each time point, three different inversion times (TI; 200 msec, 300 msec, and 400 msec) were applied. Contrast-to-noise ratios (CNR) between blood and myocardium were calculated and compared using mixed linear models.

Results: No significant differences of CNR were found between IR-GRE and IR SSFP. At 3 and 5 min after contrast agent administration, VSOP showed a significantly higher CNR than gadofosveset trisodium when TI of 200 msec and 300 msec were applied (TI of 200 msec at 3 min: 8.2 ± 0.7 vs. 5.4 ± 0.7; TI of 200 msec at 5 min: 7.9 ± 0.7 vs. 3.5 ± 0.8; TI of 300 msec at 3 min: 11.7 ± 0.7 vs. 8.8 ± 0.8; TI of 300 msec at 5 min: 11.4 ± 0.7 vs. 8.0 ± 0.8; p < 0.05). Moreover, significant differences in favor of VSOP were found for all time points from 10 to 40 min irrespective of TI (p < 0.05).

Conclusion: VSOP has superior blood-pool properties compared to gadofosveset trisodium resulting in prolonged improvement of CNR on CMRA.

Zusammenfassung

Ziel: Vergleich von citratbeschichteten sehr kleinen superparamagnetischen Eisenoxidpartikeln (VSOP) mit Gadofosveset Trisodium als Blutpool-Kontrastmittel zur kontrastverstärkten Magnetresonanzangiografie des Herzens (CMRA) am Schwein.

Material und Methoden: Nach entsprechender Genehmigung des Tierexperiments wurden 10 CMRA-Untersuchungen bei 1,5 T nach Gabe von VSOP (0,06 mmol Fe/kg; 5 Untersuchungen) und Gadofosveset Trisodium (0,03 mmol Gd/kg; 5 Untersuchungen) durchgeführt. Das CMRA-Protokoll beinhaltete eine EKG-getriggerte, Inversion-Recovery-präparierte T1-gewichtete Gradientenecho-Sequenz (IR-GRE; eine Schicht) und eine EKG-getriggerte, Inversion-Recovery-präparierte Steady-State-Free-Precession-Sequenz (IR-SSFP; eine Schicht) vor und 1, 3, 5, 10, 15, 20, 25, 30, 40, 50 sowie 60 min nach Kontrastmittelgabe. Zu jedem Zeitpunkt wurden 3 verschiedene Inversionszeiten (TI; 200 ms, 300 ms und 400 ms) angewendet. Das Verhältnis von Kontrast zu Rauschen (CNR) zwischen Blut und Myokard wurde berechnet und unter Verwendung gemischter linearer Regressionsmodelle verglichen.

Ergebnisse: In Bezug auf das CNR bestand zwischen IR-GRE und IR-SSFP kein signifikanter Unterschied. 3 und 5 min nach Kontrastmittelgabe zeigte VSOP bei TI von 200 ms und 300 ms ein signifikant höheres CNR als Gadofosveset Trisodium (TI von 200 ms nach 3 Minuten: 8,2 ± 0,7 vs. 5,4 ± 0,7; TI von 200 ms nach 5 min: 7,9 ± 0,7 vs. 3,5 ± 0,8; TI von 300 ms nach 3 min: 11,7 ± 0,7 vs. 8,8 ± 0,8; TI von 300 ms nach 5 min: 11,4 ± 0,7 vs. 8,0 ± 0,8; p < 0,05). Daneben war das CNR von VSOP unabhängig von TI zu jedem Zeitpunkt zwischen 10 und 40 Minuten signifikant höher (p < 0,05).

Schlussfolgerung: Im Vergleich zu Gadofosveset Trisodium hat VSOP einen ausgeprägteren Blutpool-Effekt mit einem anhaltend höheren CNR in der CMRA.

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