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MR imaging of the wrist in rheumatoid arthritis using gadobenate dimeglumine
H M Bonél1, P Schneider, M D Seemann
1Institute for Clinical Radiology, Ludwig Maximilians University, Munich-Grosshadern, Munich, Germany.
Objective:
To determine the dosage of gadobenate dimeglumine (Gd-BOPTA) necessary for MRI of rheumatoid arthritis of the wrist.
Design And Patients:
Seven wrists inflamed with rheumatoid arthritis were imaged using a dedicated 0.2-T MR unit. Four cumulative dosages of 0.0125, 0.025, 0.05 and 0.1 mmol/kg body weight (BW) Gd-BOPTA were tested. Three-dimensional T1-weighted gradient-recalled echo sequences (GRE; TR: 100 ms, TE: 18 ms, flip angle 90 degrees , 4:55 min) were acquired prior to an intravenous injection and after each additional dosage of Gd-BOPTA. Relative enhancement, signal-difference-to-noise ratios (SDNRs) and the size of the inflamed tissue were quantified. Three radiologists independently evaluated the image quality, the size and the contrast of the enhancing tissue.
Results:
The readers agreed on a dose of 0.05 mmol/kg BW as satisfactory for the evaluation of the size of the inflammatory tissue and for determination of bone involvement (kappa = 0.9, P < 0.001). Highly inflammatory pannus was depicted with adequate image contrast using 0.025 mmol/kg BW Gd-BOPTA. According to the SDNR and relative enhancement findings, a dose of 0.05 mmol/kg BW suffices for both off-center and centered regions of tissue inflammation (t-test, P < 0.05).
Conclusion:
Gadolinium-BOPTA is an alternative contrast agent for MRI of rheumatoid disease. This study shows that a dose of 0.05 mmol/kg BW suffices at low field strength.
Insights
A dosage of 0.05 mmol/kg body weight (BW) of gadobenate dimeglumine (Gd-BOPTA) is sufficient for wrist MRI in rheumatoid arthritis. This dose effectively evaluates inflammatory tissue size and bone involvement, offering an alternative contrast agent for low-field MRI.
Area of Science:
- Radiology
- Rheumatology
- Medical Imaging
Background:
- Rheumatoid arthritis (RA) diagnosis and monitoring often involve Magnetic Resonance Imaging (MRI).
- Gadolinium-based contrast agents enhance visualization of inflammatory changes in RA.
- Determining optimal contrast agent dosage is crucial for accurate MRI assessment.
Purpose of the Study:
- To establish the effective dosage of gadobenate dimeglumine (Gd-BOPTA) for wrist MRI in rheumatoid arthritis.
- To assess the utility of Gd-BOPTA at low field strength (0.2-T) for evaluating RA.
Main Methods:
- Seven wrists with RA underwent MRI using a 0.2-T unit.
- Cumulative doses of Gd-BOPTA (0.0125 to 0.1 mmol/kg BW) were administered.
- T1-weighted GRE sequences were used to quantify enhancement and evaluate image quality, tissue size, and contrast.
Main Results:
- A Gd-BOPTA dose of 0.05 mmol/kg BW was deemed satisfactory for evaluating inflammatory tissue size and bone involvement.
- Adequate contrast of highly inflammatory pannus was achieved with 0.025 mmol/kg BW.
- The 0.05 mmol/kg BW dose was sufficient for both centered and off-center inflammation based on SDNR and enhancement.
Conclusions:
- Gadobenate dimeglumine (Gd-BOPTA) serves as a viable alternative contrast agent for MRI in rheumatoid disease.
- A dosage of 0.05 mmol/kg BW is adequate for wrist MRI in RA at low magnetic field strength.