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Published on: June 11, 2019
1 M Gd-chelate (gadobutrol) for multislice first-pass magnetic resonance myocardial perfusion imaging
M Fenchel1, A Franow, P Martirosian
1Department of Diagnostic Radiology, Eberhard-Karls-University, Tuebingen, Germany. michael.fenchel@med.uni-tuebingen.de
Insights
This study shows that 1 M gadobutrol is effective for magnetic resonance (MR) myocardial perfusion imaging in patients with suspected coronary artery disease (CAD). Gadobutrol demonstrated high sensitivity and specificity in detecting reduced blood flow, comparable to existing contrast agents.
Area of Science:
- Cardiovascular Imaging
- Radiology
- Medical Diagnostics
Background:
- Coronary artery disease (CAD) diagnosis relies on accurate myocardial perfusion assessment.
- Gadolinium-based contrast agents are crucial for Magnetic Resonance (MR) perfusion imaging.
- Evaluating novel contrast agents like gadobutrol is essential for improving diagnostic accuracy.
Purpose of the Study:
- To assess the efficacy of 1 M gadobutrol for first-pass MR myocardial perfusion imaging.
- To compare the signal properties of gadobutrol with Gd-DTPA in phantom studies.
- To determine the diagnostic performance of gadobutrol in patients with suspected CAD.
Main Methods:
- Phantom studies comparing signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of gadobutrol and Gd-DTPA.
- Dynamic rest/stress MR perfusion examinations in 25 patients with suspected CAD using 0.05 mmol/kg gadobutrol.
- Semi-quantitative analysis using myocardial perfusion reserve index (MPRI) and correlation with coronary angiography.
Main Results:
- Gadobutrol showed superior SNR/CNR compared to Gd-DTPA in phantom studies.
- MR perfusion imaging with gadobutrol achieved 82% sensitivity and 91% specificity for significant CAD.
- Per-vessel analysis combining all patient data yielded 89% sensitivity and 94% specificity.
Conclusions:
- 1 M gadobutrol exhibits favorable signal characteristics for MR myocardial perfusion.
- Rest/stress MR perfusion with gadobutrol offers high sensitivity and specificity for detecting myocardial malperfusion.
- Gadobutrol performance is comparable to established contrast agents like Gd-DTPA.
Abstract:
The aim of the study was to evaluate a 1 M gadolinium-chelate (gadobutrol) for first-pass MR myocardial perfusion examinations in patients with suspected coronary artery disease (CAD). In phantom studies, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) values of gadobutrol were compared with gadopentetate (Gd-DTPA). 25 consecutive patients with clinically suspected CAD were examined with dynamic rest/stress MR perfusion examinations using 0.05 mmol kg(-1) gadobutrol. Semi-quantitative evaluation of the myocardial perfusion was performed by calculating the myocardial perfusion reserve index (MPRI). Hypoperfused regions were correlated with data from X-ray coronary angiography. In phantom studies, SNR/CNR of gadobutrol-doped blood samples were consistently higher for all applied flip angles at concentrations < or =1.0 mmol L(-1) compared with Gd-DTPA. Assessment of 81 stress perfusion series with gadobutrol in 25 patients yielded a sensitivity of 82% and specificity of 91% for significant CAD. Combining the information from all perfusion series of one patient yielded a sensitivity of 89% and specificity of 94% on a per-vessel basis. Gadobutrol exhibited favourable signal properties in phantom studies. Rest/stress myocardial perfusion examinations using 1 M gadobutrol yielded high sensitivity and specificity in detection of malperfused areas (82% and 91%, respectively). This is comparable with recently published perfusion data using 0.5 M Gd-DTPA.
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