Comparison of Gd-DTPA and Gd-BOPTA for studying renal perfusion and filtration

To measure the systematic error in perfusion and filtration parameters derived from magnetic resonance (MR) renography caused by protein binding of MR contrast agents.

Eight healthy Danish Landrace pigs were examined with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). In four pigs a bolus of gadopentetate-dimeglumine (Gd-DTPA; no protein binding) was injected, followed by gadobenate-dimeglumine (Gd-BOPTA; 10% protein binding). The order was reversed in the other four pigs. A two-compartment filtration model was generalized to allow for protein binding and fitted to whole-cortex region of interest (ROI) curves. Single-kidney plasma flow and volume, tubular flow (or GFR), and tubular transit time of both agents were compared.

The data show a strong systematic underestimation (P < 0.001) in GFR by Gd-BOPTA (33 ± 7.2%), and no significant differences (P > 0.05) in plasma flow (2.2 ± 18%), plasma volume (-1.7 ± 7.8%) and tubular transit time (3.1 ± 7.2%). The order of injection had no significant effect.

Theory and experiments agree that perfusion parameters of both agents are comparable, whereas GFR is underestimated with Gd-BOPTA due to the dependence of relaxivity on protein content. Hence, GFR cannot be measured with protein-bound contrast agents, but the proposed dual-agent protocol may produce new functional indices measuring protein filtration.