Single bolus versus split dose gadolinium administration in extra-cellular volume calculation at 3 Tesla

Area of Science:

• Cardiovascular Magnetic Resonance (CMR)
• Medical Imaging
• Biomedical Engineering

Background:

• Diffuse myocardial fibrosis quantification relies on cardiovascular magnetic resonance (CMR) calculating extra-cellular volume (ECV).
• Accurate ECV calculation requires contrast agent equilibrium, often achieved with infusion or single bolus injections.
• Clinical practice commonly uses split-dose contrast for stress/rest perfusion, necessitating evaluation of its impact on ECV.

Purpose of the Study:

• To assess the effects of split-dose versus single-bolus contrast administration on ECV calculation in CMR.
• To determine the reproducibility of ECV quantification using split-dose contrast.
• To compare ECV measurements obtained with split-dose contrast to established methods.

Main Methods:

• Ten healthy volunteers and five patients underwent multiple CMR studies on a 3.0 Tesla MR system.
• Volunteers received a single bolus contrast injection in one study and split-dose injections in others.
• Patients received one bolus and one stress perfusion study; T1 maps were acquired pre- and post-contrast.

Main Results:

• ECV measurements showed good agreement between single bolus and split-dose contrast administration (r² = 0.973).
• Inter-study agreement with split-dose administration was also good (coefficient of variability 5.67%).
• ECV quantification demonstrated high reproducibility and strong correlation between methods.

Conclusions:

• Split-dose contrast administration is a reproducible method for ECV quantification in CMR.
• ECV measurements using split-dose contrast align well with validated methods.
• Clinical perfusion CMR studies can incorporate ECV assessment for tissue composition analysis.