Appropriate Minimal Dose of Gadobutrol for 3D Time-Resolved MRA of the Supra-Aortic Arteries: Comparison with
S H Bak1,2, H G Roh3, W-J Moon1
1From the Department of Radiology (S.H.B., H.G.R., W.-J.M., J.W.C.), Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Background And Purpose:
The development of nephrogenic systemic fibrosis and neural tissue deposition is gadolinium dose-dependent. The purpose of this study was to determine the appropriate minimal dose of gadobutrol with time-resolved MRA to assess supra-aortic arterial stenosis with contrast-enhanced MRA as a reference standard.
Materials And Methods:
Four hundred sixty-two consecutive patients underwent both standard-dose contrast-enhanced MRA and low-dose time-resolved MRA and were classified into 3 groups; group A (a constant dose of 1 mL for time-resolved MRA), group B (2 mL), or group C (3 mL). All studies were independently evaluated by 2 radiologists for image quality by using a 5-point scale (from 0 = failure to 4 = excellent), grading of arterial stenosis (0 = normal, 1 = mild [<30%], 2 = moderate [30%-69%], 3 = severe to occlusion [≥70%]), and signal-to-noise ratio.
Results:
The image quality of time-resolved MRA was similar to that of contrast-enhanced MRA in groups B and C, but it was inferior to contrast-enhanced MRA in group A. For the grading of arterial stenosis, there was an excellent correlation between contrast-enhanced MRA and time-resolved MRA (R = 0.957 for group A, R = 0.988 for group B, R = 0.991 for group C). The SNR of time-resolved MRA tended to be lower than that of contrast-enhanced MRA in groups A and B. However, SNR was higher for time-resolved MRA compared with contrast-enhanced MRA in group C.
Conclusions:
Low-dose time-resolved MRA is feasible in the evaluation of supra-aortic stenosis and could be used as an alternative to contrast-enhanced MRA for a diagnostic technique in high-risk populations.
Insights
Low-dose time-resolved MRA using gadobutrol is effective for evaluating supra-aortic arterial stenosis. This technique is a viable alternative to standard contrast-enhanced MRA, especially for high-risk patients.
Area of Science:
- Radiology
- Medical Imaging
- Cardiovascular Imaging
Background:
- Gadolinium-based contrast agents carry risks like nephrogenic systemic fibrosis.
- Gadolinium dosage is a critical factor in mitigating these risks.
Purpose of the Study:
- To determine the minimal effective dose of gadobutrol for time-resolved MRA.
- To assess supra-aortic arterial stenosis using time-resolved MRA against contrast-enhanced MRA as a reference.
Main Methods:
- 462 patients underwent standard-dose contrast-enhanced MRA and low-dose time-resolved MRA.
- Patients were divided into three groups based on gadobutrol dose (1 mL, 2 mL, or 3 mL) for time-resolved MRA.
- Image quality, stenosis grading, and signal-to-noise ratio (SNR) were evaluated by radiologists.
Main Results:
- Time-resolved MRA image quality was comparable to contrast-enhanced MRA at 2 mL and 3 mL doses.
- Excellent correlation (R=0.957-0.991) was observed in stenosis grading between the two MRA techniques.
- SNR was higher in time-resolved MRA compared to contrast-enhanced MRA at the 3 mL dose.
Conclusions:
- Low-dose time-resolved MRA is a feasible diagnostic technique for supra-aortic stenosis.
- It can serve as an alternative to contrast-enhanced MRA, particularly for patients at high risk.
- Optimized gadobutrol dosing enhances the utility of time-resolved MRA in clinical practice.
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