<b>Gadobenate Dimeglumine-Enhanced MRI of the Breast:</b>Analysis of Dose Response and Comparison with Gadopentetate Dimeglumine

Knopp, Michael V.; Bourne, Michael W.; Sardanelli, Francesco; Wasser, Martin; Bonomo, Lorenzo; Boetes, C.; Müller-Schimpfle, Markus; Hall-Craggs, M. A.; Hamm, Bernd; Orlacchio, Antonio; Bartolozzi, Carlo; Keßler, M.; Fischer, Uwe; Schneider, Günther; Oudkerk, Matthijs; Teh, William; Gehl, H; Salerio, Isabella; Pirovano, Gianpaolo; Noce, A. La; Kirchin, Miles A.; Spinazzi, Alberto

doi:10.2214/ajr.181.3.1810663

Cited by 67 publications

(62 citation statements)

References 40 publications

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“…Secondly, due to the rapidly evolving developments of MRI technology, further reductions in equipment costs are likely to result in lower equipment costs per screening examination. Thirdly, there are likely to be cost reductions with regard to the contrast medium: a lower dose (0.1 mmol kg À1 body weight) of Gd-DTPA has been shown to be similarly effective (Knopp et al, 2003) compared to 0.2 mmol kg À1 used in our study and in addition, the expected availability of a generic formulation. Further cost reductions can be expected due to the increasing experience of radiologists with this new technique, resulting in a reduction of recalled cases as shown in a recent report ).…”

Section: Discussionmentioning

confidence: 85%

“…Improved CE MRI protocols for routine clinical practice will require less time for the MRI examination and subsequent analysis than dictated by the research protocol, which was designed to collect additional information to determine which features of a range of potential measurements provided the most sensitive and specific assessment of breast cancer (Brown et al, 2000b). Other cost reducing factors in routine practice are lower MRI equipment costs (compared with the highly specified systems purchased by research centres), more experienced radiologists working in breast CE MRI and the possible introduction of generic formulations of Gd-DTPA coupled with potential lower dose than o0.2 mmol per kg (Knopp et al, 2003). We therefore estimated alternative unit cost based on the following assumptions:…”

Section: Unit Costmentioning

confidence: 99%

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Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer

et al. 2006

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Contrast enhanced magnetic resonance imaging (CE MRI) is the most sensitive tool for screening women who are at high familial risk of breast cancer. Our aim in this study was to assess the cost-effectiveness of X-ray mammography (XRM), CE MRI or both strategies combined. In total, 649 women were enrolled in the MARIBS study and screened with both CE MRI and mammography resulting in 1881 screens and 1 -7 individual annual screening events. Women aged 35 -49 years at high risk of breast cancer, either because they have a strong family history of breast cancer or are tested carriers of a BRCA1, BRCA2 or TP53 mutation or are at a 50% risk of having inherited such a mutation, were recruited from 22 centres and offered annual MRI and XRM for between 2 and 7 years. Information on the number and type of further investigations was collected and specifically calculated unit costs were used to calculate the incremental cost per cancer detected. The numbers of cancer detected was 13 for mammography, 27 for CE MRI and 33 for mammography and CE MRI combined. In the subgroup of BRCA1 (BRCA2) mutation carriers or of women having a first degree relative with a mutation in BRCA1 (BRCA2) corresponding numbers were 3 (6), 12 (7) and 12 (11), respectively. For all women, the incremental cost per cancer detected with CE MRI and mammography combined was d28 284 compared to mammography. When only BRCA1 or the BRCA2 groups were considered, this cost would be reduced to d11 731 (CE MRI vs mammography) and d15 302 (CE MRI and mammography vs mammography). Results were most sensitive to the unit cost estimate for a CE MRI screening test. Contrast-enhanced MRI might be a cost-effective screening modality for women at high risk, particularly for the BRCA1 and BRCA2 subgroups. Further work is needed to assess the impact of screening on mortality and health-related quality of life.

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Section: Discussionmentioning

confidence: 85%

Section: Unit Costmentioning

confidence: 99%

Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer

et al. 2006

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“…We excluded lesions that were smaller than 0.7 cm (7), cystic lesions (4), lesions for which we did not obtain pathology (11), and one lesion because the patient moved during the exam. Two of the seven lesions that were smaller than 0.7 cm were malignant at pathology and demonstrated a high signal on DWI.…”

Section: Resultsmentioning

confidence: 99%

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Rubesova

Grell

Maertelaer

et al. 2006

Magnetic Resonance Imaging

230

199

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Purpose: To study the correlation between apparent diffusion coefficient (ADC) and pathology in patients with undefined breast lesion, to validate how accurately ADC is related to histology, and to define a threshold value of ADC to distinguish malignant from benign lesions. Materials and Methods:Seventy-eight patients (110 lesions) were referred for positive or dubious findings. Threedimensional fast low-angle shot (3D-FLASH) with contrast injection was applied. EPI diffusion-weighted imaging (DWI) with fat saturation was performed, and ROIs were selected on subtraction 3D-FLASH images before and after contrast injection, and copied on an ADC map. Inter-and intraobserver analyses were performed.Results: At pathology 22 lesions were benign, 65 were malignant, and 23 were excluded. The ADCs of malignant and benign lesions were statistically different. In malignant tumors the ADC was (mean Ϯ SEM) 0.95 Ϯ 0.027 ϫ 10 -3mm 2 /second, and in benign tumors it was 1.51 Ϯ 0.068 ϫ 10 -3 mm 2 /second. According to receiver operating characteristic (ROC) curves, we found a threshold between malignant and benign lesions for highest sensitivity and specificity (both 86%) around 1.13 Ϯ 0.10 ϫ 10 -3 mm 2 /second. For a threshold of 0.95 Ϯ 0.10 ϫ 10 -3 mm 2 /second, specificity was 100% but sensitivity was very low. Inter-and intraobserver studies showed good reproducibility. Conclusion:The ADC may help to differentiate benign and malignant lesions with good specificity, and may increase the overall specificity of breast MRI.

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“…No significant differences were observed between the two contrast agents in terms of lesion detection, Breast Imaging-Reporting and Data System assessment or lesion enhancement and morphology and the authors concluded that gadobutrol is non-inferior to gadobenate dimeglumine for breast cancer staging. 33 However, unlike the comparisons of gadobenate dimeglumine and gadopentetate dimeglumine [22][23][24][25][26] this study was open to criticism in terms of the patient inclusion criteria and the manner in which the study end-points were selected and analyzed. …”

Section: Unique Features Of Gadobenate Dimeglumine For Breast Mrimentioning

confidence: 99%

“…[22][23][24][25][26] An early study to establish the optimal dose of gadobenate dimeglumine to use for breast MRI established that 0.1 mmol/kg of bodyweight is superior to doses of 0.05 and 0.2 mmol/kg of bodyweight in terms of lesion detection in women with known or suspected breast cancer. 22 Furthermore, 0.1 mmol/kg gadobenate dimeglumine was also shown to be significantly superior to an equivalent dose of gadopentetate dimeglumine, not only in terms of malignant lesion detection but also for quantitative contrast enhancement and sensitivity for lesion characterization, meaning that detected lesions were easier to see and classify. Importantly, fewer false positive determinations were made with 0.1 mmol/kg gadobenate dimeglumine than with 0.1 mmol/kg gadopentetate dimeglumine.…”

Section: Gadobenate Dimeglumine (Multihance) In Breast Mrimentioning

confidence: 99%

Clinical utility of gadobenate dimeglumine in contrast-enhanced MRI of the breast: a review

Luciani¹,

Telesca²,

Kirchin³

et al. 2015

RRNM

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Breast magnetic resonance imaging (MRI) is considered the technique with the highest sensitivity for breast cancer detection. Gadobenate dimeglumine is a gadolinium-based contrast agent (GBCA) that is specifically approved in Europe for breast MRI and which has the highest r1 relaxivity among all GBCAs for this indication. In order to improve the diagnostic performance of breast MRI, several intra-individual crossover studies have evaluated gadobenate dimeglumine as a possible GBCA for this application. This review focuses on the role and advantages of gadobenate dimeglumine as a contrast agent for breast MRI by describing the unique properties of this agent and by summarizing published studies.

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Gadobenate Dimeglumine-Enhanced MRI of the Breast:Analysis of Dose Response and Comparison with Gadopentetate Dimeglumine

Cited by 67 publications

References 40 publications

Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer

Cost-effectiveness of screening with contrast enhanced magnetic resonance imaging vs X-ray mammography of women at a high familial risk of breast cancer

Quantitative diffusion imaging in breast cancer: A clinical prospective study

Clinical utility of gadobenate dimeglumine in contrast-enhanced MRI of the breast: a review

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