Optimized high‐resolution contrast‐enhanced hepatobiliary imaging at 3 tesla: A cross‐over comparison of gadobenate dimeglumine and gadoxetic acid

Abstract

Purpose To evaluate the SNR and CNR performance of 0.05 mmol/kg gadoxetic acid and 0.1 mmol/kg gadobenate dimeglumine for dynamic and hepatobiliary phase imaging. In addition, flip angles (FA) that maximize relative contrast-to-noise performance for hepatobiliary phase imaging were determined. Materials and Methods A cross-over study in ten volunteers was performed using each agent. Imaging was performed at 3T with a 32-channel phased-array coil using breath-held 3D spoiled gradient echo sequences for SNR and CNR analysis, and for FA optimization of hepatobiliary phase imaging. Results Gadobenate dimeglumine (0.1 mmol/kg) had superior SNR performance during the dynamic phase, statistically significant for portal vein and hepatic vein in the portal venous and venous phase (for all, p<0.05) despite twice the approved dose of gadoxetic acid (0.05 mmol/kg), while gadoxetic acid had superior SNR performance during the hepatobiliary phase. Optimal FA’s for hepatobiliary phase imaging using gadoxetic acid and gadobenate dimeglumine were 25–30° and 25–30° for relative contrast liver vs. muscle (surrogate for non-hepatocellular tissues), and 45° and 20° (relative contrast liver vs. biliary structures), respectively. Conclusion Gadobenate dimeglumine may be preferable for applications that require dynamic phase imaging only, while gadoxetic acid may be preferable when the hepatobiliary phase is clinically important. Hepatobiliary phase imaging with both agents benefits from flip angle optimization.

Comparison of Dynamic Phase Enhancement of Hepatocellular Carcinoma Using Gadoxetate Disodium vs Gadobenate Dimeglumine

“…Hepatic vascular SNR was lower in the Gd-EOB-DTPA group despite doubling the FDAapproved dose, and it was suggested that this agent be reserved for cases in which hepatobiliary phase imaging is needed [7]. Therefore, it should not be surprising that a hypervascular lesion such as HCC should show relatively lower early dynamic enhancement with Gd-EOB-DTPA compared to Gd-BOPTA.…”

“…In comparison, Gadobenate dimeglumine (Gd-BOPTA) undergoes 78-96% renal excretion and therefore yields a lower percentage of hepatocyte enhancement in the hepatobiliary phase when compared to Gd-EOB-DTPA [7]. Page | 6…”

Intraindividual Crossover Comparison of Gadoxetic Acid Dose for Liver MRI in Normal Volunteers

“…We used muscle as a surrogate for weakly enhancing liver lesions such as hypovascular metastasis. 7,18 We used the following equations to calculate the SNR of the liver, portal vein, and muscle:…”

“…In fact, many institutions have adopted the use of higher doses, such as a fixed dose of 10 mL rather than a dose based on patient weight, as a standard in clinical MR imaging. [18][19][20] For patients weighing 50 to 100 kg, this results in effective doses of 0.025 to 0.05 mmol/kg. Considering that a dose of 0.025 mmol/kg of gadolinium is only a quarter of the conventional MR contrast agent dose, the expected risk of toxicity from dose escalation is likely to be minimal.…”

Rules, Roles, and Room for Discussion in Gadoxetic Acid-enhanced Magnetic Resonance Liver Imaging: Current Knowledge and Future Challenges

“…33 Coronal or sagittal images of good quality can be reconstructed from the isovoxel axial images with submillimeter spatial resolution. 33,34 How to shorten examination time A 20-min waiting period for the hepatocyte phase is su‹cient to obtain other sequences, so many researchers have attempted to shorten examination time by obtaining T 2 -weighted and diŠu-sion-weighted images after gadoxetic acid administration. Acquisition of T 2 -weighted images after gadoxetic acid injection has been demonstrated without compromise of image contrast.…”