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European Radiology
Published in: European Radiology 3/2015

01-03-2015 | Breast

Intraindividual, randomized comparison of the macrocyclic contrast agents gadobutrol and gadoterate meglumine in breast magnetic resonance imaging

Authors: Eva M. Fallenberg, Diane M. Renz, Bettina Karle, Carsten Schwenke, Barbara Ingod-Heppner, Angela Reles, Florian J. Engelken, Alexander Huppertz, Bernd Hamm, Matthias Taupitz

Published in: European Radiology | Issue 3/2015

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Abstract

Objectives

To compare intraindividually two macrocyclic contrast agents - gadobutrol and gadoterate meglumine (Gd-DOTA) - for dynamic and quantitative assessment of relative enhancement (RE) in benign and malignant breast lesions.

Methods

This was an ethically approved, prospective, single-centre, randomized, crossover study in 52 women with suspected breast lesions referred for magnetic resonance imaging (MRI). Each patient underwent one examination with gadobutrol and one with Gd-DOTA (0.1 mmol/kg BW) on a 1.5 T system 1 – 7 days apart. Dynamic, T1-weighted, 3D gradient echo sequences were acquired under identical conditions. Quantitative evaluation with at least three regions of interest (ROI) per lesion was performed. Primary endpoint was RE during the initial postcontrast phase after the first and second dynamic acquisition, and peak RE. All lesions were histologically proven; differences between the examinations were evaluated.

Results

Forty-five patients with a total of 11 benign and 34 malignant lesions were assessed. Mean RE was significantly higher for gadobutrol than Gd-DOTA (p < 0.0001). Gadobutrol showed significantly less washout (64.4 %) than Gd-DOTA (75.4 %) in malignant lesions (p = 0.048)

Conclusions

Gadobutrol has higher RE values compared with Gd-DOTA, whereas Gd-DOTA shows more marked washout in malignant lesions. This might improve the detection of breast lesions and influence the specificity of breast MRI-imaging.

Key Points

• Contrast agents differ in terms of peak enhancement and postinitial contrast behaviour.
• Gadobutrol results in greater peak RE in lesions, likely due to relaxivity.
• Gd-DOTA shows more pronounced washout in postinitial contrast behaviour of malignant lesions.
• Further investigations of the differences among GD-CM may improve sensitivity and specificity.
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Metadata
Title
Intraindividual, randomized comparison of the macrocyclic contrast agents gadobutrol and gadoterate meglumine in breast magnetic resonance imaging
Authors
Eva M. Fallenberg
Diane M. Renz
Bettina Karle
Carsten Schwenke
Barbara Ingod-Heppner
Angela Reles
Florian J. Engelken
Alexander Huppertz
Bernd Hamm
Matthias Taupitz
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2015
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3426-0

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