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  • 1
    Keywords: brain ; tumor ; AGENTS ; evaluation ; FOLLOW-UP ; IMAGES ; imaging ; INFORMATION ; VISUALIZATION ; DISEASE ; TUMORS ; SURGERY ; TIME ; PATIENT ; QUALITY ; CONTRAST ; INTERVENTION ; CONTRAST AGENT ; MR ; magnetic resonance ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; ACID ; PERFORMANCE ; ECHO ; DIFFERENCE ; METASTASIS ; statistics ; metastases ; PARAMETERS ; CENTRAL-NERVOUS-SYSTEM ; CONTRAST AGENTS ; DOUBLE-BLIND ; GADODIAMIDE INJECTION ; GD-DTPA ; MR imaging ; MANAGEMENT ; AGENT ; brain tumor ; BRAIN-TUMORS ; END ; GLIOMA ; MALIGNANT GLIOMA ; ENHANCEMENT ; MAGNEVIST GD-DTPA ; INTERVAL ; methods ; surgical planning ; USA ; EXTENT ; E ; AGREEMENT ; SERUM-PROTEINS ; comparison ; POINT ; quantitative ; RESONANCE ; KAPPA ; TESLA ; CONTRAST-MEDIA ; HUMAN CEREBRAL GLIOMAS ; neuroradiology
    Abstract: Object. The goal in this article was to compare 0.1 mmol/kg doses of gadobenate dimeglumine (Gd-BOPTA) and gadopentetate dimeglumine, also known as gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), for enhanced magnetic resonance (MR) imaging of intraaxial brain tumors. Methods. Eighty-four patients with either intraaxial glioma (47 patients) or metastasis (37 patients) underwent two MR imaging examinations at 1.5 tesla, one with Gd-BOPTA as the contrast agent and the other with Gd-DTPA. The interval between fully randomized contrast medium administrations was 2 to 7 days. The T-1-weighted spin echo and T-1-weighted fast spin echo images were acquired before administration of contrast agents and T-1-weighted spin echo images were obtained after the agents were administered. Acquisition parameters and postinjection acquisition times were identical for the two examinations in each patient. Three experienced readers working in a fully blinded fashion independently evaluated all images for degree and quality of available information (lesion contrast enhancement, lesion border delineation, definition of disease extent, visualization of the lesion's internal structures, global diagnostic preference) and quantitative enhancement (that is, the extent of lesion enhancement after contrast agent administration compared with that seen before its administration [hereafter referred to as percent enhancement], lesion/brain ratio, and contrast/noise ratio). Differences were tested with the Wilcoxon signed-rank test. Reader agreement was assessed using kappa statistics. Significantly better diagnostic information/imaging performance (p 〈 0.0001, all readers) was obtained with Gd-BOPTA for all visualization end points. Global preference for images obtained with Gd-BOPTA was expressed for 42 (50%), 52 (61.9%), and 56 (156.7%) of 84 patients (readers 1, 2, and 3, respectively) compared with images obtained with Gd-DTPA contrast in four (4.8%), six (7.1%), and three (3.6%) of 84 patients. Similar differences were noted for all other visualization end points. Significantly greater quantitative contrast enhancement (p 〈 0.04) was noted after administration of Gd-BOPTA. Reader agreement was good (K 〉 0.4). Conclusions. Lesion visualization, delineation, definition, and contrast enhancement are significantly better after administration of 0.1 mmol/kg Gd-BOPTA, potentially allowing better surgical planning and follow up and improved disease management
    Type of Publication: Journal article published
    PubMed ID: 17432704
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  • 2
    Keywords: brain ; tumor ; evaluation ; Germany ; imaging ; TUMORS ; TIME ; PATIENT ; primary ; BODY-WEIGHT ; CONTRAST ; INJECTION ; MR ; ACQUISITION ; EFFICACY ; metastases ; PARAMETERS ; STATISTICAL-ANALYSIS ; MORPHOLOGY ; SAFETY ; CENTRAL-NERVOUS-SYSTEM ; CONTRAST AGENTS ; DOUBLE-BLIND ; GADOBENATE-DIMEGLUMINE ; GADODIAMIDE INJECTION ; GADOPENTETATE DIMEGLUMINE ; INTRACRANIAL METASTASES ; gadobenate dimeglumine ; MR imaging ; VASCULARIZATION ; GLIOMAS ; ENHANCED MRI ; brain neoplasms,MR,gadolinium,magnetic resonance (MR),contrast media ; HIGH-DOSE GADOTERIDOL ; MAGNEVIST GD-DTPA
    Abstract: PURPOSE: To evaluate the safety of and compare the enhancement characteristics of gadobenate dimeglumine (MultiHance; Bracco Imaging, Milan, Italy) with those of a standard gadolinium chelate (gadopentetate dimeglumine, Magnevist; Schering, Berlin, Germany) in primary and secondary brain tumors on the basis of qualitative and quantitative parameters, on an intraindiviual basis.MATERIALS AND METHODS: Twenty-seven patients with either high-grade glioma or metastases were enrolled in a bicentric intraindividual crossover study to compare lesion enhancement with doses of 0.1 mmol per kilogram of body weight of 0.5 mol/L gadopentetate dimeglumine and 0.5 mol/L gadobenate dimeglumine. MR imaging was performed before injection (T1-weighted spin-echo [SE] and T2-weighted fast SE acquisitions) and at 1, 3, 5, 7, 9, and 16 minutes after injection (T1-weighted SE acquisitions). Qualitative assessment was performed by blinded off-site readers (for 22 patients) and on-site investigators (for 24 patients) in terms of global contrast enhancement, lesion-to-brain contrast, lesion delineation, internal lesion morphology and structure, tumor vascularization, and global image preference. Additional quantitative assessment with region-of-interest analysis was performed by off-site readers alone. Statistical analysis of qualitative data was performed with the Wilcoxon signed rank test, whereas a nonparametric approach was adopted for analysis of quantitative data.RESULTS: Significant (P 〈 .05) preference for gadobenate dimeglumine over gadopentetate dimeglumine was noted both off-site and on-site for the global assessment of contrast enhancement. For off-site readers I and 2 and the on-site investigators, respectively, gadobenate dimeglumine was preferred in 13, 17, and 16 patients; gadopentetate dimeglumine was preferred in four, four, and four patients; and equality was found in five, one, and four patients). Similar preference for gadobenate dimeglumine was noted by off-site readers and on-site investigators for lesion-to-brain contrast and all other qualitative parameters. Off-site quantitative evaluation revealed significantly (P 〈 .05) superior enhancement for gadobenate dimeglumine compared with that for gadopentetate dimeglumine at all time points from 3 minutes after injection.CONCLUSION: Significantly superior contrast enhancement of intraaxial enhancing brain tumors was achieved with 0.1 mmol/kg gadobenate dimeglumine compared with that with 0.1 mmol/kg gadopentetate dimeglumine. (C) RSNA, 2004
    Type of Publication: Journal article published
    PubMed ID: 14695387
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  • 3
    Keywords: AGENTS ; IMAGES ; imaging ; INFORMATION ; SYSTEM ; VOLUME ; DISEASE ; TIME ; PATIENT ; CONTRAST ; CONTRAST AGENT ; MR ; MAGNETIC-RESONANCE ; NERVOUS-SYSTEM ; LESIONS ; AGE ; WOMEN ; MEN ; PARAMETERS ; CENTRAL-NERVOUS-SYSTEM ; CONTRAST AGENTS ; DOUBLE-BLIND ; GADODIAMIDE INJECTION ; GADOPENTETATE DIMEGLUMINE ; gadobenate dimeglumine ; BODY ; brain metastases ; MULTICENTER ; MULTIPLE-SCLEROSIS ; MR imaging ; FEATURES ; RE ; WEIGHT ; MAGNEVIST GD-DTPA ; EXTENT ; CEREBRAL METASTASES ; DOSE GADOPENTETATE DIMEGLUMINE ; GADOLINIUM-DTPA ; INTRACRANIAL TUMORS
    Abstract: Purpose: To prospectively compare gadobenate dimeglumine with gadopentetate dimeglumine (0.1 mmol per kilogram body weight) for enhanced magnetic resonance (MR) imaging of central nervous system (CNS) lesions. Materials and Methods: This study was HIPAA-compliant at U. S. centers and was conducted at all centers according to the Good Clinical Practice standard. Institutional review board and regulatory approval were granted; written informed consent was obtained. Seventy-nine men and 78 women (mean age, 50.5 years +/- 14.4 [ standard deviation]) were randomized to group A (n = 78) or B (n = 79). Patients underwent two temporally separated 1.5-T MR imaging examinations. In randomized order, gadobenate followed by gadopentetate was administered in group A; order of administration was reversed in group B. Contrast agent administration (volume, speed of injection), imaging parameters before and after injection, and time between injections and postinjection acquisitions were identical for both examinations. Three blinded neuroradiologists evaluated images by using objective image interpretation criteria for diagnostic information end points (lesion border delineation, definition of disease extent, visualization of internal morphologic features of the lesion, enhancement of the lesion) and quantitative parameters (percentage of lesion enhancement, contrast-to-noise ratio [CNR]). Overall diagnostic preference in terms of lesion conspicuity, detectability, and diagnostic confidence was assessed. Between-group comparisons were performed with Wilcoxon signed rank test. Results: Readers 1, 2, and 3 demonstrated overall preference for gadobenate in 75, 89, and 103 patients, compared with that for gadopentetate in seven, 10, and six patients, respectively (P 〈 .0001). Significant (P 〈 .0001) preference for gadobenate was demonstrated for diagnostic information end points, percentage of lesion enhancement, and CNR. Superiority of gadobenate was significant (P 〈 .001) in patients with intraaxial and extraaxial lesions. Conclusion: Gadobenate compared with gadopentetate at an equivalent dose provides significantly better enhancement and diagnostic information for CNS MR imaging. (c) RSNA, 2006
    Type of Publication: Journal article published
    PubMed ID: 16801373
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