Does higher gadolinium concentration play a role in the morphologic assessment of brain tumors? Results of a multicenter intraindividual crossover comparison of gadobutrol versus gadobenate dimeglumine (the MERIT study)

Zdenek Seidl, J. Vymazal, M. Mechl, M. Goyal, M. Herman, C. Colosimo, M. Pasowicz, R. Yeung, B. Paraniak-Gieszczyk, B. Yemen, N. Anzalone, A. Citterio, G. Schneider, S. Bastianello, J. Ruscalleda

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND PURPOSE: Gadobenate dimeglumine has proved advantageous compared with other gadolinium-based contrast agents for contrast-enhanced brain MR imaging. Gadobutrol is a more highly concentrated agent (1.0 mol/L). This study intraindividually compared 0.1-mmol/kg doses of these agents for qualitative and quantitative evaluation of brain tumors. MATERIALS AND METHODS: Adult patients with suspected or known brain tumors underwent 2 identical MR imaging examinations at 1.5T, 1 with gadobenate dimeglumine and the other with gadobutrol, both at a dose of 0.1-mmol/kg body weight. The agents were injected in randomized order separated by 3-14 days. Imaging sequences and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images qualitatively for diagnostic information (lesion extent, delineation, morphology, enhancement, global preference) and quantitatively for CNR and LBR. RESULTS: One hundred fourteen of 123 enrolled patients successfully underwent both examinations. Final diagnoses were intra-axial tumors, metastases, extra-axial tumors, "other" tumors, and "nontumor" (49, 46, 8, 7, and 4 subjects, respectively). Readers 1, 2, and 3 demonstrated preference for gadobenate dimeglumine in 46 (40.7%), 54 (47.4%), and 49 (43.0%) patients, respectively, compared with 6, 7, and 7 patients for gadobutrol (P <.0001, all readers). Highly significant (P <.0001, all readers) preference for gadobenate dimeglumine was demonstrated for all other qualitative end points. Inter-reader agreement was good for all evaluations (κ = 0.414-0.629). Significantly superior CNR and LBR were determined for gadobenate dimeglumine (P <.019, all readers). CONCLUSIONS: Significantly greater morphologic information and lesion enhancement are achieved on brain MR imaging with 0.1-mmol/kg gadobenate dimeglumine compared with gadobutrol at an equivalent dose.

Original languageEnglish
Pages (from-to)1050-1058
Number of pages9
JournalAmerican Journal of Neuroradiology
Volume33
Issue number6
DOIs
Publication statusPublished - Jun 2012

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

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    Seidl, Z., Vymazal, J., Mechl, M., Goyal, M., Herman, M., Colosimo, C., Pasowicz, M., Yeung, R., Paraniak-Gieszczyk, B., Yemen, B., Anzalone, N., Citterio, A., Schneider, G., Bastianello, S., & Ruscalleda, J. (2012). Does higher gadolinium concentration play a role in the morphologic assessment of brain tumors? Results of a multicenter intraindividual crossover comparison of gadobutrol versus gadobenate dimeglumine (the MERIT study). American Journal of Neuroradiology, 33(6), 1050-1058. https://doi.org/10.3174/ajnr.A3033