title: Gadoteridol-enhanced MR imaging of malignant hepatic tumors: effects of triple versus standard doses on lesion-liver contrast.
abstract: OBJECTIVE
  The purpose of this study was to compare liver signal-to-noise ratio (SNR), lesion SNR, and lesion-liver contrast-to-noise-ratio (CNR) in patients with malignant liver lesions after the administration of a standard dose (0.1 mmol/kg of body weight) or a triple dose (0.3 mmol/kg) of a gadolinium chelate (gadoteridol). We hypothesized that the higher dose would produce a higher lesion-liver CNR and therefore increase the conspicuity of hepatic lesions.
  
  
  METHODS
  A total of 85 patients with malignant hepatic masses (61 metastases, 22 hepatocellular carcinomas, and two lymphomas) proved by histologic or follow-up studies underwent MR imaging at 1.5 T. T1-weighted spin-echo imaging and gradient-echo imaging were done before and within 1 min after (gradient echo) as well as 5 (spin echo) and 15 (spin echo) min after the injection of 0.1 or 0.3 mmol of gadoteridol per kg, randomized before the start of the study (39 patients received the standard dose, and 46 received the triple dose). The signal intensities of the liver and lesions and the SD of background noise were measured by use of regions of interest to calculate the SNR of the liver and malignant lesions and the lesion-liver CNR.
  
  
  RESULTS
  The lesion-liver CNR was increased significantly at 5 and 15 min after the administration of gadoteridol. No significant differences in the liver SNR, lesion SNR, and lesion-liver CNR (after 1 min: standard dose, -5 +/- 8, and triple dose, -4 +/- 14; after 5 min: standard dose, -1 +/- 5, and triple dose, 2 +/- 8; and after 15 min: standard dose, 1 +/- 5, and triple dose, 6 +/- 20) were found between the doses at all time points.
  
  
  CONCLUSIONS
  Triple-dose gadoteridol does not improve the lesion-liver contrast of malignant hepatic lesions over that provided by the standard dose and is not warranted for liver MR imaging.
authors.affiliation: Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
authors.forename: J
authors.initials: J
authors.lastname: Petersein
authors.forename: S
authors.initials: S
authors.lastname: Saini
authors.forename: D G
authors.initials: DG
authors.lastname: Mitchell
authors.forename: P L
authors.initials: PL
authors.lastname: Davis
authors.forename: C D
authors.initials: CD
authors.lastname: Johnson
authors.forename: J E
authors.initials: JE
authors.lastname: Kuhlman
authors.forename: Y R
authors.initials: YR
authors.lastname: Parisky
authors.forename: V M
authors.initials: VM
authors.lastname: Runge
authors.forename: J
authors.initials: J
authors.lastname: Weinreb
authors.forename: M E
authors.initials: ME
authors.lastname: Bernardino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D003287:Contrast Media / Q000008:administration & dosage*; D005682:Gadolinium; D006571:Heterocyclic Compounds / Q000008:administration & dosage; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008223:Lymphoma / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium