title: The effect of contrast dose, imaging time, and lesion size in the MR detection of intracerebral metastasis.
abstract: OBJECTIVE
  To evaluate the effect of MR contrast dose versus delayed imaging time on the detection of metastatic brain lesions based on lesion size.
  
  
  METHODS
  Contrast MR examinations with gadoteridol were obtained in 45 patients with brain metastases. The patients were divided into two groups: 16 received cumulative standard dose (0.1 mmol/kg) and 29 received cumulative triple dose (0.3 mmol/kg). Both groups were evaluated at two dose levels (lower dose and higher dose) with two separate injections. Each patient received an initial bolus injection of either 0.05 (cumulative standard dose) or 0.1 (cumulative triple dose) mmol/kg of gadoteridol to reach the lower-dose level and underwent imaging immediately and 10 and 20 minutes later. Thirty minutes after injection, an additional bolus injection of 0.05 (cumulative standard dose) or 0.2 (cumulative triple dose) mmol/kg was administered to reach the cumulative higher-dose level (cumulative standard dose, 0.1 mmol/kg; cumulative triple dose, 0.3 mmol). Images were acquired immediately.
  
  
  RESULTS
  There was no difference in the detection rate for lesions larger than 10 mm among T2-weighted, lower-dose immediate and delayed, or immediate higher-dose images in both study groups. Lesions smaller than 10 mm had improved detection with delayed imaging in both study groups; however, the immediate higher-dose studies still had the highest detection rate.
  
  
  CONCLUSIONS
  In the evaluation of small central nervous system metastases, either delayed imaging after the injection of standard contrast dose or higher contrast dose may improve their detection, and therefore affect clinical management. Higher contrast dose (cumulative triple dose) studies appear to be more effective than delayed imaging with standard dose.
authors.affiliation: Department of Radiology, University of Iowa College of Medicine, Iowa City, USA.
authors.forename: W T
authors.initials: WT
authors.lastname: Yuh
authors.forename: E T
authors.initials: ET
authors.lastname: Tali
authors.forename: H D
authors.initials: HD
authors.lastname: Nguyen
authors.forename: T M
authors.initials: TM
authors.lastname: Simonson
authors.forename: N A
authors.initials: NA
authors.lastname: Mayr
authors.forename: D J
authors.initials: DJ
authors.lastname: Fisher
mesh_terms: D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000556:secondary*; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D005682:Gadolinium; D006571:Heterocyclic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors
chemical_list: D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C062402:gadoteridol; D005682:Gadolinium