title: Brain metastases--comparison of gadodiamide injection-enhanced MR imaging at standard and high dose, contrast-enhanced CT and non-contrast-enhanced MR imaging.
abstract: The aim was to compare the abilities of contrast-enhanced CT, non-contrast-enhanced MR imaging and contrast-enhanced MR imaging using standard (0.1 mmol/kg b.w.) and high (0.3 mmol/kg b.w.) doses of Gadodiamide injection to detect brain metastases (i.e. blood-brain barrier damage). Sixteen patients with at least 2 metastases found by CT were evaluated by MR imaging using non-contrast-enhanced spin-echo, T1-weighted, T2-weighted sequences, and contrast-enhanced spin-echo T1-weighted sequences at 2 dose levels. Gadodiamide injection was first given at the dose of 0.1 mmol/kg b.w. After imaging, another 0.2 mmol/kg b.w. was given, yielding a cumulative dose of 0.3 mmol/kg b.w. No contrast media-related adverse events were recorded. The images were evaluated openly by one and blindly by 2 investigators and the number of metastases, size, delineation (open study) and diagnostic certainty (blind study) of each individual metastasis noted. High-dose MR imaging showed significantly more and smaller metastases than any other examination, and gave a higher diagnostic certainty. All high-dose images were superior to those with the standard dose MR imaging when compared blindly in pairs. We conclude that spin-echo MR imaging with a high dose of Gadodiamide injection is an efficient way to improve the detection of brain metastases, in particular of small ones.
authors.affiliation: Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Akeson
authors.forename: E M
authors.initials: EM
authors.lastname: Larsson
authors.forename: D T
authors.initials: DT
authors.lastname: Kristoffersen
authors.forename: E
authors.initials: E
authors.lastname: Jonsson
authors.forename: S
authors.initials: S
authors.lastname: Holtås
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage / Q000009:adverse effects; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015588:Observer Variation; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010146:Pain / Q000209:etiology; D004369:Pentetic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D011856:Radiographic Image Enhancement; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; C064925:gadodiamide; D005682:Gadolinium; D019786:Gadolinium DTPA