Value of 1.0- M gadolinium chelates: review of preclinical and clinical data on gadobutrol.
Several preclinical and clinical studies with the first commercially available highly concentrated Gd-chelate gadobutrol (1 mol/l) are reviewed. Physicochemical, pharmacological, and pharmacokinetic properties, safety analysis, as well as experimental and clinical efficacy studies are highlighted in comparison with 0.5- M Gd-chelates. The 1-mol gadobutrol has been proven to be safe in an examined dose range from 0.04 up to 0.5 mmol/kg body weight (b.w.). Even in patients with chronic renal impairment, including hemodialysis, gadobutrol can safely be applied at doses up to 0.3 mmol/kg b.w. For contrast-enhanced MRI in the equilibrium phase, efficacy data analysis shows comparable results to other commercially available extracellular Gd-chelates with lower Gd-concentrations (0.5 M). Studies focused on the potential benefit of a tighter bolus, such as brain perfusion imaging using T2*-effects, document the superiority of a highly concentrated Gd contrast agent. For contrast-enhanced MRA, clinical studies are still ongoing; therefore, the ultimate potential of a more compact bolus, using 1- M Gd-chelates, for contrast-enhanced MRI, has still to be analyzed, especially for time-resolved magnetic resonance angiography.
Tombach
Bernd
B
Department of Clinical Radiology, Westfalian Wilhelms University of Muenster, Albert-Schweitzer-Strasse 33, 48129 Münster, Germany. Tombach@uni-muenster.de
Heindel
Walter
W
D000818:Animals; D001932:Brain Neoplasms / Q000175:diagnosis; D003287:Contrast Media; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009942:Organometallic Compounds; D012449:Safety
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol