title: Gadolinium dose optimisation in patients with multiple sclerosis: intra- and inter-individual comparisons.
abstract: OBJECTIVE
  To assess the efficacy of single, double and triple doses of 1M gadolinium in the magnetic resonance (MR) evaluation of multiple sclerosis (MS) lesions in order to establish the best trade-off in terms of dose and number of injections.
  
  
  METHODS
  Twenty-three patients with relapsing remitting or secondary progressive MS underwent MR scans of the brain, spine or both. Signal intensity, the number of enhancing lesions and the areas of MS plaque were measured in T1-weighted images before and after single, double or triple doses of contrast medium. Wilcoxon's two-sample test and the Mann-Whitney U-test were used to evaluate the differences between the groups, and between doses in the same patient.
  
  
  RESULTS
  There was no significant difference in area signal intensity or the number of enhancing lesions between the group examined after a single injection of double-dose (DD) contrast medium and the group examined after multiple injections of a triple dose (TD). The difference in the areas of enhancement and signal intensity between a single dose (SD) and TD significantly increased after the second bolus.
  
  
  CONCLUSIONS
  Gadolinium injections in MS patients can be optimised by giving a single DD bolus, which leads to the same results as a TD administered as two boli.
authors.affiliation: Istituto di Radiologia Diagnostica e Interventistica, Università degli Studi del Piemonte Orientale A. Avogadro, Azienda Ospedaliera Maggiore della Carità, Novara, Italy. astecco@sirm.org
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stecco
authors.forename: Elena
authors.initials: E
authors.lastname: Migazzo
authors.forename: Antonio
authors.initials: A
authors.lastname: Saponaro
authors.forename: Tommaso
authors.initials: T
authors.lastname: Scarabino
authors.forename: Fabiana
authors.initials: F
authors.lastname: Tesser
authors.forename: Francesco
authors.initials: F
authors.lastname: Monaco
authors.forename: Alessandro
authors.initials: A
authors.lastname: Carriero
mesh_terms: D000328:Adult; D002648:Child; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA