title: Contrast enhancement of central nervous system lesions: multicenter intraindividual crossover comparative study of two MR contrast agents.
abstract: OBJECTIVE
  To prospectively compare gadobenate dimeglumine with gadopentetate dimeglumine (0.1 mmol per kilogram body weight) for enhanced magnetic resonance (MR) imaging of central nervous system (CNS) lesions.
  
  
  METHODS
  This study was HIPAA-compliant at U.S. centers and was conducted at all centers according to the Good Clinical Practice standard. Institutional review board and regulatory approval were granted; written informed consent was obtained. Seventy-nine men and 78 women (mean age, 50.5 years +/- 14.4 [standard deviation]) were randomized to group A (n = 78) or B (n = 79). Patients underwent two temporally separated 1.5-T MR imaging examinations. In randomized order, gadobenate followed by gadopentetate was administered in group A; order of administration was reversed in group B. Contrast agent administration (volume, speed of injection), imaging parameters before and after injection, and time between injections and postinjection acquisitions were identical for both examinations. Three blinded neuroradiologists evaluated images by using objective image interpretation criteria for diagnostic information end points (lesion border delineation, definition of disease extent, visualization of internal morphologic features of the lesion, enhancement of the lesion) and quantitative parameters (percentage of lesion enhancement, contrast-to-noise ratio [CNR]). Overall diagnostic preference in terms of lesion conspicuity, detectability, and diagnostic confidence was assessed. Between-group comparisons were performed with Wilcoxon signed rank test.
  
  
  RESULTS
  Readers 1, 2, and 3 demonstrated overall preference for gadobenate in 75, 89, and 103 patients, compared with that for gadopentetate in seven, 10, and six patients, respectively (P < .0001). Significant (P < .0001) preference for gadobenate was demonstrated for diagnostic information end points, percentage of lesion enhancement, and CNR. Superiority of gadobenate was significant (P < .001) in patients with intraaxial and extraaxial lesions.
  
  
  CONCLUSIONS
  Gadobenate compared with gadopentetate at an equivalent dose provides significantly better enhancement and diagnostic information for CNS MR imaging.
authors.affiliation: Neuroradiology and MR Research Laboratory, University of Washington, Box 357115, 1959 NE Pacific St, Seattle, WA 98195, USA. kmarav@u.washington.edu
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Maravilla
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Maldjian
authors.forename: Ilona M
authors.initials: IM
authors.lastname: Schmalfuss
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Kuhn
authors.forename: Brian C
authors.initials: BC
authors.lastname: Bowen
authors.forename: Franz J
authors.initials: FJ
authors.lastname: Wippold
authors.forename: Val M
authors.initials: VM
authors.lastname: Runge
authors.forename: Michael V
authors.initials: MV
authors.lastname: Knopp
authors.forename: Stephane
authors.initials: S
authors.lastname: Kremer
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Wolansky
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Anzalone
authors.forename: Marco
authors.initials: M
authors.lastname: Essig
authors.forename: Lars
authors.initials: L
authors.lastname: Gustafsson
mesh_terms: D002493:Central Nervous System Diseases / Q000175:diagnosis*; D003287:Contrast Media; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA