Dose comparison of single- vs. double-dose in contrast-enhanced magnetic resonance angiography of the carotid arteries: Intraindividual cross-over blinded trial using Gd-DTPA.
OBJECTIVE
To compare the intraindividual differences of single-dose (D(S)) and double-dose (D(D)) gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA)-enhanced magnetic resonance angiography (MRA) in the carotid arterial territory, an open-label single-center trial with blinded evaluations by two independent radiologists was undertaken.


METHODS
A total of 11 healthy volunteers were included in the study. Carotid MRAs were carried out in a 1.5 T clinical scanner using a neurovascular phased-array coil. Images were acquired with three-dimensional (3D) fast spoiled gradient recalled echo (FSPGR) sequence. Contrast agent was injected with a power injector, keeping the injection time constant for D(S) and D(D).


RESULTS
Both readers found at least 97% of vascular segments evaluable. Median overall image quality and diagnostic confidence were rated excellent and confident to very confident. No statistically significant difference between the dosage groups could be demonstrated. Variability based on a region of interest (ROI) signal intensity (SI) measurement was 7% for the D(S) and 5% for the D(D) group. SI, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were significantly higher for the D(D) group.


CONCLUSIONS
Our results demonstrate that while a double dosing of contrast agent does increase SNR, it does not lead to further improvement in visual and perceptual image quality. A single dosage of approximately 0.1 mmol/kg body weight (bw) Gd-DTPA may be the preferable dosage in the carotid arteries.
Jourdan
C
C
Department of Radiology, College of Medicine, Ohio State University, Columbus, Ohio 43210, USA.
Heverhagen
J T
JT
Knopp
M V
MV
D000328:Adult; D016477:Artifacts; D002339:Carotid Arteries / Q000033:anatomy & histology*; D003287:Contrast Media / Q000008:administration & dosage*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015588:Observer Variation; D012016:Reference Values
D003287:Contrast Media; D019786:Gadolinium DTPA