title: Contrast-enhanced MR imaging of brain lesions: a large-scale intraindividual crossover comparison of gadobenate dimeglumine versus gadodiamide.
abstract: OBJECTIVE
  The higher relaxivity of gadobenate dimeglumine compared with gadodiamide is potentially advantageous for contrast-enhanced brain MR imaging. This study intraindividually compared 0.1-mmol/kg doses of these agents for qualitative and quantitative lesion enhancement.
  
  
  METHODS
  Adult patients with suggested or known brain lesions underwent 2 identical MR imaging examinations at 1.5T, one with gadobenate dimeglumine and the other with gadodiamide. The agents were administered in randomized order separated by 3-14 days. Imaging sequences and postinjection acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images qualitatively for diagnostic information (lesion extent, delineation, morphology, enhancement, and global preference) and quantitatively for contrast-to-noise ratio (CNR).
  
  
  RESULTS
  One hundred thirteen of 138 enrolled patients successfully underwent both examinations. Final diagnoses were intra-axial tumor, metastasis, extra-axial tumor, or other (47, 27, 18, and 21 subjects, respectively). Readers 1, 2, and 3 demonstrated global preference for gadobenate dimeglumine in 63 (55.8%), 77 (68.1%), and 73 (64.6%) patients, respectively, compared with 3, 2, and 3 patients for gadodiamide (P < .0001, all readers). Highly significant (P < .0001, all readers) preference for gadobenate dimeglumine was demonstrated for all qualitative end points and for CNR (increases of 23.3%-34.7% and 42.4%-48.9% [spin-echo and gradient-refocused echo sequences, respectively] for gadobenate dimeglumine compared with gadodiamide). Inter-reader agreement was good for all evaluations (kappa = 0.47-0.69). Significant preference for gadobenate dimeglumine was demonstrated for all lesion subgroup analyses.
  
  
  CONCLUSIONS
  Significantly greater diagnostic information and lesion enhancement are achieved on brain MR imaging with 0.1-mmol/kg gadobenate dimeglumine compared with gadodiamide at an equivalent dose.
authors.affiliation: Department of Radiology, University of Wisconsin, Madison, WI 53792-3252, USA. hrowley@uwhealth.org
authors.forename: H A
authors.initials: HA
authors.lastname: Rowley
authors.forename: G
authors.initials: G
authors.lastname: Scialfa
authors.forename: P-y
authors.initials: PY
authors.lastname: Gao
authors.forename: J A
authors.initials: JA
authors.lastname: Maldjian
authors.forename: D
authors.initials: D
authors.lastname: Hassell
authors.forename: M J
authors.initials: MJ
authors.lastname: Kuhn
authors.forename: F J
authors.initials: FJ
authors.lastname: Wippold
authors.forename: M
authors.initials: M
authors.lastname: Gallucci
authors.forename: B C
authors.initials: BC
authors.lastname: Bowen
authors.forename: I M
authors.initials: IM
authors.lastname: Schmalfuss
authors.forename: J
authors.initials: J
authors.lastname: Ruscalleda
authors.forename: S
authors.initials: S
authors.lastname: Bastianello
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000556:secondary; D003287:Contrast Media; D018592:Cross-Over Studies; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; C064925:gadodiamide; D019786:Gadolinium DTPA