Contrast agent dose effects in cerebral dynamic susceptibility contrast magnetic resonance perfusion imaging.
OBJECTIVE
To study the contrast agent dose sensitivity of hemodynamic parameters derived from brain dynamic susceptibility contrast MRI (DSC-MRI).


METHODS
Sequential DSC-MRI (1.5T gradient-echo echo-planar imaging using an echo time of 61-64 msec) was performed using contrast agent doses of 0.1 and 0.2 mmol/kg delivered at a fixed rate of 5.0 mL/second in 12 normal subjects and 12 stroke patients.


RESULTS
1) Arterial signal showed the expected doubling in relaxation response (DeltaR2*) to dose doubling. 2) The brain signal showed a less than doubled DeltaR2* response to dose doubling. 3) The 0.2 mmol/kg dose studies subtly underestimated cerebral blood volume (CBV) and cerebral blood flow (CBF) relative to the 0.1 mmol/kg studies. 4) In the range of low CBV and CBF, the 0.2 mmol/kg studies overestimated the CBV and CBF compared with the 0.1 mmol/kg studies. 5) The 0.1 mmol/kg studies reported larger ischemic volumes in stroke.


CONCLUSIONS
Subtle but statistically significant dose sensitivities were found. Therefore, it is advisable to carefully control the contrast agent dose when DSC-MRI is used in clinical trials. The study also suggests that a 0.1 mmol/kg dose is adequate for hemodynamic measurements.
Alger
Jeffry R
JR
Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA. jralger@ucla.edu
Schaewe
Timothy J
TJ
Lai
Tom C
TC
Frew
Andrew J
AJ
Vespa
Paul M
PM
Etchepare
Maria
M
Liebeskind
David S
DS
Saver
Jeffrey L
JL
Kidwell
S Chelsea
SC
D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D002545:Brain Ischemia / Q000473:pathology / Q000503:physiopathology*; D003287:Contrast Media / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D017352:Echo-Planar Imaging / Q000379:methods*; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA