title: Does higher gadolinium concentration play a role in the morphologic assessment of brain tumors? Results of a multicenter intraindividual crossover comparison of gadobutrol versus gadobenate dimeglumine (the MERIT Study).
abstract: OBJECTIVE
  Gadobenate dimeglumine has proved advantageous compared with other gadolinium-based contrast agents for contrast-enhanced brain MR imaging. Gadobutrol is a more highly concentrated agent (1.0 mol/L). This study intraindividually compared 0.1-mmol/kg doses of these agents for qualitative and quantitative evaluation of brain tumors.
  
  
  METHODS
  Adult patients with suspected or known brain tumors underwent 2 identical MR imaging examinations at 1.5T, 1 with gadobenate dimeglumine and the other with gadobutrol, both at a dose of 0.1-mmol/kg body weight. The agents were injected in randomized order separated by 3-14 days. Imaging sequences and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images qualitatively for diagnostic information (lesion extent, delineation, morphology, enhancement, global preference) and quantitatively for CNR and LBR.
  
  
  RESULTS
  One hundred fourteen of 123 enrolled patients successfully underwent both examinations. Final diagnoses were intra-axial tumors, metastases, extra-axial tumors, "other" tumors, and "nontumor" (49, 46, 8, 7, and 4 subjects, respectively). Readers 1, 2, and 3 demonstrated preference for gadobenate dimeglumine in 46 (40.7%), 54 (47.4%), and 49 (43.0%) patients, respectively, compared with 6, 7, and 7 patients for gadobutrol (P < .0001, all readers). Highly significant (P < .0001, all readers) preference for gadobenate dimeglumine was demonstrated for all other qualitative end points. Inter-reader agreement was good for all evaluations (κ = 0.414-0.629). Significantly superior CNR and LBR were determined for gadobenate dimeglumine (P < .019, all readers).
  
  
  CONCLUSIONS
  Significantly greater morphologic information and lesion enhancement are achieved on brain MR imaging with 0.1-mmol/kg gadobenate dimeglumine compared with gadobutrol at an equivalent dose.
authors.affiliation: Lekarska Fakulta, Neurologicka Klinika, Prague, Czech Republic. zseid@lf1.cuni.cz
authors.forename: Z
authors.initials: Z
authors.lastname: Seidl
authors.forename: J
authors.initials: J
authors.lastname: Vymazal
authors.forename: M
authors.initials: M
authors.lastname: Mechl
authors.forename: M
authors.initials: M
authors.lastname: Goyal
authors.forename: M
authors.initials: M
authors.lastname: Herman
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
authors.forename: M
authors.initials: M
authors.lastname: Pasowicz
authors.forename: R
authors.initials: R
authors.lastname: Yeung
authors.forename: B
authors.initials: B
authors.lastname: Paraniak-Gieszczyk
authors.forename: B
authors.initials: B
authors.lastname: Yemen
authors.forename: N
authors.initials: N
authors.lastname: Anzalone
authors.forename: A
authors.initials: A
authors.lastname: Citterio
authors.forename: G
authors.initials: G
authors.lastname: Schneider
authors.forename: S
authors.initials: S
authors.lastname: Bastianello
authors.forename: J
authors.initials: J
authors.lastname: Ruscalleda
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media; D018153:Czech Republic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; C090600:gadobutrol; D008536:Meglumine