title: Multicenter, intraindividual comparison of single-dose gadobenate dimeglumine and double-dose gadopentetate dimeglumine for MR angiography of the supra-aortic arteries (the Supra-Aortic VALUE study).
abstract: OBJECTIVE
  Gadobenate dimeglumine has markedly higher R1 relaxivity compared to gadopentetate dimeglumine meaning that lower doses can be used to achieve similar contrast enhancement. Our aim was to prospectively compare single-dose gadobenate dimeglumine with double-dose gadopentetate dimeglumine for contrast-enhanced MRA of the supra-aortic vasculature.
  
  
  METHODS
  Forty-six patients (37 men, 9 women; mean age, 63.5±10.1 years) with known or suspected steno-occlusive disease of the supra-aortic vessels underwent 2 identical CE-MRA examinations at 1.5T. Contrast agents were administered in randomized order, with the 2-fold greater volume of gadopentetate dimeglumine injected at a 2 times faster rate. Image assessment was performed by 3 independent blinded readers for vessel anatomic delineation, detection/exclusion of pathology, and global preference. Diagnostic performance (sensitivity, specificity, accuracy, PPV, and NPV) for detection of ≥60% stenosis was determined for 39/46 patients who underwent preinterventional DSA. Data were analyzed by using the Wilcoxon signed-rank, McNemar, and Wald tests in terms of the noninferiority of single-dose gadobenate dimeglumine compared with double-dose gadopentetate dimeglumine. Quantitative enhancement (signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)) was also compared.
  
  
  RESULTS
  All images were technically adequate. No differences (P=1.0) were noted by any reader for any qualitative parameter. All readers considered single-dose gadobenate dimeglumine and double-dose gadopentetate dimeglumine equivalent in at least 42/46 patients (91.3% three-reader agreement) for all parameters. Nonsignificant superiority for gadobenate dimeglumine was reported for all diagnostic performance indicators (sensitivity: 82.7%-88.5% versus 75.0%-80.8%; specificity: 96.4%-98.6% versus 94.6%-98.6%; accuracy: 94.6%-96.1% versus 92.4%-94.9%; PPV: 81.5%-91.5% versus 73.7%-90.7%; NPV: 96.8%-97.8% versus 95.4%-96.4%). No differences (P>.05) in quantitative enhancement were noted.
  
  
  CONCLUSIONS
  The image quality and diagnostic performance achieved with 0.1-mmol/kg gadobenate dimeglumine is at least equivalent to that achieved with 0.2-mmol/kg gadopentetate dimeglumine.
authors.affiliation: Department of Radiology, Shanghai Changhai Hospital, and Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Yanjun
authors.initials: Y
authors.lastname: Li
authors.forename: X
authors.initials: X
authors.lastname: Li
authors.forename: D
authors.initials: D
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Lu
authors.forename: X
authors.initials: X
authors.lastname: Xing
authors.forename: F
authors.initials: F
authors.lastname: Yan
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: X
authors.initials: X
authors.lastname: Wang
authors.forename: R
authors.initials: R
authors.lastname: Iezzi
authors.forename: F
authors.initials: F
authors.lastname: De Cobelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000473:pathology*; D002536:Cerebral Arteries / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects; D018592:Cross-Over Studies; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008875:Middle Aged; D008954:Models, Biological; D018482:Muscle, Skeletal; D015588:Observer Variation; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D059629:Signal-To-Noise Ratio
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA