title: Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality.
abstract: OBJECTIVE
  To determine whether acute transient dyspnea and/or arterial phase image degradation occurs more or less often after intravenous administration of gadoxetate disodium than with intravenous administration of gadobenate dimeglumine.
  
  
  METHODS
  Institutional review board approval and patient consent were obtained for this prospective observational study. One hundred ninety-eight gadolinium-based contrast media administrations (99 with gadoxetate disodium [10 mL, n = 97; 8 mL, n = 1; 16 mL, n = 1] and 99 with gadobenate dimeglumine [0.1 mmol per kilogram of body weight, maximum dose, 20 mL]) for hepatobiliary indications were assessed in 192 patients. Subjective patient complaints were assessed. Objective respiratory motion degradation on T1-weighted precontrast and dynamic postcontrast (arterial, venous, or late dynamic or extracellular) magnetic resonance (MR) imaging datasets were independently assessed in a randomized, blinded fashion by five readers using a five-point scale, with mean scores of 4 or greater indicating severe motion. Comparisons between agents were made by using χ(2) or Fisher exact test, where appropriate.
  
  
  RESULTS
  Significantly more patient complaints of acute transient dyspnea occurred after gadoxetate disodium administration than gadobenate dimeglumine (14% [14 of 99] vs 5% [five of 99], P = .05). There were significantly more severely degraded arterial phase data sets for gadoxetate disodium than for gadobenate dimeglumine for both the general population (17% [17 of 99] vs 2% [two of 99], P = .0007) and the subpopulation with cirrhosis (19% [14 of 72] vs 3% [one of 37], P = .02). This effect did not extend to venous (1% [one of 99] vs 2% [two of 99], P > .99 [overall population]) or late dynamic or extracellular (2% [two of 99] vs 0% [zero of 99], P = .5 [overall population]) phases. No patient required treatment for self-limited dyspnea.
  
  
  CONCLUSIONS
  Intravenous gadoxetate disodium can result in acute self-limiting dyspnea that can have a deleterious effect on arterial phase MR image quality and occurs significantly more often than with intravenous gadobenate dimeglumine.
authors.affiliation: Department of Radiology University of Michigan Health System, 1500 E Medical Center Dr, B2-A209P, Ann Arbor, MI 48109, USA. matdaven@med.umich.edu
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Davenport
authors.forename: Benjamin L
authors.initials: BL
authors.lastname: Viglianti
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Al-Hawary
authors.forename: Elaine M
authors.initials: EM
authors.lastname: Caoili
authors.forename: Ravi K
authors.initials: RK
authors.lastname: Kaza
authors.forename: Peter S C
authors.initials: PS
authors.lastname: Liu
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Maturen
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Chenevert
authors.forename: Hero K
authors.initials: HK
authors.lastname: Hussain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D016009:Chi-Square Distribution; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects*; D004417:Dyspnea / Q000139:chemically induced*; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007275:Injections, Intravenous; D008107:Liver Diseases / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA