title: Lesion detection and assessment of extrahepatic findings in abdominal MRI using hepatocyte specific contrast agents--comparison of Gd-EOB-DTPA and Gd-BOPTA.
abstract: BACKGROUND
  To evaluate the contrast agent performance of Gd-EOB-DTPA and Gd-BOPTA for detection and assessment of extrahepatic findings, semi-quantitatively and qualitatively.
  
  
  METHODS
  13 patients with 19 extrahepatic lesions underwent liver MRI with Gd-EOB-DTPA and Gd-BOPTA. Quantitative and relative SNR measurements were performed in each dataset in the arterial and portalvenous phase within the extrahepatic lesion, aorta, inferior vena cava, portal vein, spleen, pancreas and renal cortex. Further, relative CNR measurements were performed. Three readers assessed contrast quality using a five-point scale and choosing the preferred image dataset. Statistical analysis consisted of a Student's t-test with p < 0.05 deemed significant, a weighted kappa statistic for assessment of interobserver variability and an ROC analysis.
  
  
  RESULTS
  Mean SNR after injection of Gd-BOPTA was significantly higher compared with Gd-EOB-DTPA for all measurements (p < 0.05). Mean relative SNR was also higher for Gd-BOPTA, but without being statistically significant. There was no significant difference in relative CNR. Interobserver agreement for selection of image preference was moderate (mean weighted kappa 0.485). The area under the curve for the ROC-analysis regarding contrast agent performance was 0.464.
  
  
  CONCLUSIONS
  Even though mean SNR is significantly higher after injection of Gd-BOPTA compared with Gd-EOB-DTPA, there is no significant difference in relative CNR with extrahepatic lesions being assessed equally well. Visual impression may differ after injection of Gd-EOB-DTPA, but does not influence image interpretation. Extrahepatic findings can be assessed similarly to MRI after injection of Gd-BOPTA.
authors.affiliation: Department of Diagnostic and Interventional Radiology, Hannover Medical School, Carl-Neuberg Str. 1, 30625 Hannover, Germany. ringe.kristina@mh-hannover.de
authors.forename: Kristina I
authors.initials: KI
authors.lastname: Ringe
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Boll
authors.forename: Daniela B
authors.initials: DB
authors.lastname: Husarik
authors.forename: Mustafa R
authors.initials: MR
authors.lastname: Bashir
authors.forename: Rajan T
authors.initials: RT
authors.lastname: Gupta
authors.forename: Elmar M
authors.initials: EM
authors.lastname: Merkle
mesh_terms: D000005:Abdomen / Q000473:pathology; D000008:Abdominal Neoplasms / Q000473:pathology*; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D022781:Hepatocytes / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C073590:gadolinium ethoxybenzyl DTPA; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA