title: Less is better? Intraindividual and interindividual comparison between 0.075 mmol/kg of gadobenate dimeglumine and 0.1 mmol/kg of gadoterate meglumine for cranial MRI.
abstract: OBJECTIVE
  To retrospectively compare a reduced dose (RD) (0.075 mmol/kg) of gadobenate dimeglumine (RD-gadobenate) with standard single dose (SSD) (0.1 mmol/kg) of gadoterate meglumine (SSD-gadoterate) for cranial MRI.
  
  
  METHODS
  Thirty-one patients (12 males; aged 52 ± 16 years) underwent cranial MRI with SSD-gadoterate and repeated the examination with RD-gadobenate after a median interval of 10 months. Signal-to-noise ratio (SNR) was obtained on contrast-enhanced images for enhancing lesions (n=10) as well as for right and left transverse venous sinuses, internal carotid arteries, and parotid glands. Moreover, a consecutive series of 100 cranial MRI with SSD-gadoterate (49 males; aged 51 ± 19 years) was compared with a consecutive series of 100 cranial MRI with RD-gadobenate (45 males; aged 54 ± 18 years). Two blinded neuroradiologists (R1, R2) judged contrast enhancement as sufficient, good, or optimal. Wilcoxon, Mann-Whitney, χ(2), and Cohen κ statistics were used.
  
  
  RESULTS
  At intraindividual analysis, median SNR ranged 57-88 for SSD-gadoterate and 79-99 for RD-gadobenate, the latter being systematically higher, the difference being significant for both transverse venous sinuses (p ≤ 0.011), not significant for both internal carotid arteries and both parotid glands, and enhancing lesions (p ≤ 0.101). The two series of interindividual analysis were not significantly different for gender/age (p>0.415). Contrast enhancement was optimal in 59% (R1) and 76% (R2) of patients using RD-gadobenate, in 39% (R1) and 49% (R2) of patients using SSD-gadoterate (p ≤ 0.016), with substantial reproducibility (κ ≥ 0.606).
  
  
  CONCLUSIONS
  Both analyses showed an equal or better contrast enhancement when using RD-gadobenate compared to SSD-gadoterate for routine cranial MRI. The high relaxivity of gadobenate allowed for a 25% dose reduction.
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy. Electronic address: khouri.katia@gmail.com.
authors.forename: Katia
authors.initials: K
authors.lastname: Khouri Chalouhi
authors.affiliation: Unità di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy. Electronic address: docgde@gmail.com.
authors.forename: Giacomo D E
authors.initials: GDE
authors.lastname: Papini
authors.affiliation: Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122 Milan, Italy. Electronic address: michele.bandirali@hotmail.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Bandirali
authors.affiliation: Unità di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Morandi 30, 20097 San Donato Milanese, Milano, Italy. Electronic address: io@lucasconfienza.it.
authors.forename: Luca M
authors.initials: LM
authors.lastname: Sconfienza
authors.affiliation: Unità di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy. Electronic address: gianni.dileo77@gmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Leo
authors.affiliation: Unità di Radiologia, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy; Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Morandi 30, 20097 San Donato Milanese, Milano, Italy. Electronic address: francesco.sardanelli@unimi.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; C072417:gadoterate meglumine
keywords: Brain MRI; Contrast material dose; Contrast-enhanced MRI; Gadobenate dimeglumine; Gadoterate meglumine