title: Contrast-enhanced MR angiography: does a higher relaxivity MR contrast agent permit a reduction of the dose administered for routine vascular imaging applications?
abstract: OBJECTIVE
  The authors prospectively compared single dose (0.1 mmol/kg bodyweight) gadobenate dimeglumine with double dose (0.2 mmol/kg bodyweight) gadopentetate dimeglumine for contrast-enhanced magnetic resonance angiography (CE-MRA) in patients with suspected or known steno-occlusive disease of the carotid, renal or peripheral vasculature using an intra-individual crossover study design.
  
  
  METHODS
  Twenty-eight patients with suspected or known steno-occlusive disease of the carotid (n = 16), renal (n = 5) or peripheral arteries (n = 7) were randomised to receive either 0.1 mmol/kg gadobenate dimeglumine or 0.2 mmol/kg gadopentetate dimeglumine for a first CE-MRA procedure. After 3-5 days all patients underwent a second identical CE-MRA procedure with the other contrast agent. Three blinded readers assessed images for vessel anatomical delineation, disease detection/exclusion, and global preference. Diagnostic performance for detection of ≥51 % stenosis was determined for 20/28 patients who also underwent digital subtraction angiography (DSA). Non-inferiority was assessed using the Wilcoxon signed rank, McNemar and Wald tests. Quantitative (signal-to-noise and contrast-to-noise ratio) enhancement based on 3D maximum intensity projection reconstructions was compared.
  
  
  RESULTS
  No differences were noted for any qualitative parameter. Equivalence was reported for all diagnostic preference end-points. Superiority for gadobenate dimeglumine was reported by all readers for sensitivity for disease detection (80.8-86.5 vs. 75.0-82.7 %). Quantitative enhancement was similar for single dose gadobenate dimeglumine and double dose gadopentetate dimeglumine.
  
  
  CONCLUSIONS
  Under identical examination conditions a single 0.1 mmol/kg body weight dose of gadobenate dimeglumine can fully replace a double 0.2 mmol/kg body weight dose of gadopentetate dimeglumine for routine CE-MRA procedures.
authors.affiliation: Peking University Third Hospital, 49 North Garden Road, Haidian District, 100191, Beijing, China.
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Xing
authors.forename: Xiangzhu
authors.initials: X
authors.lastname: Zeng
authors.forename: Xuan
authors.initials: X
authors.lastname: Li
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
authors.forename: Miles A
authors.initials: MA
authors.lastname: Kirchin
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Pirovano
authors.forename: Xiaoying
authors.initials: X
authors.lastname: Wang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Li
authors.forename: Roberto
authors.initials: R
authors.lastname: Iezzi
authors.forename: Francesco
authors.initials: F
authors.lastname: De Cobelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000175:diagnosis*; D003287:Contrast Media / Q000008:administration & dosage*; D018592:Cross-Over Studies; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage*; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D019786:Gadolinium DTPA