title: The Benefits of High Relaxivity for Brain Tumor Imaging: Results of a Multicenter Intraindividual Crossover Comparison of Gadobenate Dimeglumine with Gadoterate Meglumine (The BENEFIT Study).
abstract: OBJECTIVE
  Gadobenate dimeglumine (MultiHance) has higher r1 relaxivity than gadoterate meglumine (Dotarem) which may permit the use of lower doses for MR imaging applications. Our aim was to compare 0.1- and 0.05-mmol/kg body weight gadobenate with 0.1-mmol/kg body weight gadoterate for MR imaging assessment of brain tumors.
  
  
  METHODS
  We performed crossover, intraindividual comparison of 0.1-mmol/kg gadobenate with 0.1-mmol/kg gadoterate (Arm 1) and 0.05-mmol/kg gadobenate with 0.1-mmol/kg gadoterate (Arm 2). Adult patients with suspected or known brain tumors were randomized to Arm 1 (70 patients) or Arm 2 (107 patients) and underwent 2 identical examinations at 1.5 T. The agents were injected in randomized-sequence order, and the 2 examinations were separated by 2-14 days. MR imaging scanners, imaging sequences (T1-weighted spin-echo and T1-weighted high-resolution gradient-echo), and acquisition timing were identical for the 2 examinations. Three blinded readers evaluated images for diagnostic information (degree of definition of lesion extent, lesion border delineation, visualization of lesion internal morphology, contrast enhancement) and quantitatively for percentage lesion enhancement and lesion-to-background ratio. Safety assessments were performed.
  
  
  RESULTS
  In Arm 1, a highly significant superiority (P < .002) of 0.1-mmol/kg gadobenate was demonstrated by all readers for all end points. In Arm 2, no significant differences (P > .1) were observed for any reader and any end point, with the exception of percentage enhancement for reader 2 (P < .05) in favor of 0.05-mmol/kg gadobenate. Study agent-related adverse events were reported by 2/169 (1.2%) patients after gadobenate and by 5/175 (2.9%) patients after gadoterate.
  
  
  CONCLUSIONS
  Significantly superior morphologic information and contrast enhancement are demonstrated on brain MR imaging with 0.1-mmol/kg gadobenate compared with 0.1-mmol/kg gadoterate. No meaningful differences were recorded between 0.05-mmol/kg gadobenate and 0.1-mmol/kg gadoterate.
authors.affiliation: From the Charles University in Prague (M.V.), First Faculty of Medicine and General University Hospital, Prague, Czech Republic man.van@post.cz.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-8784-7997
authors.initials: M
authors.lastname: Vaneckova
authors.affiliation: University Hospital Olomouc (M.H.), Olomouc, Czech Republic.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-9167-3435
authors.initials: M
authors.lastname: Herman
authors.affiliation: Beth Israel Deaconess Medical Center (M.P.S.), Boston, Massachusetts.
authors.forename: M P
authors.identifier: http://orcid.org/0000-0003-0775-6516
authors.initials: MP
authors.lastname: Smith
authors.affiliation: Faculty of Medicine (M.M.), University Hospital Brno, Masaryk University, Brno, Czech Republic.
authors.forename: M
authors.identifier: http://orcid.org/0000-0002-1736-2310
authors.initials: M
authors.lastname: Mechl
authors.affiliation: MR Research Laboratory (K.R.M.), University of Washington, Seattle, Washington.
authors.forename: K R
authors.identifier: http://orcid.org/0000-0001-9188-5374
authors.initials: KR
authors.lastname: Maravilla
authors.affiliation: Na Homolce Hospital (J.W.), Prague, Czech Republic.
authors.forename: J
authors.identifier: http://orcid.org/0000-0001-5774-9651
authors.initials: J
authors.lastname: Weichet
authors.affiliation: Department of Radiology and Radiological Science (M.V.S.), Medical University of South Carolina, Charleston, South Carolina.
authors.forename: M V
authors.identifier: http://orcid.org/0000-0002-2040-1894
authors.initials: MV
authors.lastname: Spampinato
authors.affiliation: University Faculty of Medicine in Hradec Králové (J.Ž.), University Hospital Hradec Králové and Charles University in Prague, Prague, Czech Republic.
authors.forename: J
authors.identifier: http://orcid.org/0000-0002-8035-0144
authors.initials: J
authors.lastname: Žižka
authors.affiliation: Mallinckrodt Institute of Radiology (F.J.W.), Washington University School of Medicine, St. Louis, Missouri.
authors.forename: F J
authors.identifier: http://orcid.org/0000-0001-5412-8307
authors.initials: FJ
authors.lastname: Wippold
authors.affiliation: Clinical Radiologists, S.C. (J.J.B.), Springfield, Illinois.
authors.forename: J J
authors.identifier: http://orcid.org/0000-0002-4502-7851
authors.initials: JJ
authors.lastname: Baima
authors.affiliation: Good Samaritan Regional Medical Center (R.B.), Corvallis, Oregon.
authors.forename: R
authors.identifier: http://orcid.org/0000-0002-0059-6081
authors.initials: R
authors.lastname: Babbel
authors.affiliation: Institute of Diagnostic and Interventional Neuroradiology (E.B.), Hannover, Germany.
authors.forename: E
authors.identifier: http://orcid.org/0000-0003-4453-0612
authors.initials: E
authors.lastname: Bültmann
authors.affiliation: Harvard Medical School (R.Y.H.), Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: R Y
authors.identifier: http://orcid.org/0000-0001-7661-797X
authors.initials: RY
authors.lastname: Huang
authors.affiliation: University Medical Center Hamburg Eppendorf (J.-H.B.), Hamburg, Germany.
authors.forename: J-H
authors.identifier: http://orcid.org/0000-0002-8003-6446
authors.initials: JH
authors.lastname: Buhk
authors.affiliation: Hopital Gui de Chauliac (A.B.), Montpellier, France.
authors.forename: A
authors.initials: A
authors.lastname: Bonafé
authors.affiliation: Policlinico "Agostino Gemelli" (C.C.), Rome, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Colosimo
authors.affiliation: West China Hospital of Sichuan University (S.L.), Chengdu, Sichuan, China.
authors.forename: S
authors.initials: S
authors.lastname: Lui
authors.affiliation: Global Medical & Regulatory Affairs (M.A.K.), Bracco Imaging S.p.A., Milan, Italy.
authors.forename: M A
authors.identifier: http://orcid.org/0000-0001-5803-7867
authors.initials: MA
authors.lastname: Kirchin
authors.affiliation: Global Medical & Regulatory Affairs (N.S., G.P., A.S.), Bracco Diagnostics, Monroe, New Jersey.
authors.forename: N
authors.initials: N
authors.lastname: Shen
authors.affiliation: Global Medical & Regulatory Affairs (N.S., G.P., A.S.), Bracco Diagnostics, Monroe, New Jersey.
authors.forename: G
authors.initials: G
authors.lastname: Pirovano
authors.affiliation: Global Medical & Regulatory Affairs (N.S., G.P., A.S.), Bracco Diagnostics, Monroe, New Jersey.
authors.forename: A
authors.initials: A
authors.lastname: Spinazzi
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology*; D003287:Contrast Media; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives; D008875:Middle Aged; D009942:Organometallic Compounds
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; C072417:gadoterate meglumine