title: Prospective, randomized comparison of gadopentetate and gadobutrol to assess chronic myocardial infarction applying cardiovascular magnetic resonance.
abstract: BACKGROUND
  We hypothesized that the contrast medium gadobutrol is not inferior compared to Gd-DTPA in identifying and quantifying ischemic late gadolinium enhancement (LGE), even by using a lower dose.
  
  
  METHODS
  We prospectively enrolled 30 patients with chronic myocardial infarction as visualized by LGE during clinical routine scan at 1.5 T with 0.20 mmol/kg Gd-DTPA. Participants were randomized to either 0.15 mmol/kg gadobutrol (group A) or 0.10 mmol/kg gadobutrol (group B). CMR protocol was identical in both exams. LGE was quantified using a semiautomatic approach. Signal intensities of scar, remote myocardium, blood and air were measured. Signal to noise (SNR) and contrast to noise ratios (CNR) were calculated.
  
  
  RESULTS
  Signal intensities were not different between Gd-DTPA and gadobutrol in group A, whereas significant differences were detected in group B. SNR of injured myocardium (53.5+/-21.4 vs. 30.1+/-10.4, p = 0.0001) and CNR between injured and remote myocardium (50.3+/-20.3 vs. 27.3+/-9.3, p < 0.0001) were lower in gadobutrol. Infarct size was lower in both gadobutrol groups compared to Gd-DTPA (group A: 16.8+/-10.2 g vs. 12.8+/-6.8 g, p = 0.03; group B: 18.6+/-12.0 g vs. 14.0+/-9.9 g, p = 0.0016).
  
  
  CONCLUSIONS
  Taking application of 0.2 mmol/kg Gd-DTPA as the reference, the delineation of infarct scar was similar with 0.15 mmol/kg gadobutrol, whereas the use 0.10 mmol/kg gadobutrol led to reduced tissue contrast.
  
  
  BACKGROUND
  The study had been registered under EudraCT Number: 2010-020775-22. Registration date: 2010.08.10.
authors.affiliation: Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. a.rudolph@charite.de.|Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. a.rudolph@charite.de.
authors.forename: Andre
authors.initials: A
authors.lastname: Rudolph
authors.affiliation: Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. daniel.messroghli@charite.de.
authors.forename: Daniel
authors.initials: D
authors.lastname: Messroghli
authors.affiliation: Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. Florian.Von-Knobelsdorff@charite.de.|Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. Florian.Von-Knobelsdorff@charite.de.
authors.forename: Florian
authors.initials: F
authors.lastname: von Knobelsdorff-Brenkenhoff
authors.affiliation: Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. julius.traber@charite.de.|Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. julius.traber@charite.de.
authors.forename: Julius
authors.initials: J
authors.lastname: Traber
authors.affiliation: Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. johannes.schueler@charite.de.|Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. johannes.schueler@charite.de.
authors.forename: Johannes
authors.initials: J
authors.lastname: Schüler
authors.affiliation: Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. ralf.wassmuth@charite.de.|Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. ralf.wassmuth@charite.de.
authors.forename: Ralf
authors.initials: R
authors.lastname: Wassmuth
authors.affiliation: Working Group CMR, Experimental and Clinical Research Center, a joint cooperation between the Charité Medical Faculty and the Max-Delbrück Center for Molecular Medicine, Lindenberger Weg 80, 13125, Berlin, Germany. jeanette.schulz-menger@charite.de.|Dept. of Cardiology and Nephrology, HELIOS-Kliniken Berlin Buch, Schwanebecker Chaussee 50, 13125, Berlin, Germany. jeanette.schulz-menger@charite.de.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Schulz-Menger
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology*; D009942:Organometallic Compounds; D011446:Prospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol; D019786:Gadolinium DTPA