title: Part 2 - Coronary angiography with gadofosveset trisodium: a prospective intra-subject comparison for dose optimization for 100 % efficiency imaging.
abstract: BACKGROUND
  Three tesla (3T) coronary magnetic resonance angiography (MRA) may be optimized using gadolinium-based contrast agents (GBCA) such as gadofosveset trisodium. The goal of this study was to evaluate if there is a qualitative or quantitative improvement in the coronary arteries with variation in contrast dose.
  
  
  METHODS
  Twenty-eight healthy volunteers were prospectively recruited for coronary MRA at 3T using a steady state injection technique for 3D radial whole-heart image acquisition with retrospective respiratory self-gating (ClinicalTrials.gov identifier: NCT01853592). Nineteen volunteers completed both single- and double-dose imaging instances (0.03 and 0.06 mmol/kg, respectively). Intra-individual comparison of image quality was assessed by measurement of apparent signal/contrast-to-noise ratio (aSNR/aCNR) and subjective evaluation of image quality by 2 independent reviewers.
  
  
  RESULTS
  The average duration of coronary MRA acquisition was 7.2 ± 1.2 min. There was significantly higher (60 %, p < 0.001) aSNR of the aorta and right/left ventricle for the double dose compared to single dose injection scheme and aSNR of the coronary arteries increased by 70 % (p < 0.001) for the double dose injection. aCNR increased by +55 % and +60 % in the ventricles and coronary arteries, respectively (p < 0.001). Overall segmental artery visualization for single dose was possible 47 % of the time, which improved to 60 % with double dose (p = 0.019), predominantly driven by improvements in more distal segment visualization (+40 % improvement in mid arterial segments, p = 0.013).
  
  
  CONCLUSIONS
  Gadofosveset trisodium dose of 0.06 mmol/kg significantly quantitatively and qualitatively improves the coronary artery image quality compared to 0.03 mmol/kg at 3T for moderate duration (6-8 min) steady state contrast enhanced coronary MRA.
authors.affiliation: National Institutes of Health, Radiology and Imaging Sciences, Clinical Center, 10 Center Drive, Building 10, Rm B1N264B.7, Bethesda, MD, 20892, USA. mark.ahlman@gmail.com.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Ahlman
authors.affiliation: National Institutes of Health, Radiology and Imaging Sciences, Clinical Center, 10 Center Drive, Building 10, Rm B1N264B.7, Bethesda, MD, 20892, USA.|Medical Scientist Training Program, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Fabio S
authors.initials: FS
authors.lastname: Raman
authors.affiliation: Bioengineering, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Jianing
authors.initials: J
authors.lastname: Pang
authors.affiliation: William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Barts & The London School of Medicine & Dentistry, London, UK.
authors.forename: Filip
authors.initials: F
authors.lastname: Zemrak
authors.affiliation: National Institutes of Health, Radiology and Imaging Sciences, Clinical Center, 10 Center Drive, Building 10, Rm B1N264B.7, Bethesda, MD, 20892, USA.
authors.forename: Veit
authors.initials: V
authors.lastname: Sandfort
authors.affiliation: Department of Pharmacotherapy, University of North Texas, Fort Worth, Texas, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Penzak
authors.affiliation: Bioengineering, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Zhaoyang
authors.initials: Z
authors.lastname: Fan
authors.affiliation: National Institutes of Health, Radiology and Imaging Sciences, Clinical Center, 10 Center Drive, Building 10, Rm B1N264B.7, Bethesda, MD, 20892, USA.
authors.forename: Songtao
authors.initials: S
authors.lastname: Liu
authors.affiliation: Bioengineering, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Debiao
authors.initials: D
authors.lastname: Li
authors.affiliation: National Institutes of Health, Radiology and Imaging Sciences, Clinical Center, 10 Center Drive, Building 10, Rm B1N264B.7, Bethesda, MD, 20892, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D017023:Coronary Angiography / Q000379:methods*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage* / Q000009:adverse effects; D064368:Healthy Volunteers; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000009:adverse effects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D059629:Signal-To-Noise Ratio; D013997:Time Factors; D055815:Young Adult
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D005682:Gadolinium; C109932:gadofosveset trisodium
keywords: 3.0 Tesla; Gadofosveset trisodium; Gadolinium-based intravascular contrast agent; Image quality; MS-325; Navigator-based angiography; Respiratory motion correction; Whole-heart coronary magnetic resonance angiography