MRA of the Supraaortic Vasculature: Comparison of Gadobutrol and Gadoterate Meglumine at 1.5 T

John W. Cerne; Ashitha Pathrose; Alyssa M. Singer; Jackson E. Moore; Ali Serhal; Pascale Aouad; Muhammad Umair; Ann Ragin; Bradley D. Allen; Ryan Avery; Michael Markl; James C. Carr

doi:10.1002/jmri.28044

MRA of the Supraaortic Vasculature: Comparison of Gadobutrol and Gadoterate Meglumine at 1.5 T

John W. Cerne^*, Ashitha Pathrose, Alyssa M. Singer, Jackson E. Moore, Ali Serhal, Pascale Aouad, Muhammad Umair, Ann Ragin, Bradley D. Allen, Ryan Avery, Michael Markl, James C. Carr

^*Corresponding author for this work

Radiology

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Gadobutrol (GB) and gadoterate meglumine (GM) are contrast agents used for contrast-enhanced magnetic resonance angiography (CEMRA). Supraaortic vasculature (SAV) CEMRAs are used to evaluate stroke risk and neurologic symptoms. There is a need to compare the SAV CEMRA image quality obtained with GB and GM. Purpose: To intra-individually compare MRA images obtained with equimolar GB and GM at 1.5 T in the SAV. Study Type: Prospective, crossover. Population: Twenty-eight subjects (54 ± 13 years; 17 female). Field Strength/Sequence: 1.5 T; three-dimensional (3D) gradient recalled echo. Assessment: Quantitative image quality was measured by normalized signal intensity (SI_n) [SI_n = SI blood/SD blood] and contrast ratio (CR) [CR = SI blood/SI muscle], determined by an observer (JWC) with 1 year of vascular imaging experience. Three radiologists (AS, PA, and MU) with (5, 5, and 6 years of) vascular imaging experience evaluated image quality by Likert-scale ratings (of image impression, wall conspicuity, and artifact absence). Statistical Tests: SI_n and CR were compared with paired t-tests or Wilcoxon signed-rank tests and Bland–Altman plots. Qualitative ratings were compared with Wilcoxon signed-rank test. Results: No significant difference in SI_n was found between GB and GM. CRs with GB were significantly higher than GM at the right common carotid (6.9 ± 2.5 vs. 4.8 ± 1), left internal carotid (7.3 ± 2 vs. 4.4 ± 1.2), right internal carotid (7.7 ± 2.2 vs. 5 ± 1.1), and left vertebral (6.6 ± 2.2 vs. 4.5 ± 1.1) arteries. Bland–Altman plots showed relatively greater differences between GB and GM at higher CRs and SI_ns. GM showed significantly higher artifact than GB (3.56 ± 0.52 vs. 3.36 ± 0.46) and significantly lower overall image quality (10.73 ± 1.45 vs. 11.26 ± 1.58) at the left vertebral artery. Data Conclusion: At 1.5 T and equimolar demonstration, GB (0.1 mL/kg, i.e., 0.1 mmol/kg) showed higher CRs in the SAV compared to GM (0.2 mL/kg, i.e., 0.1 mmol/kg) at most vessels. Subjective image quality was not significantly different between the two agents for most vessels. Level of Evidence: 2. Technical Efficacy: Stage 2.

Original language	English (US)
Pages (from-to)	440-449
Number of pages	10
Journal	Journal of Magnetic Resonance Imaging
Volume	56
Issue number	2
DOIs	https://doi.org/10.1002/jmri.28044
State	Published - Aug 2022

Funding

This study was funded by Guerbet. All funding was directed towards implementation of the research study and the research protocol execution. The funding body played no role in the study design, data collection, data analysis, or manuscript writing. The funding body reviewed the final manuscript from an editorial perspective.

Keywords

gadobutrol
gadoterate meglumine
supraaortic vasculature

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/jmri.28044

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@article{75545cd66dca4780a9dce934dcef7a49,

title = "MRA of the Supraaortic Vasculature: Comparison of Gadobutrol and Gadoterate Meglumine at 1.5 T",

abstract = "Background: Gadobutrol (GB) and gadoterate meglumine (GM) are contrast agents used for contrast-enhanced magnetic resonance angiography (CEMRA). Supraaortic vasculature (SAV) CEMRAs are used to evaluate stroke risk and neurologic symptoms. There is a need to compare the SAV CEMRA image quality obtained with GB and GM. Purpose: To intra-individually compare MRA images obtained with equimolar GB and GM at 1.5 T in the SAV. Study Type: Prospective, crossover. Population: Twenty-eight subjects (54 ± 13 years; 17 female). Field Strength/Sequence: 1.5 T; three-dimensional (3D) gradient recalled echo. Assessment: Quantitative image quality was measured by normalized signal intensity (SIn) [SIn = SI blood/SD blood] and contrast ratio (CR) [CR = SI blood/SI muscle], determined by an observer (JWC) with 1 year of vascular imaging experience. Three radiologists (AS, PA, and MU) with (5, 5, and 6 years of) vascular imaging experience evaluated image quality by Likert-scale ratings (of image impression, wall conspicuity, and artifact absence). Statistical Tests: SIn and CR were compared with paired t-tests or Wilcoxon signed-rank tests and Bland–Altman plots. Qualitative ratings were compared with Wilcoxon signed-rank test. Results: No significant difference in SIn was found between GB and GM. CRs with GB were significantly higher than GM at the right common carotid (6.9 ± 2.5 vs. 4.8 ± 1), left internal carotid (7.3 ± 2 vs. 4.4 ± 1.2), right internal carotid (7.7 ± 2.2 vs. 5 ± 1.1), and left vertebral (6.6 ± 2.2 vs. 4.5 ± 1.1) arteries. Bland–Altman plots showed relatively greater differences between GB and GM at higher CRs and SIns. GM showed significantly higher artifact than GB (3.56 ± 0.52 vs. 3.36 ± 0.46) and significantly lower overall image quality (10.73 ± 1.45 vs. 11.26 ± 1.58) at the left vertebral artery. Data Conclusion: At 1.5 T and equimolar demonstration, GB (0.1 mL/kg, i.e., 0.1 mmol/kg) showed higher CRs in the SAV compared to GM (0.2 mL/kg, i.e., 0.1 mmol/kg) at most vessels. Subjective image quality was not significantly different between the two agents for most vessels. Level of Evidence: 2. Technical Efficacy: Stage 2.",

keywords = "gadobutrol, gadoterate meglumine, supraaortic vasculature",

author = "Cerne, {John W.} and Ashitha Pathrose and Singer, {Alyssa M.} and Moore, {Jackson E.} and Ali Serhal and Pascale Aouad and Muhammad Umair and Ann Ragin and Allen, {Bradley D.} and Ryan Avery and Michael Markl and Carr, {James C.}",

note = "Publisher Copyright: {\textcopyright} 2021 International Society for Magnetic Resonance in Medicine.",

year = "2022",

month = aug,

doi = "10.1002/jmri.28044",

language = "English (US)",

volume = "56",

pages = "440--449",

journal = "Journal of Magnetic Resonance Imaging",

issn = "1053-1807",

publisher = "John Wiley and Sons Inc.",

number = "2",

}

TY - JOUR

T1 - MRA of the Supraaortic Vasculature

T2 - Comparison of Gadobutrol and Gadoterate Meglumine at 1.5 T

AU - Cerne, John W.

AU - Pathrose, Ashitha

AU - Singer, Alyssa M.

AU - Moore, Jackson E.

AU - Serhal, Ali

AU - Aouad, Pascale

AU - Umair, Muhammad

AU - Ragin, Ann

AU - Allen, Bradley D.

AU - Avery, Ryan

AU - Markl, Michael

AU - Carr, James C.

PY - 2022/8

Y1 - 2022/8

N2 - Background: Gadobutrol (GB) and gadoterate meglumine (GM) are contrast agents used for contrast-enhanced magnetic resonance angiography (CEMRA). Supraaortic vasculature (SAV) CEMRAs are used to evaluate stroke risk and neurologic symptoms. There is a need to compare the SAV CEMRA image quality obtained with GB and GM. Purpose: To intra-individually compare MRA images obtained with equimolar GB and GM at 1.5 T in the SAV. Study Type: Prospective, crossover. Population: Twenty-eight subjects (54 ± 13 years; 17 female). Field Strength/Sequence: 1.5 T; three-dimensional (3D) gradient recalled echo. Assessment: Quantitative image quality was measured by normalized signal intensity (SIn) [SIn = SI blood/SD blood] and contrast ratio (CR) [CR = SI blood/SI muscle], determined by an observer (JWC) with 1 year of vascular imaging experience. Three radiologists (AS, PA, and MU) with (5, 5, and 6 years of) vascular imaging experience evaluated image quality by Likert-scale ratings (of image impression, wall conspicuity, and artifact absence). Statistical Tests: SIn and CR were compared with paired t-tests or Wilcoxon signed-rank tests and Bland–Altman plots. Qualitative ratings were compared with Wilcoxon signed-rank test. Results: No significant difference in SIn was found between GB and GM. CRs with GB were significantly higher than GM at the right common carotid (6.9 ± 2.5 vs. 4.8 ± 1), left internal carotid (7.3 ± 2 vs. 4.4 ± 1.2), right internal carotid (7.7 ± 2.2 vs. 5 ± 1.1), and left vertebral (6.6 ± 2.2 vs. 4.5 ± 1.1) arteries. Bland–Altman plots showed relatively greater differences between GB and GM at higher CRs and SIns. GM showed significantly higher artifact than GB (3.56 ± 0.52 vs. 3.36 ± 0.46) and significantly lower overall image quality (10.73 ± 1.45 vs. 11.26 ± 1.58) at the left vertebral artery. Data Conclusion: At 1.5 T and equimolar demonstration, GB (0.1 mL/kg, i.e., 0.1 mmol/kg) showed higher CRs in the SAV compared to GM (0.2 mL/kg, i.e., 0.1 mmol/kg) at most vessels. Subjective image quality was not significantly different between the two agents for most vessels. Level of Evidence: 2. Technical Efficacy: Stage 2.

AB - Background: Gadobutrol (GB) and gadoterate meglumine (GM) are contrast agents used for contrast-enhanced magnetic resonance angiography (CEMRA). Supraaortic vasculature (SAV) CEMRAs are used to evaluate stroke risk and neurologic symptoms. There is a need to compare the SAV CEMRA image quality obtained with GB and GM. Purpose: To intra-individually compare MRA images obtained with equimolar GB and GM at 1.5 T in the SAV. Study Type: Prospective, crossover. Population: Twenty-eight subjects (54 ± 13 years; 17 female). Field Strength/Sequence: 1.5 T; three-dimensional (3D) gradient recalled echo. Assessment: Quantitative image quality was measured by normalized signal intensity (SIn) [SIn = SI blood/SD blood] and contrast ratio (CR) [CR = SI blood/SI muscle], determined by an observer (JWC) with 1 year of vascular imaging experience. Three radiologists (AS, PA, and MU) with (5, 5, and 6 years of) vascular imaging experience evaluated image quality by Likert-scale ratings (of image impression, wall conspicuity, and artifact absence). Statistical Tests: SIn and CR were compared with paired t-tests or Wilcoxon signed-rank tests and Bland–Altman plots. Qualitative ratings were compared with Wilcoxon signed-rank test. Results: No significant difference in SIn was found between GB and GM. CRs with GB were significantly higher than GM at the right common carotid (6.9 ± 2.5 vs. 4.8 ± 1), left internal carotid (7.3 ± 2 vs. 4.4 ± 1.2), right internal carotid (7.7 ± 2.2 vs. 5 ± 1.1), and left vertebral (6.6 ± 2.2 vs. 4.5 ± 1.1) arteries. Bland–Altman plots showed relatively greater differences between GB and GM at higher CRs and SIns. GM showed significantly higher artifact than GB (3.56 ± 0.52 vs. 3.36 ± 0.46) and significantly lower overall image quality (10.73 ± 1.45 vs. 11.26 ± 1.58) at the left vertebral artery. Data Conclusion: At 1.5 T and equimolar demonstration, GB (0.1 mL/kg, i.e., 0.1 mmol/kg) showed higher CRs in the SAV compared to GM (0.2 mL/kg, i.e., 0.1 mmol/kg) at most vessels. Subjective image quality was not significantly different between the two agents for most vessels. Level of Evidence: 2. Technical Efficacy: Stage 2.

KW - gadobutrol

KW - gadoterate meglumine

KW - supraaortic vasculature

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MRA of the Supraaortic Vasculature: Comparison of Gadobutrol and Gadoterate Meglumine at 1.5 T

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UN SDGs

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