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Vascular enhancement in early dynamic liver MR imaging in an animal model: comparison of two injection regimen and two different doses Gd-EOB-DTPA (gadoxetic acid) with standard Gd-DTPA

Christoph J Zech, Bernhard Vos, Anders Nordell, Matthias Urich, Lennart Blomqvist, Josy Breuer, Maximilian F Reiser, Hanns-Joachim Weinmann
Investigative Radiology 2009, 44 (6): 305-10
19462484

OBJECTIVES: To investigate the influence of 2 different doses and injection rates on the enhancement of liver vasculature in Gd-EOB-DTPA enhanced liver MRI compared with the standard dose Gd-DTPA.

MATERIALS AND METHODS: This animal experimental study has been approved by the local authorities. In 5 pigs, a time-resolved T1w 3D GRE sequence, and in a second experiment, a single-slice turbo FLASH T1w sequence with 3 frames/s were started each with contrast agent application of Gd-EOB-DTPA and Gd-DTPA. Three sets with different doses were performed with an injection rate of 1 and 2 mL/s which are as follows: A, Standard dose: 25 [mu]mol Gd-EOB-DTPA/kg body-weight (bw); B, Double dose: 50 [mu]mol Gd-EOB-DTPA/kg bw; and C, Standard dose: 100 [mu]mol Gd-DTPA/kg bw. Signal intensities were measured in aorta, vena cava inferior, portal vein, and liver parenchyma, and time-signal-to-noise (SNR)-curves were generated. The increase in SNR from baseline and several perfusion parameters were calculated. Statistical significance was tested with the Wilcoxon rank test at a significance level of P = 0.05.

RESULTS: Mean peak enhancement (SNR) in the aorta was not significantly different for set A, B, and C with the same injection rate. Mean peak enhancement in the aorta was significantly higher for set A at 1 mL/s than at 2 mL/s (159.1 vs. 144.4, P = 0.043). Mean peak enhancement in the PV, the vena cava inferior, and the liver parenchyma was significantly lower for set A compared with set B and set C, at both injection speeds. The full width at half max was significantly longer for injection protocols with 1 as compared with 2 mL/s for sets A and set B. Set A with 1 mL/s reached similar values as compared with set C with 2 mL/s for the full width at half max (8.92 vs. 9.40; P = 0.35), for the area-under-the curve (1736.64 vs. 1912.74; P = 0.69) and the maximal signal-to-noise ratio (25.21 vs. 25.37; P = 0.69).

CONCLUSION: Despite the lower amount of gadolinium in the standard dose of Gd-EOB-DTPA, the results showed that the arterial enhancement in Gd-EOB-DTPA-enhanced dynamic liver MRI was comparable to Gd-DTPA. This result can be explained mainly by the higher relaxivity. Choosing a lower injection rate additionally supported to compensate for the lower injection volume by stretching the bolus without decreasing the peak. In this respect, an injection rate of 1 mL/s showed better results with regard to the arterial enhancement compared with 2 mL/s.

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