3.0-T whole-heart coronary magnetic resonance angiography: comparison of gadobenate dimeglumine and gadofosveset trisodium

Abstract

Gadolinium enhanced coronary magnetic resonance angiography (MRA) at 3 T appears to be superior to non-contrast methods. Gadofosveset is an intravascular contrast agent that may be well suited to this application. The purpose of this study was to perform an intra-individual comparison of gadofosveset and gadobenate for coronary MRA at 3 T. In this prospective randomized study, 22 study subjects [8 (36%) male; 27.9 ± 6 years; BMI = 22.8 ± 2 kg/m(2)] underwent two studies using a contrast-enhanced inversion recovery three-dimensional fast low angle shot MRA at 3 T. The order of contrast agent administration was varied randomly, separated by an average of 30 ± 5 days, using either gadobenate dimeglumine (Gd-BOPTA; Bracco, 0.1 mmol/Kg) or gadofosveset trisodium (MS-325; Lantheus Med, 0.03 mmol/Kg). Acquisition time, signal-to-noise ratio (SNR) of coronary vessels and contrast-to-noise ratio (CNR) were evaluated. Of 308 coronary arteries and veins segment analyzed, overall SNR of coronary arteries and veins segments were not different for the two contrast agents (132 ± 79 for gadofosveset vs. 135 ± 78 for gadobenate, p = 0.69). Coronary artery CNR was greater for gadofosveset in comparison to gadobenate (73.5 ± 46.9 vs. 59.3 ± 75.7 respectively, p = 0.03). Gadofosveset-enhanced MRA images displayed better image quality than gadobenate-enhanced MRA images (2.77 ± 0.61 for gadofosveset vs. 2.11 ± 0.51, p < .001). Inter- and intra-reader variability was excellent (ICC > 0.90) for both contrast agents. Gadofosveset trisodium appears to show slightly better performance for coronary MRA at 3 T compared to gadobenate.

Trial registration: ClinicalTrials.gov NCT01130545.

Figures

Fig. 1

22-year-old male healthy volunteer. Good quality representation of same individual with both contrast agents. The arrows indicate the general locations of the ROIs that were measured at the proximal sections of the various arterial segments. Note – Ao, Aorta; LMS, left main stem; LAD, left anterior descending coronary artery; LCX, left circumflex coronary artery; and RCA, right coronary artery.

Fig. 2

27 year-old woman healthy volunteer. Study done with Gadovosveset. (A and C) Segment analysis of LAD and RCA. (B and D) Reformatted images through curve maximum intensity projection (MIP) of LAD and RCA, respectively. Note – Ao, Aorta; LMS, left main stem; LAD, left anterior descending coronary artery; LCX, left circumflex coronary artery; and RCA, right coronary artery. Prox, mid and dist indicates proximal, middle and distal coronary segments, respectively.

Fig. 3

28 year-old male healthy volunteer. (A) Segment analysis of LAD and RCA. (B) Inverted, “negative”, black and white image similar of (A). (C) Volume-rendered image of LAD and LCx providing nice display of coronary anatomy. Note – LMS, left main stem; LAD, left anterior descending coronary artery; LCX, left circumflex coronary artery; and RCA, right coronary artery. Prox, mid and dist indicates proximal, middle and distal coronary segments, respectively.