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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 21:1603-1610 (10 2000)
© 2000 American Society of Neuroradiology

ARTICLE

Effects of Three Different Doses of a Bolus Injection of Gadodiamide: Assessment of Regional Cerebral Blood Volume Maps in a Blinded Reader Study

Roland Bruening^,a, Christian Berchtenbreiter^a, Nicolaus Holzknecht^a, Marco Essig^a, Ren Hua Wu^a, Andrew Simmons^a, Andreas Heuck^a, Anne Maschek^a, Monika Meusel^a, Steve C. R. Williams^a, Tim Cox^a, Michael V Knopp^a and Maximilian Reiser^a

^a From the Institute of Clinical Radiology, Klinikum Grosshadern, University of Munich, Germany (R.B., C.B., N.H., R.H.W., A.H., M.R.); German Cancer Research Center (DKFZ), Heidelberg, Germany (M.E., M.V.K.); Neuroimaging Research, Institute of Psychiatry & Maudsley Hospital, London, United Kingdom (A.S., S.C.R.W., T.C.); and Nycomed Amersham Arzneimittel GmbH, Ismaning, Germany (A.M., M.M.).

BACKGROUND AND PURPOSE: Reconstruction of first-pass bolus information to derive regional cerebral blood volume (rCBV) maps is commonly performed in many centers; however, various protocols with different doses of paramagnetic contrast injections have been reported. We evaluated the dose dependency of rCBV maps in a brain tumor population by using three different doses of gadodiamide injection to evaluate their diagnostic accuracy in blinded reader sessions.

METHODS: Eighty-three patients with intraaxial brain tumors (72 gliomas) were studied at three centers and randomized to receive a bolus injection of 0.1, 0.2, or 0.3 mmol/kg per body weight of gadodiamide. rCBV maps were generated from T2*-weighted gradient-echo echo-planar sequences at 1.5 T. Data processing was performed according to the indicator dilution theory.

RESULTS: The mean contrast-to-noise ratio (CNR) was significantly different between gadodiamide doses of 0.1 and 0.2 mmol/kg (CNR = 8.7 and 15.7) and between 0.1 and 0.3 mmol/kg (CNR = 17.7). No significant difference was found between doses of 0.2 and 0.3 mmol/kg. Sensitivity for the differentiation of benign and malignant brain tumors was 80%, 95%, and 91%, and specificity was 45%, 54%, and 43% by blinded readings at 0.1, 0.2, and 0.3 mmol/kg, respectively, as compared with histologic findings. Nonblinded readings had a sensitivity of 83%, 100%, and 90% and a specificity of 82%, 100%, and 73% at 0.1, 0.2, and 0.3 mmol/kg, respectively.

CONCLUSION: A dose of 0.2 mmol/kg of gadodiamide is recommended for reconstruction of rCBV maps if data are acquired with the T2*-weighted protocol described.

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