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MRI in multiple sclerosis: an intra-individual, randomized and multicentric comparison of gadobutrol with gadoterate meglumine at 3 T

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Abstract

Objectives

To compare contrast effects of gadobutrol with gadoterate meglumine for brain MRI in multiple sclerosis (MS) in a multicentre, randomized, prospective, intraindividual study at 3 T.

Methods

Institutional review board approval was obtained. Patients with known or suspected active MS lesions were included. Two identical MRIs were performed using randomized contrast agent order. Four post-contrast T1 sequences were acquired (start time points 0, 3, 6 and 9 min). If no enhancing lesion was present in first MRI, second MRI was cancelled. Quantitative (number and signal intensity of enhancing lesions) and qualitative parameters (time points of first and all lesions enhancing; subjective preference regarding contrast enhancement and lesion delineation; global preference) were evaluated blinded.

Results

Seventy-four patients (male, 26; mean age, 35 years) were enrolled in three centres. In 45 patients enhancing lesions were found. Number of enhancing lesions increased over time for both contrast agents without significant difference (median 2 for both). Lesions signal intensity was significantly higher for gadobutrol (p < 0.05 at time points 3, 6 and 9 min). Subjective preference rating showed non-significant tendency in favour of gadobutrol.

Conclusion

Both gadobutrol and gadoterate meglumine can be used for imaging of acute inflammatory MS lesions. However, gadobutrol generates higher lesion SI.

Key Points

• Contrast-enhanced MRI plays a key role in the management of multiple sclerosis.

• Different gadolinium-based contrast agents are available.

• Number of visibly enhancing lesions increases over time after contrast injection.

• Gadobutrol and gadoterate meglumine do not differ in number of visible lesions.

• Gadobutrol generates higher signal intensity than gadoterate meglumine.

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Abbreviations

BBBD:

blood–brain barrier disruption

DCE-MRI:

dynamic contrast-enhanced MRI

GBCA:

gadolinium-based contrast agent

MRI:

magnetic resonance imaging

MS:

multiple sclerosis

SE:

spin echo

SI:

signal intensity

TE:

echo time

TR:

repetition time

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Acknowledgments

The scientific guarantor of this publication is Prof. Dr. A. Doerfler. The authors of this manuscript declare relationships with the following companies: Carsten Schwenke works as a freelance statistician for Bayer on an honorary basis. Norbert Hosten is a stockholder of Siemens and is an institutional grant recipient of Siemens and Bayer. This study has received funding by Bayer. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, randomised controlled trial, multicentre study.

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Authors and Affiliations

  1. Department of Neuroradiology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany

    Marc Saake, Marina Weibart & Arnd Doerfler

  2. Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany

    Soenke Langner & Norbert Hosten

  3. SCO:SSiS, Statistical Consulting, Berlin, Germany

    Carsten Schwenke

  4. Department of Radiology and Neuroradiology, University of Kiel, Kiel, Germany

    Olav Jansen

Authors
  1. Marc Saake
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  2. Soenke Langner
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  3. Carsten Schwenke
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  4. Marina Weibart
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  7. Arnd Doerfler
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Correspondence to Marc Saake.

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Saake, M., Langner, S., Schwenke, C. et al. MRI in multiple sclerosis: an intra-individual, randomized and multicentric comparison of gadobutrol with gadoterate meglumine at 3 T. Eur Radiol 26, 820–828 (2016). https://doi.org/10.1007/s00330-015-3889-7

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  • DOI: https://doi.org/10.1007/s00330-015-3889-7

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