Focal Liver Lesions: Whether a Standard Dose (0.05 mmol/kg) Gadobenate Dimeglumine Can Provide the Same Diagnostic Data as the 0.1 mmol/kg Dose

Abstract

Objective: Gadobenate dimeglumine (Gd-BOPTA) is a liver-specific contrast agent also showing a distribution in the extracellular compartment which is recommended to be used at standard dose (0.05 mmol/kg) in magnetic resonance imaging (MRI) of liver lesions. However, its use at 0.1 mmol/kg is gradually increasing in recent clinical practice. Which dose should we use in routine MRI of liver lesions from now on? This study investigated the efficacy of Gd-BOPTA at a standard dose versus 0.1 mmol/kg dose in demonstrating diagnostic data in MRI of focal liver lesions. Materials and methods: The study included 47 patients with focal liver lesions. Twenty-two patients received standard dose and 25 patients received 0.1 mmol/kg dose Gd-BOPTA intravenously. MRI of both groups was carried out with T1-A FLASH-2D and T2-A TURBO spin echo before contrast injection and T1-A FLASH-2D sequences in dynamic and late phase (90th minute) after the contrast injection. The lesion conspicuity for each image was evaluated qualitatively. Liver signal to noise ratio (SNR), absolute lesion-liver contrast to noise ratio (CNR), mean lesion-liver CNR and contrast enhancement rate of the liver obtained from both groups were compared quantitatively. Results: While liver contrast enhancement rate in the group receiving standard dose Gd-BOPTA were 41% ± 42 in the arterial phase, 66% ± 58 in the portal phase, 45% ± 45 in the venous phase and 42% ± 88 in the late phase, these values were 43% ± 59, 86% ± 73, 63% ± 75 and 61% ± 105, respectively, in the group receiving the dose of 0.1 mmol/kg. There were no statistically significant differences between the means of both groups. While the absolute lesion-liver CNR values were 18 ± 15 precontrast, 22 ± 18 in the arterial phase, 19 ± 17 in the portal phase, 15 ± 10 in the venous phase and 24 ± 26 in the late phase in the group receiving the standard dose Gd-BOPTA, these values were 13 ± 11, 18 ± 15, 15 ± 15, 13 ± 13 and 19 ± 21, respectively, in the group receiving the 0.1 mmol/kg dose. There were no statistically significant differences between the means of both groups (p > 0.05). However, when the mean lesion-liver CNR values were compared, there was statistically significant difference between each arterial and portal phases of metastases in both groups (p < 0.05). There was no statistical difference found in other lesions. When lesion conspicuity scores were compared, there were no significant differences between the two groups. Conclusion: In liver lesions, similar diagnostic data are obtained in dynamic and late phase MRI with either standard dose Gd-BOPTA or with a dose of 0.1 mmol/kg. Because there was a difference in only metastases in both groups, in oncological patients who are being investigated for liver metastasis, it is expedient to use a dose of 0.1 mmol/kg. © 2007 Elsevier Ireland Ltd. All rights reserved.