Low-dose gadobutrol versus standard-dose gadoterate for contrast-enhanced brain MRI

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T1 axial weighted MRI images obtained with standard dose gadoterate (A) and low dose gadobutrol (B) 4 days later. The mean score between the three standard-dose gadoterate and low-dose gadobutrol readers was 3.4 and 3.4, respectively, for subjective lesion improvement; 3.5 and 3.4, respectively, for the delimitation of the injury boundary; and 2.9 and 2.9, respectively, for the internal morphology of the lesion. Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

According to ARRS American Journal of Roentgenology (AJR), a reduced dose of gadobutrol is not less than the standard dose of gadoterate to obtain a contrast-enhanced brain MRI.

“A reduced dose of 25% gadobutrol demonstrated an efficacy not lower than the standard dose of gadoterate for brain MRI with improved contrast,” said the corresponding author Jan Endrikat of the Faculty of Medicine of the University of Germany of Saarland, which justifies a particular consideration a they undergo multiple examinations with improved contrast “.

In this international, prospective, multicenter, open, and cross-sectional trial (LEADER-75), 141 patients (78 men, 63 women; mean age, 58.5 years) with known or suspected CNS pathology were submitted. – Enhanced brain MRI with standard dose gadoterate (0.1 mmol / kg). If an improving lesion was identified, a second MRI was performed with reduced doses of gadobutrol (0.075 mmol / kg) within 15 days.

Comparison of low-dose gadobutrol and standard-dose gadoterate versus unimproved image showed no inferiority by a 20% margin for three primary efficacy measures: subjective lesion improvement, lesion boundary delimitation, morphology internal of the lesion.

Low-dose gadobutrol versus standard-dose gadoterate for contrast-enhanced brain MRI

T1 axial weighted MRI images obtained with standard dose gadoterate (A) and low dose gadobutrol (B). The mean score between the three standard-dose gadoterate and low-dose gadobutrol readers was 3.3 and 3.0, respectively, for subjective improvement of lesions; 4.0 and 3.3, respectively, for delimitation of injury boundaries; and 3.0 and 2.7, respectively, for the internal morphology of the lesion. Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

In addition, in the post-hoc analysis, mean readings for subjective improvement of the lesion, delimitation of the lesion boundary, and internal morphology of the lesions differ by less than 1%, supporting the equivalence with a narrow margin of ± 5%.

“Several secondary variables also supported the non-inferiority of gadobutrol in reduced doses,” said the authors of the AJR article added.

Low-dose gadobutrol versus standard-dose gadoterate for contrast-enhanced brain MRI

“Several secondary variables also supported non-inferiority of gadobutrol in reduced doses,” the authors of this AJR article added. Credit: American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)


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More information:
Benjamin P. Liu et al, Clinical efficacy of the reduced dose of Gadobutrol versus Gadoterate of the standard dose for enhanced magnetic resonance imaging of CNS contrast: international multicenter cross-prospecting analysis (LEADER-75), American Journal of Roentgenology (2021). DOI: 10.2214 / AJR.21.25924

Citation: Reduced-dose gadobutrol versus standard-dose gadoterate for contrast-enhanced brain MRI (2021, June 17) retrieved June 17, 2021 from https://medicalxpress.com/news/2021-06-reduced-dose- gadobutrol-standard-dose -gadoterate-contrast-enhanced.html

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