Albumin-binding MR blood pool contrast agent improves diagnostic performance in human brain tumour: comparison of two contrast agents for glioblastoma.

Abstract

We qualitatively and quantitatively compared MRI enhancement obtained with gadofosveset, an albumin-binding blood-pool contrast agent, and with gadobutrol, an extracellular contrast agent, in patients with glioblastoma. Thirty-five patients (25 men; 64 ± 14 years) with histologically proven glioblastoma underwent MRI including pre- and post-contrast T1-weighted SE images acquired 5 min after gadobutrol (0.1 mmol/kg) and, 48 h later, images acquired with identical parameters 5 min and 3, 6, and 24 h after gadofosveset (0.03 mmol/kg). Lesion extent, delineation, internal morphology, multifocality, and global diagnostic preference were evaluated quantitatively for the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast enhancement (CE). Mean values of SNR, CNR, and tumour CE were highest 6 h after gadofosveset. Multifocality was seen in 17 (48.6 %) patients; additional lesions had stronger enhancement 6 h after gadofosveset in 12 patients (70.6 %). In 21 (60 %) patients, radiologists' global preference was highest in images acquired 6 h after gadofosveset (kappa = 0.764). In 22 patients (62.8 %), all qualitative endpoints were better at 5 min after gadobutrol than in images acquired 5 min after gadofosveset injection. Gadobutrol gives significant tumour enhancement in early postcontrast imaging. However, images acquired 6 h after gadofosveset injection have significantly better diagnostic information endpoints and contrast enhancement.