Anzalone_edit_Cardiology_book_temp 10/03/2010 10:03 Page 100
Imaging
Figure 2: Release of Gd
3+
into Native Human Serum at 37°C
A B
Human serum + 10mM phosphate at 37ºC
50 50
Gadoversetamine
Gadodiamide
40 40
Optimark
®
Omniscan
®
30
Gadoversetamine
30
(% total Gd) (% total Gd)
3+ Gadodiamide 3+
Optimark
®
20
Omniscan
®
20
Released GD Released GD Magnevist
®
Magnevist
®
Multihance
®
10 Multihance
®
10
Vasovist
® Vasovist
®
Primovist
®
Primovist
®
0 0 Dotarem
®
0 5 10 15
Dotarem
®
0 5 10 15 Gadovist
®
Gadovist
®
Prohance
®
Incubation time (days) Prohance
®
Incubation time (days)
3+
The release of Gd ions from gadolinium-based contrast agents (GBCAs) over 15 days at 1mM at 37°C in native human serum from healthy volunteers (A) and
with the addition of 10mmol/l phosphate (B).
9
Source: Frenzel, 2008.
Table 1: Gadolinium-based Contrast Agents by Stability Figure 3: Relaxivity of Gadolinium Chelates Under
Increasing Magnetic Fields
Contrast Agent Trade Name Initial Rate of Gd
3+
Release after
Gd
3+
Release After 15 Days
10
(%/day) (% of total Gd
3+
)
Gadodiamide (active agent) 24 25
)
-1
8
Gadoversertamide (active agent) 17 29
s
-1
Gadodiamide Omniscan 0.16 20
6
Gadoversertamide OptiMARK 0.44 21
Gadopentetate Magnevist 0.16 1.9
4
Gadobenate MultiHance 0.18 1.9
Gadofosveset Vasovist 0.12 1.8
Relaxivity (l mmol
2
Gadoxetic acid Primovist 0.07 1.1
Gadobutrol Gadovist <0.007 <0.1
0
Gadoteridol ProHance <0.007 <0.1
1.5T 3.0T 4.7T
Gadoterate Dotarem <0.007 <0.1
Magnevist Gadovist Primovist Multihance
Dotarem Omniscan Prohance Optimark
9
Source: Frenzel, 2008.
Relaxivities of gadolinium chelates measured in bovine plasma at 37°C at field strengths
of 1.5, 3 and 4.7T.
affect the quality of the obtained image via the mode of action and
10
Source: Rohrer et al., 2005.
shortening of relaxation times. Advantages in terms of concentration
have previously been proposed; for example, the relatively high resonance brain perfusion imaging.
19
With the higher-concentration
gadolinium concentration of gadobutrol at 1.0M potentially allows for formulation of 1.0M, a significantly smaller bolus width was achieved
a 50% reduction in injection volume compared with equimolar at the half maximum signal intensity decrease. Moreover, the smaller
dosages of the standard gadolinium chelates at 0.5M. A smaller and mean peak time observed, higher contrast and higher signal-to-noise
more highly concentrated bolus volume may allow for increased ratio (SNR) ultimately led to better brain perfusion images than those
intravascular concentration. This is on top of advantages in obtained with the 0.5M formulation.
perfusion-weighted imaging and multiphasic ultra-fast imaging
techniques, including magnetic resonance angiography (MRA) and In another study where 0.5M gadopentetate (Magnevist), 0.5 M
time-resolved MRA.
17
It is also possible that a better-defined bolus gadobenate and 1.0M gadobutrol were compared in a pelvic 3D
stemming from this improved bolus effect may also enhance the MRA setting, the quality of images obtained with either gadobutrol
contrast-to-noise ratio (CNR) and therefore the imaging or gadobenate were similar in their superiority over those obtained
characteristics of first-pass MRI techniques.
18
by gadopentetate when administered at an equal dose and
injection rate.
20
Undiluted gadobutrol performed better than its
Tombach et al. had previously compared gadobutrol at concentrations diluted counterpart against gadobenate, although statistically
of 0.5 and 1.0M in an intra-individually controlled study with magnetic significant results were not reached. The results still suggest that a
100 EUROPEAN NEUROLOGICAL REVIEW
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