Evolving Characteristics of Gadolinium-Based Contrast Agents for MR Imaging: A Systematic Review of the Importance of Relaxivity

Autores de IIS La Fe

• 

  Luis Martí Bonmatí

  Autor

Participantes ajenos a IIS La Fe

• Kanal, E
• Maki, JH
• Schramm, P

Grupos

• Investigacion Biomédica en Imagen (GIBI 2-30)

Abstract

Gadolinium-based contrast agents (GBCAs) are widely and routinely used to enhance the diagnostic performance of magnetic resonance imaging and magnetic resonance angiography examinations. T1 relaxivity (r(1)) is the measure of their ability to increase signal intensity in tissues and blood on T1-weighted images at a given dose. Pharmaceutical companies have invested in the design and development of GBCAs with higher and higher T1 relaxivity values, and "high relaxivity" is a claim frequently used to promote GBCAs, with no clear definition of what "high relaxivity" means, or general concurrence about its clinical benefit. To understand whether higher relaxivity values translate into a material clinical benefit, well-designed, and properly powered clinical studies are necessary, while mere in vitro measurements may be misleading. This systematic review of relevant peer-reviewed literature provides high-quality clinical evidence showing that a difference in relaxivity of at least 40% between two GBCAs results in superior diagnostic efficacy for the higher-relaxivity agent when this is used at the same equimolar gadolinium dose as the lower-relaxivity agent, or similar imaging performance when used at a lower dose. Either outcome clearly implies a relevant clinical benefit.

© 2024 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals LLC on behalf of International Society for Magnetic Resonance in Medicine.

Keywords

• Contrast Media; Gadolinium; Humans; Image Enhancement; Magnetic Resonance Imaging; Reproducibility of Results; contrast medium; gadobutrol; Gadolinium Based Contrast Agent; gadolinium pentetate; gadoterate meglumine; gadoteridol; gadoxetic acid; unclassified drug; gadolinium; diffusion weighted imaging; drug potency; drug safety; human; magnetic resonance angiography; mammography; nerve lesion; nuclear magnetic resonance imaging; relaxation time; Review; risk assessment; sensitivity and specificity; systematic review; T1 weighted imaging; chemistry; image enhancement; procedures; reproducibility