Breast lesion detection and characterization with contrast-enhanced magnetic resonance imaging: Prospective randomized intraindividual comparison of gadoterate meglumine (0.15 mmol/kg) and gadobenate dimeglumine (0.075 mmol/kg) at 3T
Breast lesion detection and characterization with contrast-enhanced magnetic resonance imaging: Prospective randomized intraindividual comparison of gadoterate meglumine (0.15 mmol/kg) and gadobenate dimeglumine (0.075 mmol/kg) at 3T
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DOI：
10.1002/jmri.26335
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发表时间：
2019-04-01
影响因子：
4.4
通讯作者：
Baltzer, Pascal A. T.
中科院分区：
文献类型：
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作者：
Clauser, Paola;Helbich, Thomas H.;Baltzer, Pascal A. T.
背景 乳腺对比增强磁共振成像 (CE-MRI) 对于乳腺癌检测高度敏感。多通道线圈和 3T 扫描仪可以提高信号、空间和时间分辨率。此外，钆基造影剂 (GBCA) 的 T-1 还原效果在 3T 时更高。因此，在不丢失诊断信息的情况下减少 3T 时 GBCA 的剂量是可能的。目的 比较四分之三 (0.075 mmol/kg) 剂量的高弛豫 GBCA 钆苯酸二甲葡胺与比标签上剂量 (0.15 mmol/kg) 高 1.5 倍的钆酸葡甲胺在 3T CE-MRI 上的乳腺病变检测和表征。研究类型 前瞻性、随机、个体比较研究。符合条件的人群是常规影像学表现异常（BI-RADS 0、4、5）的患者。每名患者接受两次检查，间隔 24-72 小时，一次使用 0.075 mmol/kg 钆贝酯，另一次使用 0.15 mmol/kg 钆贝酯，按随机顺序给药。总共前瞻性招募了 109 名患者。采用标准乳腺方案的场强/序列 3T MRI（动态 CE、T(2)w-TSE、STIR-T(2)w、DWI）。评估组织病理学是参考标准。三名不知情的异地乳腺放射科医生使用 BI-RADS 词典对检查进行了评估。统计测试针对每个病变和每个区域计算病变检测、敏感性、特异性和诊断准确性，并通过单变量和多变量分析（广义估计方程，GEE）进行比较。结果 5 名患者被排除，留下 104 名女性，其中 142 个经组织学证实的乳腺病变（109 个恶性，33 个良性）可供评估。钆贝酯的病灶检出率 (84.5-88.7%) 并不逊色于钆贝酯 (84.5-90.8%) (P >= 0.165)。在每个区域的分析中，钆贝酯表现出更高的特异性（96.4-98.7% vs. 92.6-97.3%，P
Background Contrast-enhanced magnetic resonance imaging (CE-MRI) of the breast is highly sensitive for breast cancer detection. Multichannel coils and 3T scanners can increase signal, spatial, and temporal resolution. In addition, the T-1-reduction effect of a gadolinium-based contrast agent (GBCA) is higher at 3T. Thus, it might be possible to reduce the dose of GBCA at 3T without losing diagnostic information. Purpose To compare a three-quarter (0.075 mmol/kg) dose of the high-relaxivity GBCA gadobenate dimeglumine, with a 1.5-fold higher than on-label dose (0.15 mmol/kg) of gadoterate meglumine for breast lesion detection and characterization at 3T CE-MRI. Study Type Prospective, randomized, intraindividual comparative study. Population Eligible were patients with imaging abnormalities (BI-RADS 0, 4, 5) on conventional imaging. Each patient underwent two examinations, 24-72 hours apart, one with 0.075 mmol/kg gadobenate and the other with 0.15 mmol/kg gadoterate administered in a randomized order. In all, 109 patients were prospectively recruited. Field Strength/Sequence 3T MRI with a standard breast protocol (dynamic-CE, T(2)w-TSE, STIR-T(2)w, DWI). Assessment Histopathology was the standard of reference. Three blinded, off-site breast radiologists evaluated the examinations using the BI-RADS lexicon. Statistical Tests Lesion detection, sensitivity, specificity, and diagnostic accuracy were calculated per-lesion and per-region, and compared by univariate and multivariate analysis (Generalized Estimating Equations, GEE). Results Five patients were excluded, leaving 104 women with 142 histologically verified breast lesions (109 malignant, 33 benign) available for evaluation. Lesion detection with gadobenate (84.5-88.7%) was not inferior to gadoterate (84.5-90.8%) (P >= 0.165). At per-region analysis, gadobenate demonstrated higher specificity (96.4-98.7% vs. 92.6-97.3%, P