Efficacy and safety of MR imaging with liver-specific contrast agent

U.S. multicenter phase III study

David A. Bluemke, Dushyant Sahani, Marco Amendola, Thomas Balzer, Josy Breuer, Jeffrey J. Brown, David D. Casalino, Peter L. Davis, Isaac R. Francis, Glenn Krinsky, Fred T. Lee, David Lu, Erik K. Paulson, Lawrence H. Schwartz, Evan S. Siegelman

Research output: Contribution to journalArticle

Abstract

To assess prospectively the efficacy and safety of postcontrast magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) compared with that of precontrast MR imaging in patients who are known to have or are suspected of having liver lesions and who are scheduled for hepatic surgery. MATERIALS AND METHODS: Investigational review board approval and written informed consent were obtained. HIPAA went into effect after data collection. A total of 172 patients were enrolled. After precontrast MR imaging, 169 patients (94 men, 75 women; mean age, 61 years; age range, 19-84 years) received an intravenous bolus of 25 μmol/kg Gd-EOB-DTPA and underwent dynamic gradient-recalled-echo and delayed MR imaging 20 minutes after injection. Arterial and portal phase computed tomography (CT) were performed within 6 weeks of MR imaging. The standard of reference was surgery with intraoperative ultrasonography (US) and biopsy and/or pathologic evaluation of resected liver segments and/or 3-month follow-up of nonresected segments if intraoperative US was not available. Three blinded reviewers and unblinded site investigators identified liver lesions on segment maps. The Wilcoxon signed rank test was used to compare differences in per-patient sensitivity of precontrast and postcontrast MR images. Adverse events were recorded, and patient monitoring and laboratory assay were performed at time of injection and up to 24 hours after contrast material administration. RESULTS: At MR imaging, 316 lesions were identified in 131 patients. In 77% (P = .012), 72% (P = .15), and 71% (P = .027) of patients for readers 1, 2, and 3, respectively, more lesions were seen at precontrast and postcontrast MR imaging combined than at precontrast MR imaging alone. Sensitivity values for blinded readings were significantly greater at postcontrast MR imaging than at precontrast MR imaging for two of three blinded readers. For all blinded readers, combined precontrast and postcontrast MR images showed no difference in sensitivity compared with helical CT scans. The use of MR imaging, however, yielded fewer patients with at least one false-positive lesion (37%, 31%, and 34% of patients for readers 1, 2, and 3, respectively) than did helical CT (45%, 36%, and 43% of patients for readers 1, 2, and 3, respectively). CONCLUSION: Compared with precontrast MR imaging, postcontrast MR imaging with Gd-EOB-DTPA demonstrated improved sensitivity for lesion detection in the majority of blinded readers, with no substantial adverse events.

Original languageEnglish (US)
Pages (from-to)89-98
Number of pages10
JournalRadiology
Volume237
Issue number1
DOIs
StatePublished - Oct 2005

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Contrast Media
Magnetic Resonance Imaging
Safety
Liver
Rubiaceae
Gadolinium
Acetic Acid
Spiral Computed Tomography
Ultrasonography
Magnetic Resonance Spectroscopy
Health Insurance Portability and Accountability Act
Injections
Physiologic Monitoring
Nonparametric Statistics
Informed Consent
Reading
Tomography
Research Personnel
Biopsy

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Bluemke, D. A., Sahani, D., Amendola, M., Balzer, T., Breuer, J., Brown, J. J., ... Siegelman, E. S. (2005). Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study. Radiology, 237(1), 89-98. https://doi.org/10.1148/radiol.2371031842

Efficacy and safety of MR imaging with liver-specific contrast agent : U.S. multicenter phase III study. / Bluemke, David A.; Sahani, Dushyant; Amendola, Marco; Balzer, Thomas; Breuer, Josy; Brown, Jeffrey J.; Casalino, David D.; Davis, Peter L.; Francis, Isaac R.; Krinsky, Glenn; Lee, Fred T.; Lu, David; Paulson, Erik K.; Schwartz, Lawrence H.; Siegelman, Evan S.

In: Radiology, Vol. 237, No. 1, 10.2005, p. 89-98.

Research output: Contribution to journalArticle

Bluemke, DA, Sahani, D, Amendola, M, Balzer, T, Breuer, J, Brown, JJ, Casalino, DD, Davis, PL, Francis, IR, Krinsky, G, Lee, FT, Lu, D, Paulson, EK, Schwartz, LH & Siegelman, ES 2005, 'Efficacy and safety of MR imaging with liver-specific contrast agent: U.S. multicenter phase III study', Radiology, vol. 237, no. 1, pp. 89-98. https://doi.org/10.1148/radiol.2371031842
Bluemke, David A. ; Sahani, Dushyant ; Amendola, Marco ; Balzer, Thomas ; Breuer, Josy ; Brown, Jeffrey J. ; Casalino, David D. ; Davis, Peter L. ; Francis, Isaac R. ; Krinsky, Glenn ; Lee, Fred T. ; Lu, David ; Paulson, Erik K. ; Schwartz, Lawrence H. ; Siegelman, Evan S. / Efficacy and safety of MR imaging with liver-specific contrast agent : U.S. multicenter phase III study. In: Radiology. 2005 ; Vol. 237, No. 1. pp. 89-98.
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abstract = "To assess prospectively the efficacy and safety of postcontrast magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) compared with that of precontrast MR imaging in patients who are known to have or are suspected of having liver lesions and who are scheduled for hepatic surgery. MATERIALS AND METHODS: Investigational review board approval and written informed consent were obtained. HIPAA went into effect after data collection. A total of 172 patients were enrolled. After precontrast MR imaging, 169 patients (94 men, 75 women; mean age, 61 years; age range, 19-84 years) received an intravenous bolus of 25 μmol/kg Gd-EOB-DTPA and underwent dynamic gradient-recalled-echo and delayed MR imaging 20 minutes after injection. Arterial and portal phase computed tomography (CT) were performed within 6 weeks of MR imaging. The standard of reference was surgery with intraoperative ultrasonography (US) and biopsy and/or pathologic evaluation of resected liver segments and/or 3-month follow-up of nonresected segments if intraoperative US was not available. Three blinded reviewers and unblinded site investigators identified liver lesions on segment maps. The Wilcoxon signed rank test was used to compare differences in per-patient sensitivity of precontrast and postcontrast MR images. Adverse events were recorded, and patient monitoring and laboratory assay were performed at time of injection and up to 24 hours after contrast material administration. RESULTS: At MR imaging, 316 lesions were identified in 131 patients. In 77{\%} (P = .012), 72{\%} (P = .15), and 71{\%} (P = .027) of patients for readers 1, 2, and 3, respectively, more lesions were seen at precontrast and postcontrast MR imaging combined than at precontrast MR imaging alone. Sensitivity values for blinded readings were significantly greater at postcontrast MR imaging than at precontrast MR imaging for two of three blinded readers. For all blinded readers, combined precontrast and postcontrast MR images showed no difference in sensitivity compared with helical CT scans. The use of MR imaging, however, yielded fewer patients with at least one false-positive lesion (37{\%}, 31{\%}, and 34{\%} of patients for readers 1, 2, and 3, respectively) than did helical CT (45{\%}, 36{\%}, and 43{\%} of patients for readers 1, 2, and 3, respectively). CONCLUSION: Compared with precontrast MR imaging, postcontrast MR imaging with Gd-EOB-DTPA demonstrated improved sensitivity for lesion detection in the majority of blinded readers, with no substantial adverse events.",
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T1 - Efficacy and safety of MR imaging with liver-specific contrast agent

T2 - U.S. multicenter phase III study

AU - Bluemke, David A.

AU - Sahani, Dushyant

AU - Amendola, Marco

AU - Balzer, Thomas

AU - Breuer, Josy

AU - Brown, Jeffrey J.

AU - Casalino, David D.

AU - Davis, Peter L.

AU - Francis, Isaac R.

AU - Krinsky, Glenn

AU - Lee, Fred T.

AU - Lu, David

AU - Paulson, Erik K.

AU - Schwartz, Lawrence H.

AU - Siegelman, Evan S.

PY - 2005/10

Y1 - 2005/10

N2 - To assess prospectively the efficacy and safety of postcontrast magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) compared with that of precontrast MR imaging in patients who are known to have or are suspected of having liver lesions and who are scheduled for hepatic surgery. MATERIALS AND METHODS: Investigational review board approval and written informed consent were obtained. HIPAA went into effect after data collection. A total of 172 patients were enrolled. After precontrast MR imaging, 169 patients (94 men, 75 women; mean age, 61 years; age range, 19-84 years) received an intravenous bolus of 25 μmol/kg Gd-EOB-DTPA and underwent dynamic gradient-recalled-echo and delayed MR imaging 20 minutes after injection. Arterial and portal phase computed tomography (CT) were performed within 6 weeks of MR imaging. The standard of reference was surgery with intraoperative ultrasonography (US) and biopsy and/or pathologic evaluation of resected liver segments and/or 3-month follow-up of nonresected segments if intraoperative US was not available. Three blinded reviewers and unblinded site investigators identified liver lesions on segment maps. The Wilcoxon signed rank test was used to compare differences in per-patient sensitivity of precontrast and postcontrast MR images. Adverse events were recorded, and patient monitoring and laboratory assay were performed at time of injection and up to 24 hours after contrast material administration. RESULTS: At MR imaging, 316 lesions were identified in 131 patients. In 77% (P = .012), 72% (P = .15), and 71% (P = .027) of patients for readers 1, 2, and 3, respectively, more lesions were seen at precontrast and postcontrast MR imaging combined than at precontrast MR imaging alone. Sensitivity values for blinded readings were significantly greater at postcontrast MR imaging than at precontrast MR imaging for two of three blinded readers. For all blinded readers, combined precontrast and postcontrast MR images showed no difference in sensitivity compared with helical CT scans. The use of MR imaging, however, yielded fewer patients with at least one false-positive lesion (37%, 31%, and 34% of patients for readers 1, 2, and 3, respectively) than did helical CT (45%, 36%, and 43% of patients for readers 1, 2, and 3, respectively). CONCLUSION: Compared with precontrast MR imaging, postcontrast MR imaging with Gd-EOB-DTPA demonstrated improved sensitivity for lesion detection in the majority of blinded readers, with no substantial adverse events.

AB - To assess prospectively the efficacy and safety of postcontrast magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) compared with that of precontrast MR imaging in patients who are known to have or are suspected of having liver lesions and who are scheduled for hepatic surgery. MATERIALS AND METHODS: Investigational review board approval and written informed consent were obtained. HIPAA went into effect after data collection. A total of 172 patients were enrolled. After precontrast MR imaging, 169 patients (94 men, 75 women; mean age, 61 years; age range, 19-84 years) received an intravenous bolus of 25 μmol/kg Gd-EOB-DTPA and underwent dynamic gradient-recalled-echo and delayed MR imaging 20 minutes after injection. Arterial and portal phase computed tomography (CT) were performed within 6 weeks of MR imaging. The standard of reference was surgery with intraoperative ultrasonography (US) and biopsy and/or pathologic evaluation of resected liver segments and/or 3-month follow-up of nonresected segments if intraoperative US was not available. Three blinded reviewers and unblinded site investigators identified liver lesions on segment maps. The Wilcoxon signed rank test was used to compare differences in per-patient sensitivity of precontrast and postcontrast MR images. Adverse events were recorded, and patient monitoring and laboratory assay were performed at time of injection and up to 24 hours after contrast material administration. RESULTS: At MR imaging, 316 lesions were identified in 131 patients. In 77% (P = .012), 72% (P = .15), and 71% (P = .027) of patients for readers 1, 2, and 3, respectively, more lesions were seen at precontrast and postcontrast MR imaging combined than at precontrast MR imaging alone. Sensitivity values for blinded readings were significantly greater at postcontrast MR imaging than at precontrast MR imaging for two of three blinded readers. For all blinded readers, combined precontrast and postcontrast MR images showed no difference in sensitivity compared with helical CT scans. The use of MR imaging, however, yielded fewer patients with at least one false-positive lesion (37%, 31%, and 34% of patients for readers 1, 2, and 3, respectively) than did helical CT (45%, 36%, and 43% of patients for readers 1, 2, and 3, respectively). CONCLUSION: Compared with precontrast MR imaging, postcontrast MR imaging with Gd-EOB-DTPA demonstrated improved sensitivity for lesion detection in the majority of blinded readers, with no substantial adverse events.

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