Document Detail


Whole-body MRI with assessment of hepatic and extraabdominal enhancement after administration of gadoxetic acid for staging of rectal carcinoma.
MedLine Citation:
PMID:  20698804     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In TNM staging of rectal cancer by MRI, unspecific extracellular contrast agent Gd-DTPA is established for extrahepatic and vascular enhancement whereas liver-specific gadoxetic acid has proven high accurate detection of liver metastasis. PURPOSE: To compare intraindividually the qualification and quantification of enhancement in liver parenchyma, abdominal, pulmonary, and pelvic vessels between gadoxetic acid and Gd-DTPA. MATERIAL AND METHODS: Sixteen patients with histologically proven rectal carcinoma (mean age 62.9 years) were imaged twice by MRI. For pretherapeutic staging 10 mL gadoxetic acid (mean dose 0.032 mmol Gd/kg body weight) and for restaging after neoadjuvant therapy Gd-DTPA (0.1 mmol Gd/kg body weight) were administered. The liver was acquired in arterial-dominant and portal venous phases, the thorax and pelvis were depicted in venous phases using three-dimensional T1-weighted sequences. Contrast enhancement was rated by two independent readers and compared by means of multinomial regression analysis using generalized estimating equations. Signal-to-noise ratios were compared by two-sided paired t-tests. RESULTS: Overall contrast enhancement was rated sufficient for diagnosis in all examinations and both contrast agents. Vascular enhancement was rated comparable with exception of the aorta, the peripheral intrahepatic veins, and the central lung vessels (p = 0.0182, p = 0.0053, p = 0.0083, in favor of Gd-DTPA). Quantitative evaluation revealed no statistically significant differences in parenchymal and vascular signal-to-noise ratios with exception of the aorta, and the central pulmonary artery (67.4 vs. 89.3; p = 0.0421, 44.5 vs. 59.5; p = 0.0446 respectively, in favor of Gd-DTPA). CONCLUSION: The contrast enhancement after gadoxetic acid is comparable to Gd-DTPA and appears suitable for comprehensive TNM-staging by combining high accurate liver-specific phases with efficacious vascular enhancement in the different anatomic regions.
Authors:
Alexander Huppertz; Tobias Franiel; Moritz Wagner; Olaf Püttcher; Joachim Wagner; Matthias Rief; Carsten Schwenke; Bernd Hamm; Joachim Strassburg
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  51     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-10     Completed Date:  2010-09-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  842-50     Citation Subset:  IM    
Affiliation:
Imaging Science Institute Charité, Berlin, Germany. Alexander.Huppertz@charite.de
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MeSH Terms
Descriptor/Qualifier:
Contrast Media / diagnostic use*
Female
Gadolinium DTPA / diagnostic use*
Humans
Image Enhancement / methods
Liver / blood supply*
Lung / blood supply*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Neoplasm Staging
Pelvis / blood supply
Prospective Studies
Rectal Neoplasms*
Regression Analysis
Whole Body Imaging
Chemical
Reg. No./Substance:
0/Contrast Media; 0/gadolinium ethoxybenzyl DTPA; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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