GADOTERIDOL-ENHANCED MR-IMAGING OF MALIGNANT HEPATIC-TUMORS - EFFECTSOF TRIPLE VERSUS STANDARD DOSES ON LESION-LIVER CONTRAST

OBJECTIVE. The purpose of this study was to compare liver signal-to-no ise ratio (SNR), lesion SNR, and lesion-liver contrast-to-noise-ratio (CNR) in patients with malignant liver lesions after the administratio n of a standard dose (0.1 mmol/kg of body weight) or a triple dose (0. 3 mmol/kg) of a gadolinium chelate (gadoteridol). We hypothesized that the higher dose would produce a higher lesion-liver CNR and therefore increase the conspicuity of hepatic lesions. MATERIALS AND METHODS. A total of 85 patients with malignant hepatic masses (61 metastases, 22 hepatocellular carcinomas, and two lymphomas) proved by histologic or follow-up studies underwent MR imaging at 1.5 T. T1-weighted spin-ech o imaging and gradient-echo imaging were done before and within 1 min after (gradient echo) as well as 5 (spin echo) and 15 (spin echo) min after the injection of 0.1 or 0.3 mmol of gadoteridol per kg, randomiz ed before the start of the study (39 patients received the standard do se, and 46 received the triple dose). The signal intensities of the li ver and lesions and the SD of background noise were measured by use of regions of interest to calculate the SNR of the liver and malignant l esions and the lesion-liver CNR. RESULTS. The lesion-liver CNR was inc reased significantly at 5 and 15 min after the administration of gadot eridol. No significant differences in the liver SNR, lesion SNR, and l esion-liver CNR (after 1 min: standard dose, -5 +/- 8, and triple dose , -4 +/- 14; after 5 min: standard dose, -1 +/- 5, and triple dose, 2 +/- 8; and after 15 min: standard dose, 1 +/- 5, and triple dose, 6 +/ - 20) were found between the doses at all time points. CONCLUSION. Tri ple-dose gadoteridol does not improve the lesion-liver contrast of mal ignant hepatic lesions over that provided by the standard dose and is not warranted for liver MR imaging.