Comparison of 1.0 M Gadobutrol and 0.5 M Gadopentetate Dimeglumine-Enhanced Magnetic Resonance Imaging in Five Hundred Seventy-Two Patients With Known or Suspected Liver Lesions: Results of a Multicenter, Double-Blind, Interindividual, Randomized Clinical Phase-III Trial.

Hammerstingl, Renate;Adam, Gerhard;Ayuso, Juan-Ramon;Van Beers, Bernard;Tombach, Bernd;et.al.
(2009) Investigative Radiology : a journal of clinical and laboratory research — Vol. 44, n° 3, p. 168-176 (2009)

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  • Hammerstingl, Renate
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  • Adam, Gerhard
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  • Ayuso, Juan-Ramon
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  • Van Beers, BernardUCLouvain
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  • Tombach, Bernd
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Abstract
OBJECTIVE:: To evaluate the diagnostic efficacy (accuracy, sensitivity, specificity) of 1.0 M gadobutrol versus 0.5 M gadopentetate for the classification of lesions as either benign or malignant in patients with known or suspected liver lesions. METHODS AND MATERIALS:: A multicenter, phase-III, randomized, interindividually controlled comparison study with blinded reader evaluation was performed to investigate the diagnostic efficacy of a bolus injection of 1.0 M gadobutrol compared with 0.5 M gadopentetate at a dose of 0.1 mmol Gd/kg BW.The imaging protocol included a dynamic 3D-evaluation, static conventional, and fat saturated T1-weighted sequences. MR datasets were evaluated by 3 independent radiologists. The standard of reference was defined by an independent truth panel (radiologist or hepatologist).The safety evaluation included adverse events, vital signs, and physical examination. RESULTS:: A total of 497 of 572 patients were eligible for the final efficacy analysis. Noninferiority of gadobutrol-enhanced magnetic resonance imaging (MRI) for the classification of liver lesions was demonstrated on the basis of diagnostic accuracy determined by the on-site investigators (-0.098, 0.021) as well as for the average reader of the blinded evaluation (-0.096, 0.014) (95% confidence interval), compared with the predefined standard of reference. Very similar increases in sensitivity (ranging from approximately 10% to approximately 55%) and specificity (ranging from approximately 1%- approximately 18%) compared with precontrast MRI were also observed for the 2 contrast agent groups, with maximum differences of 4%.Very similar, low rates of adverse events were recorded for each of the 2 groups. No clinically relevant changes in vital signs or the results of the physical examination were observed in any patient. CONCLUSION:: This study documents evidence for the noninferiority of a single i.v. bolus injection of 1.0 M gadobutrol (0.1 mmol/kg body weight) to 0.5 M gadopentetate (0.1 mmol/kg body weight) in the diagnostic assessment of liver lesions with contrast-enhanced MRI. The known excellent safety profile of gadobutrol was confirmed in this clinical trial and is similar to that of gadopentetate.
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Hammerstingl, R., Adam, G., Ayuso, J.-R., Van Beers, B., Belfiore, G., Bellin, M.-F., Bongartz, G., Ernst, O., Frericks, B., Giuseppetti, G., Heinz-Peer, G., Laghi, A., Martin, J., Pering, C., Reimer, P., Richter, G.-M., Roemer, F., Schäfer, F., Vilgrain, V., et al. (2009). Comparison of 1.0 M Gadobutrol and 0.5 M Gadopentetate Dimeglumine-Enhanced Magnetic Resonance Imaging in Five Hundred Seventy-Two Patients With Known or Suspected Liver Lesions: Results of a Multicenter, Double-Blind, Interindividual, Randomized Clinical Phase-III Trial. Investigative Radiology : a journal of clinical and laboratory research, 44(3), 168-176. https://doi.org/10.1097/RLI.0b013e318198a0ae (Original work published 2009)