Comparison of gadolinium-based contrast agents for MR cholangiography in saline, blood and bile: a phantom study

Johannes M Froehlich; Leen Moussa; Natalie Guirguis; Andreas Gutzeit; David Wu; Sabine Sartoretti-Schefer; Dow-Mu Koh; Orpheus Kolokythas; Simon Matoori

doi:10.1186/s41747-023-00331-2

Comparison of gadolinium-based contrast agents for MR cholangiography in saline, blood and bile: a phantom study

Eur Radiol Exp. 2023 Apr 24;7(1):21. doi: 10.1186/s41747-023-00331-2.

Authors

Johannes M Froehlich¹, Leen Moussa², Natalie Guirguis², Andreas Gutzeit^{3

4}, David Wu^{5

6

7}, Sabine Sartoretti-Schefer⁸, Dow-Mu Koh⁹, Orpheus Kolokythas¹⁰, Simon Matoori¹¹

Affiliations

¹ Clinical Research Group, Klus Apotheke Zurich, Zurich, Switzerland.
² Faculté de Pharmacie, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, QC, H3T 1J4, Canada.
³ Institute of Radiology and Nuclear Medicine and Breast Center St. Anna, Hirslanden Klinik St. Anna, Lucerne, Switzerland.
⁴ Department of Health Sciences and Medicine, Universität Luzern, Frohburgstrasse 3, 6002, Lucerne, Switzerland.
⁵ Laboratory for Cell and Tissue Engineering, Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA.
⁶ Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA.
⁷ Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02115, USA.
⁸ Institute of Radiology, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland.
⁹ Cancer Research UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research, Sutton, Surrey, UK.
¹⁰ Department of Radiology, University of Washington Medical Center, Seattle, WA, USA.
¹¹ Faculté de Pharmacie, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, QC, H3T 1J4, Canada. simon.matoori@umontreal.ca.

Abstract

Background: We compared T1- and T2-weighted signal intensities of liver-specific (gadoxetate, gadobenate) and non-specific (gadoterate) gadolinium contrast agents (CAs) in a bile phantom.

Methods: In a phantom study, gadoxetate, gadobenate, and gadoterate were diluted in saline, blood, and bile at different concentrations (0, 0.25, 0.5. 1, 2.5, 5, 10, and 25 mM) and imaged in a 3-T magnetic resonance imaging (MRI) system using T1- and T2-weighted sequences. The maximum signal intensities of CAs were compared for each sequence separately and across all T1-weighted sequences using one-way ANOVA.

Results: Using T1-weighted sequences, CA concentration-dependent signal intensity increase was followed by decrease due to T2* effects. Comparing CAs for each sequence in bile yielded higher maximum signal intensities with gadobenate than gadoxetate and gadoterate using T1-weighted spin-echo (p < 0.010), multiecho gradient- and spin-echo (p < 0.001), and T1-weighted high-resolution isotropic volume excitation (eTHRIVE) sequences (p < 0.010). Comparing across all T1-weighted sequences in the bile phantom, gadobenate imaged using T1-weighted turbo field-echo (TFE) sequence showed the highest signal intensity, significantly higher than that using other CAs agents or sequences (p < 0.004) except for gadobenate and gadoxetate evaluated with three-dimensional multiecho fast field-echo (3D-mFFE) and gadoxetate with T1-weighted TFE sequence (p > 0.141). Signal reduction with CA concentration-dependent decrease was observed on T2-weighted images.

Conclusion: In this bile phantom study of gadolinium-based CA, gadobenate and gadoxetate showed high signal intensity with T1-weighted TFE and 3D-mFFE sequences, which supports their potential utility for contrast-enhanced hepatobiliary MRI.

Key points: • Contrast-enhanced magnetic resonance (MR) cholangiography depends on contrast agent type, kinetics, and concentration in bile, • We compared signal intensities of three contrast agents in a bile phantom study. • Gadobenate, gadoxetate, and gadoterate demonstrated different signal intensities at identical concentrations. • Gadoxetate and gadobenate showed high signal intensities on T1-weighted MR sequences.

Keywords: Bile; Bile ducts; Contrast media; Gadolinium; Magnetic resonance imaging.

MeSH terms

Bile
Cholangiography
Contrast Media*
Gadolinium*
Magnetic Resonance Imaging / methods
Magnetic Resonance Spectroscopy
Meglumine

Substances

Contrast Media
gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate
Gadolinium
gadolinium ethoxybenzyl DTPA
Meglumine