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imp MRI 4 2004 26-05-2004 17:30 Pagina 3IntroductionThe new contrast agent Gd-BOPTA has been clinically investigated at a number of 1.5 MR imaging systems internationally.The clinical trial results have reported thus far that Gd-BOPTA when administered at a lower dosage than Gd-DPTA, stillprovides equal and or better signal to noise in contrast enhanced MRI examinations. Other clinical trials on neurologicalstudies report that Gd-BOPTA shows improved lesion detection in the instance of metastatic lesions.At the Mayne Clinical Research Imaging Centre, we conducted a limited trial in the use of Gd-BOPTA at 3.0 Tesla on clinicalpatients. Patients were randomly selected and the usage of this agent was trialled in various clinical studies. This allowedus to survey the various applications in the use of the new agent Gd-BOPTA, as well as it it’s effectiveness at 3.0TOur primary objective was to compare 0.1 mmol/kg dose of Gd-BOPTA, to the current clinical standard dose of 0.2 mmol/kgin contrast enhanced carotid imaging. This included a limited comparison of 0.1 mmol/kg hand injected to 0.1mmol/kg powerinjected examinations. The secondary objective was to compare 0.1mmol/kg dose of Gd-BOPTA to the same dose of Gd-DPTA in routine gadolinium brain imaging on patients done previously at the 3T system.Methods and Materials28 clinical patients presented with a variety of clinical indications that required the administration of gadolinium contrast.During a 10-week period patients were examined using the Gd-BOPTA contrast agent (Multihance, Bracco, Milan, Italy). Allpatient imaging was performed on a 3.0 Tesla Intera MR Imaging system (Philips Medical Systems, Best, The Netherlands).2 of these examinations were excluded from the study, due to technical failures. The remaining 26 patients consisted of 14females and 12 males, one adolescent patient aged 15 (male), while all the other patients were adults between the ages of20 to 91 years, median age of all patients being 48 years. Clinical examinations included pre- and post-contrast brain imagingand contrast enhanced carotid imaging on 23 patients, and 3 patients for aortic examinations.The pre- and post-contrast brain-imaging protocols were performed on the 8-channel SENSE Head coil with a gradient echotechnique (FFE) 2 planes pre-contrast and 3 planes post-contrast. T2 and Flair imaging was included in the clinical examinationbut not evaluated for their use with the contrast agent. The scan technique parameters used were TR/TE/FL 300/2.3/80 and reconstructed resolution 0.47 x 0.47 x 5.0 mm in the sagittal plan, and 0.47 x 0.47 x 3.0 (FOV 240, matrix 356 x 512)mm in the axial and coronal planes.Carotid ExaminationsThe pre- and post-contrast carotid examinations were performed on the quadrature body coil. The Bolus Track techniquewas used for real time contrast arrival visualization combined with rapid scan switching method for acquiring eccentricallyk-space ordered high-resolution 3D gradient echo volumes. The Bolus Track technique provides interactive method of visualizingcontrast arrival by performing real time image subtraction and image display every .509 ms in a 2D method. Theimage resolution was 1.76 x 1.76 by 80 mm, TR/TE/FL 4./0.9/25.The post-contrast 3D volume was acquired with the Centra technique, which images k 0 within the first 4 seconds of the totalimaging time. Factors used were TR/TE/FL 5.5/ 1.9/ 30, with a reconstructed resolution 0.34 x 0.34 x 0.5 mm, at a totalimaging time of 1: 18 minutes. Maximum intensity projects were reconstructed from the 3D volume and hardcopied for theimage quality evaluation. Image subtraction was performed on some of the 3D volumes to compare the quality of subtractedMIP, but this did not greatly enhance image quality and therefore was not performed on the remainder of the examinations.Aortic ExaminationsThe thoracic aortas of 3 patients were examined using Gd-BOPTA at the standard dose of 0.2 mmol/kg using the BolusTrack and Centra scan methods as mentioned above. The imaging was performed on the CTL Synergy Spine coil (phasearray) using a High Resolution 3D gradient echo volume with a TR/TE/FL 5.8/1.9/25 and at a reconstructed resolution of0.39 x 0.39 x 1.0 mm.Total scan time was 1: 20 seconds. The 3D volume images were reconstructed using the standard maximum intensity projecttechnique on the MRI scanner, but also surface rendered using the 3D Volume Rendering package on the Easy Visionworkstation (Philips Medical Systems, Best, The Netherlands). The surface and volume rendering provided a cleaner reconstructionby removing bowel motion, and eliminating other abdominal soft tissue.Dosage and Injection methodsOf the 26 patients used in this study, 12 received Gd-BOPTA at a dosage of 0.2 mmol/kg and 14 received Gd-BOPTA at 0.1mmol/kg. In each instance a saline flush was administered to equal to the contrast dosage, for example if the dosage of Gd-BOPTA was 0.2 ml/kg, resulting in a 10 ml volume of contrast, then the saline flush was as well a 10 ml volume.In 22 patients contrast was administered by hand injection estimated to be at 2 ml/sec. The gadolinium was given using 21gangiocath, minimum volume connection tubing, and a 3-way stopcock to permit immediate administration of the postgadolinium saline flush.For the remaining 4 patients, the Optstar power injector (Tyco Health Care) was used with an injection and saline volumescomparable for those used with the hand injection technique. Injection rate volume was performed at 3 ml/sec for this limitedgroup.

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