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How improved diagnostic confidence can enhance your patient care

When a patient is referred for an MRI scan, the goal is to provide them with a scan that identifies any abnormalities. Imagine if there was a lesion and it was missed on the scan.

Did you know that MRI contrast agents can vary in their ability to increase signal and improve diagnostic confidence? One of the most important factors in a contrast agent’s ability to enhance signal intensity is called relaxivity. Relaxivity matters.

 

Spot the difference:

The top row of images were acquired using a contrast agent (gadoterate meglumine) with lower relaxivity than the images in the bottom row, acquired with Gadovist®.

Relaxivity

In this comparison of these two agents, Gadovist® provided better contrast enhancement of brain lesions than gadoterate meglumine (p<0.001).1

Relaxivity can make a clinical difference particularly in small lesions that have a higher chance of being missed when using an agent with lower relaxivity.2 Gadovist® has the highest relaxivity of all macrocyclic gadolinium-based contrast agents (GBCAs) available in Canada (Figure 1).3

 

How the relaxivities of the macrocyclic agents compare at different field strengths3

Graph-01

Higher relaxivity translates to increased signal intensity in T1-weighted sequences. There have been 6 studies comparing Gadovist® with other macrocyclic GBCAs within the same individuals. In these studies, Gadovist® has been demonstrated to provide higher brain lesion enhancement than gadoterate meglumine in all 3 head-to-head comparisons of these agents and in 2 of 3 head-to-head comparisons with gadoteridol (Table 1).

Graph-02

Table 1. Signal intensities (SI) compared between macrocyclic agents in MRI of bain lesions1,4-8

 

Approved uses of macrocyclic agents

Gadovist has the most robust set of approved indications of all macrocyclic GBCAs in Canada and is unique in that it is indicated “particularly for cases where the exclusion or demonstration of additional pathology may influence the choice of therapy or patient management, for detection of very small lesions and for visualization of tumors that do not readily take up contrast media."9

Graph-03

With its high relaxivity, Gadovist® leads to a higher signal intensity and contrast in MRI of the central nervous system than the other macrocyclic agents1,4-8. Higher relaxivity could result in:

  • Increased signal on T1-weighted images12,13
  • Enhanced image quality13
  • Improved diagnostic confidence8,14

 

Find out more about the power of relaxivity:

 

References:

  1. Anzalone et al. Eur J Radiol 2013; 82:139-145
  2. Anzalone et al. Acta Radiol 2009; 50:933-940
  3. Rohrer et al. Invest Radiol 2005; 40:715-724
  4. Saake et al. Eur Radiol 2016; 26:820-828
  5. Maravilla et al. Am J Neuroradiol 2017; 38:1681-1688
  6. Koenig et al. Eur Radiol 2013; 23:3287-3295
  7. Maravilla et al. Am J Neuroradiol 2015; 36:14-23
  8. Gutierrez et al. Magn Reson Insights 2015; 8:1-10
  9. Gadovist® 1.0 Product Monograph March 5, 2018
  10. Gadoteridol Product Monograph March 9, 2018
  11. Gadoterate meglumine Product Monograph April 23, 2018
  12. Kanal, Maravilla and Rowley. AJNR Am J Neuroradiol 2014; 35:2215-2226
  13. Anzalone et al. Neurosurgery 2013; 72:691-701
  14. Katakami et al. Invest Radiol 2011; 46:411-418