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.¹

Gadovist has the highest relaxivity of all macrocyclic gadolinium based contrast agents (GBCAs) available in Canada (Figure 1).²

Figure 1. Relaxivity or macrocyclic GBCAs in plasma at 37°C.

Higher relaxivity translates to increased signal intensity in T1-weighted sequences. To demonstrate differences in contrast enhancement, there have been 6 intraindividual studies comparing Gadovist with other macrocyclic GBCAs for contrast-enhanced MRI of brain lesions. In these studies, Gadovist has been demonstrated to provide higher lesion enhancement than Dotarem in all 3 head-to-head comparisons of these agents and in 2 of 3 head-to-head comparisons with ProHance (Table 1).

Table 1. Signal intensities (SI) compared between macrocyclic agents in MRI of brain lesions^3-8

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

Commenting on the importance of small lesion detection, Dr. Marco Essig explains: “The detection of small lesions is most important in the diagnostic workup and treatment planning of brain metastasis. The number of metastases is important for treatment decision as the treatment options depend on the number and size of lesions. The detection of metastasis defines the treatment and finally also the outcome. For primary tumours, the detection of small lesions is most important in the follow up of lesions after therapy. The early detection of new, even small lesions is essential for the definition of further treatment or change of current treatment regimens.” (Dr. Marco Essig is the Chairman of the Department of Radiology at the University of Manitoba’s Faculty of Medicine and Director of Diagnostic Imaging for the Winnipeg Health Region)

References

1. Anzalone et al. Acta Radiol 2009; 50:933-940
2. Rohrer et al. Invest Radiol 2005; 40:715-724
3. Anzalone et al. Eur J Radiol 2013; 82:139-145
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