Crossover comparison of ferumoxytol and gadobenate dimeglumine for abdominal MR-angiography at 3.0 tesla: Effects of contrast bolus length and flip angle

Abstract

Purpose: Ferumoxytol (FE) has gained interest as an alternative to gadolinium-based contrast agents (GBCAs). The purpose of this study was to evaluate and optimize ferumoxytol dose and T1 weighting, in comparison to a conventional GBCA. Materials and Methods: Twelve healthy volunteers (six women / six men, mean age 44.3 years) were recruited for this study. Scanning was performed on a clinical 3 Tesla (T) MRI system. Gadobenate dimeglumine (GD)-enhanced MRA was performed followed by FE-enhanced MRA 1 month later. Volunteers were randomly assigned to a diluted (n = 6) or undiluted (n = 6) dose of GD (0.1 mmol/kg), and to FE doses of 4 mg/kg (n = 6) or 2 mg/kg (n = 6). First pass and steady-state MRA were performed for GD- and FE-enhanced MRA. Flip-angle optimization was performed after FE administration. Quantitative analysis included relative contrast-to-noise ratio (relCNR) measurements for all acquisitions. First pass GD- and FE-enhanced MRA images were evaluated qualitatively. Results: RelCNR was significantly higher with undiluted GD (31.8, 95% confidence interval [CI], 27.7–35.9) compared with diluted GD (16.2; 95% CI, 12.2–20.3; P = 0.001) and both 4 mg/kg FE (12.5; 95% CI, 8.5–16.4; P < 0.001) and 2 mg/kg FE (9.1; 95% CI, 5.1–13.2; P < 0.001) during first pass. Relative CNR did not decrease with FE 5 min postinjection compared with GD. Flip-angle analysis revealed relative CNR-peaks at 30° for FE 4 mg/kg and at 20° for FE 2 mg/kg. Diluted GD (P = 0.013) and FE 4 mg/kg (P = 0.01) revealed significantly higher image quality scores compared with undiluted GD during first pass. Conclusion: This study shows an equivalent image quality of FE and GD for first pass MRA even though GD showed significantly higher relative CNR. Level of Evidence: 1. Technical Efficacy: Stage 2. J. MAGN. RESON. IMAGING 2017;45:1617–1626.