Comparison of Dynamic Contrast-Enhancement Parameters between Gadobutrol and Gadoterate Meglumine in Posttreatment Glioma: A Prospective Intraindividual Study

Abstract

Background and purpose: Differences in molecular properties between one-molar and half-molar gadolinium-based contrast agents are thought to affect parameters obtained from dynamic contrast-enhanced imaging. The aim of our study was to investigate differences in dynamic contrast-enhanced parameters between one-molar nonionic gadobutrol and half-molar ionic gadoterate meglumine in patients with posttreatment glioma.

Materials and methods: This prospective study enrolled 32 patients who underwent 2 20-minute dynamic contrast-enhanced examinations, one with gadobutrol and one with gadoterate meglumine. The model-free parameter of area under the signal intensity curve from 30 to 1100 seconds and the Tofts model-based pharmacokinetic parameters were calculated and compared intraindividually using paired t tests. Patients were further divided into progression (n = 12) and stable (n = 20) groups, which were compared using Student t tests.

Results: Gadobutrol and gadoterate meglumine did not show any significant differences in the area under the signal intensity curve or pharmacokinetic parameters of K ^trans, V_e, V_p, or K_ep (all P > .05). Gadobutrol showed a significantly higher mean wash-in rate (0.83 ± 0.64 versus 0.29 ± 0.63, P = .013) and a significantly lower mean washout rate (0.001 ± 0.0001 versus 0.002 ± 0.002, P = .02) than gadoterate meglumine. Trends toward higher area under the curve, K ^trans, V_e, V_p, wash-in, and washout rates and lower K_ep were observed in the progression group in comparison with the treatment-related-change group, regardless of the contrast agent used.

Conclusions: Model-free and pharmacokinetic parameters did not show any significant differences between the 2 gadolinium-based contrast agents, except for a higher wash-in rate with gadobutrol and a higher washout rate with gadoterate meglumine, supporting the interchangeable use of gadolinium-based contrast agents for dynamic contrast-enhanced imaging in patients with posttreatment glioma.

FIG 1.

Flow diagram of the participant inclusion process.

FIG 2.

A 62-year-old female patient with posttreatment glioblastoma at 15 weeks after concurrent chemoradiotherapy exhibits a contrast-enhancing mass on DCE imaging with gadobutrol (A, upper row) and gadoterate meglumine (B, lower row). The K^trans, IAUC 30, K_ep, V_e, V_p, and dynamic curve show similar patterns and values. Wash-in and washout maps show differences between the 2 gadolinium-based contrast agents. The patient was diagnosed with tumor progression. C, The time-to-signal intensity curves (left: gadobutrol and right: gadoterate meglumine) are shown for both contrast agents. SI indicates signal intensity.

FIG 3.

A 55-year-old female patient with posttreatment glioblastoma at 15 weeks after concurrent chemoradiotherapy exhibits a contrast-enhancing mass on DCE imaging with gadobutrol (A, upper row) and gadoterate meglumine (B, lower row). The K^trans, IAUC 30, K_ep, V_e, V_p, and dynamic curve show similar patterns and values. Wash-in and washout maps show differences between the 2 gadolinium-based contrast agents. The patient was diagnosed with treatment-related change. C, The time-to-signal intensity curves (left: gadobutrol and right: gadoterate meglumine) are shown for both contrast agents. SI indicates signal intensity.