Gadobenate Dimeglumine (Multihance®) in Contrast-Enhanced Magnetic Resonance Angiography

Abstract

Contrast-enhanced Magnetic Resonance Angiography (CE-MRA) is a rapidly evolving technique for vascular imaging. In many centers it has replaced conventional Digital Subtraction Angiography (DSA) as the preferred technique, particularly for imaging of the abdominal and renal vasculature as well as for the carotids. At present, CE-MRA is conducted using conventional gadoliniumbased agents whose T1 relaxivity in blood falls in the range between 4.3 and 5.0 mM 1s 1 (1). It is conceivable that improved diagnostic performance would be achieved using contrast agents capable of producing higher blood T1 relaxation rates. Gadobenate dimeglumine (Gd-BOPTA; MultiHanceTM; Bracco Imaging SpA, Milan, Italy) is a gadolinium-based MR contrast agent approved in Europe for MR imaging of the CNS and the liver. This agent displays plasma kinetics that are typical of conventional gadolinium agents (2) but, because of a capacity for weak non-covalent interaction with serum albumin (3), it also demonstrates a T1 relaxivity in blood (9.7 mM 1s 1) that is considerably higher than that of other available agents. Preliminary Phase I studies have demonstrated that Gd-BOPTA achieves a higher and longerlasting vascular signal enhancement in the abdominal aorta of healthy volunteers than Gd-DTPA when administered at the same dose and injection rate (4, 5). Similar findings have been observed in the run-off vessels in healthy volunteers; significantly higher signal intensities for Gd-BOPTA compared with Gd-DTPA were found for all quantitative assessments (6). Qualitative diagnostic assessment in this study revealed a preference for Gd-BOPTA in all vascular territories, from the abdominal vasculature to the femoral and tibial vasculature. Reported below are the results of studies aimed at defining the usefulness of Gd-BOPTA in patients with vascular disease.