Gd-BOPTA Administration Research Articles

Liver enhancement during hepatobiliary phase after Gd-BOPTA administration: correlation with liver and renal function.

To assess the influence of liver and renal function on liver relative enhancement during hepatobiliary phase MRI after Gd-BOPTA administration. In this IRB-approved retrospective cohort study, we included 326 patients who underwent Gd-BOPTA-enhanced 1.5T liver MRI, including hepatobiliary phase (HBP) acquired 90-150min after injection, in two centres between Jan 2016 and Dec 2019. Liver signal intensity was measured on native and HBP phases and normalized to paraspinal muscles. Liver normalized relative enhancement (NRE) in HBP was calculated and compared with eGFR, total serum bilirubin and HBP acquisition delay by means of Spearman r correlation test and Mann-Whitney U test. 221/326 patients received 0.05mmol/Kg Gd-BOPTA (group A), whereas 105/326 received 0.1mmol/Kg (group B). Liver NRE in HBP was significantly higher in group B than in group A (0.55vs.0.33, p < 0.0001). In both groups, liver NRE in HBP had a negative correlation with total serum bilirubin level (r = - 0.32, p < 0.0001, group A; r = - 0.36, p = 0.0002, group B). Patients with total bilirubin > 1.2mg/dl showed significantly lower NRE in HBP compared with those with total bilirubin ≤ 1.2mg/dl (p < 0.0001, group A; p = 0.04, group B). Patients with impaired liver function in group B showed a NRE during HBP comparable with those with normal liver function in group A. No statistically significant correlation between liver NRE and eGFR or acquisition delay was observed. The degree of liver enhancement during HBP is not correlated with eGFR or acquisition delay, but it is significantly reduced in patients with impaired liver function. 0.1mmol/kg Gd-BOPTA dose might be useful in patients with total serum bilirubin > 1.2mg/dl. • The degree of liver enhancement during hepatobiliary phase after Gd-BOPTA administration has a negative correlation with total serum bilirubin level (r = - 0.32, p < 0.0001). • The degree of liver enhancement during HBP after Gd-BOPTA administration is not significantly correlated with renal function and acquisition delay (comprised between 90 and 150min after contrast injection). • 0.1mmol/Kg Gd-BOPTA dose might be preferable in patients with increased total serum bilirubin levels.

Ascites relative enhancement during hepatobiliary phase after Gd-BOPTA administration: a new promising tool for characterising abdominal free fluid of unknown origin.

To correlate the degree of ascites enhancement during hepatobiliary phase after gadobenate dimeglumine (Gd-BOPTA) administration with ascites aetiology. IRB-approved retrospective study, need for informed consent was waived. We included 74 consecutive ascitic patients who underwent Gd-BOPTA-enhanced liver MRI including hepatobiliary phase (HBP) images between January 2014 and December 2017. Ascites appearance on unenhanced and HBP images was classified as hypo-, iso- or hyperintense in comparison to paraspinal muscles. Ascites signal intensity on unenhanced and HBP images was measured using round ROIs and was normalised to paraspinal muscles (NSI). Normalised relative enhancement (NRE) between native phase and HBP was calculated. The results were related to ascites aetiology using Wilcoxon and Mann-Whitney tests. On native images, ascites appeared hypointense in 95.9% of the cases and isointense in 4.1%, whereas on HBP images, it appeared hyperintense in 59.4% of the cases, isointense in 36.5% and hypointense in 4.1%. Mean ascites NSI was 0.52 on unenhanced images and 1.50 on HBP ones (p < 0.0001). Mean ascites NRE was 201 ± 133%. Ascites of non-malignant aetiology showed mean NRE of 210 ± 134%, whereas malignant ascites showed mean NRE of 92 ± 20% (p = 0.001). ROC analysis showed that a NRE < 112.5% correlates with malignant aetiology with 100% sensitivity and 83.4% specificity (LR = 5.667). NRE did not show any significant correlation with ascites thickness, eGFR and time interval between contrast administration and HBP acquisition (p > 0.05). Ascites NRE in HBP after Gd-BOPTA administration is significantly lower in patients with ascites secondary to peritoneal carcinomatosis than in patients with non-malignant ascites. • Ascites enhancement in the hepatobiliary phase after Gd-BOPTA administration may determine false positive findings when looking for biliary leaks. • Ascites enhancement in the hepatobiliary phase after Gd-BOPTA administration is lower in patients with peritoneal carcinomatosis than in patients with portal hypertension or congestive heart failure. • None of the patients with peritoneal carcinomatosis showed an ascites enhancement of more than 112% as compared with unenhanced images.

Peritoneal and pleural fluids may appear hyperintense on hepatobiliary phase using hepatobiliary MR contrast agents.

To describe the effect of hepatobiliary-specific MR imaging contrast agent (HBCA) administration on the signal intensity of peritoneal and pleural fluid effusions on T1-weighted MR images. From October 2015 to May 2016 139 patients (mean 60±10 years old, 69 % males) with peritoneal or pleural effusions without biliary leakage who underwent HBCA-MRI (Gd-BOPTA or Gd-EOB-DTPA) at 1.5T and 3T were included from two centres. The fluid signal intensity was classified as hypo/iso/hyperintense before/after HBCA administration. The relative signal enhancement (RE) was calculated. On hepatobiliary phase (HBP), peritoneal fluids appeared hyper/isointense in 88-100 % and pleural effusions in 100 % of the patients following Gd-BOPTA administration. All fluids remained hypointense following Gd-EOB-DTPA. The signal intensity of fluids increased with both HBCA but RE was significantly higher following Gd-BOPTA (p=0.002 to <0.001). RE was correlated with HBP acquisition time-point (r=0.42, p<0.001 and r=0.50, p=0.033 for peritoneal and pleural fluids). The signal intensity of pleural and peritoneal fluids progressively increases following HBCA administration in the absence of biliary leakage. Due to its later hepatobiliary phase, this is more pronounced after Gd-BOPTA injection, leading to fluid hyperintensity that is not observed after Gd-EOB-DTPA injection. • Fluids appear hyper/isointense on HBP in most patients after Gd-BOPTA injection. • Fluids remain hypointense on HBP after Gd-EOB-DTPA injection. • RE of fluids increases with time after liver-specific Gd injection. • RE of fluids is higher in patients with chronic liver disease.

The relationship between liver function and liver parenchymal contrast enhancement on Gd-BOPTA-enhanced MR imaging in the hepatocyte phase

ObjectivesTo investigate the relationships between liver function parameters and the degree of hepatic contrast enhancement on gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance (MR) imaging in the hepatocyte phase, as well as to clarify whether Gd-BOPTA-enhanced MR imaging in the hepatocyte phase could be used to evaluate liver function and liver function reserve. Materials and methodsIn this study, 150 patients were classified into the following 4 groups: patients with normal liver function without liver cirrhosis (the NLF group) and cirrhosis patients with Child–Pugh Classes A, B, and C (the LCA, LCB, and LCC groups, respectively). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated from measurements of the signal intensity before (SI pre) and 90min after (SI post) the intravenous administration of Gd-BOPTA, using the following formula: RE=(SI post−SI pre)/SI pre. Statistical analysis was used to evaluate the relationship between the REs of the liver parenchyma and liver function parameters, as well as the different REs of the liver parenchyma among the NLF, LCA, LCB, and LCC groups. ResultsIncreased REs of the hepatic parenchyma showed correlations with decreased serum levels of total bilirubin (r=−0.263, P<0.01) and prothrombin time (r=−0.24, P<0.01), and elevated serum levels of albumin (r=0.328, P<0.01) for all of the patients. The REs of the liver parenchyma were significantly higher for the NLF and LCA groups compared with the LCB (P<0.001) and LCC (P<0.001) groups, respectively. ConclusionsThe intracellular uptake of Gd-BOPTA decreased with impaired liver function. Measurement of the degree of the liver parenchymal contrast enhancement on GD-BOPTA-enhanced MR imaging in the hepatocyte phase might be a non-invasive technique for assessing liver function and liver function reserve.

Ultra low-dose of gadobenate dimeglumine for late gadolinium enhancement (LGE) imaging in acute myocardial infarction: A feasibility study

PurposeTo assess the feasibility of using an ultra-low dose (0.05mmol/kg of body weight [BW]) of high relaxivity contrast agent for late gadolinium enhancement (LGE) imaging in patients with acute myocardial infarction (AMI). Materials and methods17 consecutive patients (mean age, 60.1±10.3 years) with ST-segment elevation AMI underwent two randomized cardiac magnetic resonance studies (exam intervals between 24 and 48h) on a 1.5T unit during the first week after the event using gadobenate dimeglumine (Gd-BOPTA) at the dose of 0.1mmol/kg BW (standard dose or SD group) and 0.05mmol/kg BW (half dose or HD group). Image quality was qualitatively assessed. Quantitative analysis of LGE were performed by measuring signal intensity (SI), signal-to-noise ratio (SNR) in the infarcted myocardium (IM), non-infarcted myocardium (N-IM) and left ventricular cavity (LVC) in images acquired at 1, 3, 5, 10, 15 and 20min after administration of Gd-BOPTA using both contrast media protocol. Contrast-to-noise ratio (CNR) between IM and N-IM (CNR IM/N-IM) and between IM and LVC (CNR IM/LVC) were also quantified for each time point. Moreover the extent of infarcted myocardium was measured. Results102 LGE images were evaluated for each dose group. Quality score was significantly higher for SD at 1, 15 and 20min (0.002<p<0.046) and for HD at 5min (p=0.013). SNR has been higher in the SD group compared to the HD group even though not statistically significant at any time-point for both IM (SD vs. HD: 87.7±73 vs. 65±66; 0.15<p<0.38) and N-IM (SD vs. HD: 22±61 vs. 9.9±6.5; 0.09<p<0.43). LVC SNR was significantly higher with SD at 10min (p=0.03), 15min (p=0.001) and 20min (p=0.004). CNR between the IM and N-IM was significantly higher using SD compared to HD (1382.24±1049 vs. 695.4±500; 0.000<p<0.028) at 10, 15 and 20min. No significant differences in CNR IM/LVC were noted for HD acquired 5min after CM administration compared to SD acquired at 10 (p=0.34), 15 (p=0.96) and 20 (p=0.41) min, and between HD at 10min compared to SD acquired at 15min (p=0.78) and 20min (p=0.32). Good correlation between SD and HD (0.56<r2<0.85, p<0.024) was found at all time-points in the measuring of IA. ConclusionThe use of a 0.05mmol/kg dose of gadobenate dimeglumine is feasible for LGE imaging of acute MI and the best image quality is obtained at 5min after contrast administration. It could be beneficial in patient with renal failure and a solution to improve the identification of subendocardial infarction reducing examination time, costs and total gadolinium load. However, the standard dose of 0.1mmol/kg provides overall better image quality, with the best performance obtained at the delay of 10min or more after Gd-BOPTA administration, and it should be routinely preferred.

Coronary artery angiography and myocardial viability imaging: a 3.0-T contrast-enhanced magnetic resonance coronary artery angiography with Gd-BOPTA

With improving MR sequence, phase-array coil and image quality, cardiac magnetic resonance imaging is becoming a promising method for a comprehensive non-invasive evaluation of coronary artery and myocardial viability. The study aimed to evaluate contrast-enhanced whole-heart coronary MR angiography (CE WH-CMRA) at 3.0-Tesla for the diagnosis of significant stenosis (≥50%) and detection of myocardial infarction (MI) in patients with suspected coronary artery disease (CAD). CE WH-CMRA was performed in consecutive 70 patients with suspected CAD by using a 3.0-T MR system. A respiratory-gated, electrocardiography-triggered, inversion-recovery, segmented fast low angle shot sequence (TI = 200 ms) was used. Data acquisition began 60 s after the slow injection of Gd-BOPTA (0.2 mmol/kg body weight, at an injection rate 0.3 ml/s). At last, breath-hold 2D-PSIR-SSFP sequence was performed. Diagnostic accuracy of CE WH-CMRA in detecting significant stenosis (≥50%) was evaluated using invasive coronary angiography as the referenced standard. The MI region appearing as high signal intensity visualized on CEWH-CMRA and 2D-PSIR-SSFP images were compared and analyzed. CE WH-CMRA correctly identified 42 of 44 patients with significant CAD. The overall sensitivity, specificity, negative predictive value, positive predictive value and accuracy for diagnosing significant CAD was 83.6, 95.8, 96.0, 82.8 and 93.4% respectively. The MI region detected by WH-CMRA and 2D-PSIR-SSFP were consistent in 10 patients and these segments manifested with transmural or subendocardial enhancement patterns. Only one MI patient was judged inconsistent between WH-CMRA and 2D-PSIR-SSFP, who was confirmed by clinical and electrocardiogram results. The enhancement pattern in this patient was spotted and focal in 2D-PSIR-SSFP, but was dismissed by WH-CMRA. It is feasible to obtain information about coronary artery stenosis and myocardial viability in a single CE WH-CMRA with administration of Gd-BOPTA.

Ischemic Late Gadolinium Enhancement

Chou, Shinn-Huey S. MD; Walker, Christopher M. MD; Chung, Jonathan H. MD Author Information

Contrast‐enhanced specific absorption rate‐efficient 3D cardiac cine with respiratory‐triggered radiofrequency gating

To investigate the use of radiofrequency (RF) gating in conjunction with a paramagnetic contrast agent to reduce the specific absorption rate (SAR) and increase the blood-myocardium contrast in balanced steady-state free precession (bSSFP) 3D cardiac cine. RF gating was implemented by synchronizing the RF-excitation with an external respiratory sensor (bellows), which could additionally be used for respiratory gating. For reference, respiratory-gated 3D cine images were acquired without RF gating. Free-breathing 3D cine images were acquired in eight healthy subjects before and after contrast injection (Gd-BOPTA) and compared to breath-hold 2D cine. RF-gated 3D cine reduced the SAR by nearly 40% without introducing significant artifacts while providing left ventricle (LV) measurements similar to those obtained with 2D cine. The contrast-to-noise ratio (CNR) was significantly higher for 3D cine compared to 2D cine, both before and after contrast injection; however, no statistically significant CNR increase was observed for the postcontrast 3D cine compared to the precontrast acquisitions. Respiratory-triggered RF gating significantly reduces SAR in 3D cine acquisitions, which may enable a more widespread clinical use of 3D cine. Furthermore, CNR of 3D bSSFP cine is higher than of 2D and administration of Gd-BOPTA does not improve the CNR of 3D cine.

Hepatic transit time analysis using contrast enhanced MRI with Gd‐BOPTA: A prospective study comparing patients with liver metastases from colorectal cancer and healthy volunteers

To find out if the hepatic transit time (HTT) shortening, which was already proven in patients with liver metastases by other modalities, can also be detected with MRI. The Patient group consisted of 20 subjects with liver metastases from colorectal cancer and the control group of 21 healthy subjects. Baseline and post contrast images were acquired before and after administration of Gd-BOPTA, using a T1-weighted bolus test sequence. Arrival times (AT) of the contrast agent for the aorta, the hepatic artery, the portal vein and one hepatic vein were determined. Based on arrival time measurements HTT were calculated. All analyses showed significantly shorter HTT in patients with metastases compared with healthy volunteers (P < 0.05). There were no false positives using a threshold of 10.4 s for arterial to venous HTT. For aortal to venous and portal to venous HTT a threshold of 12.5 s and 4 s was calculated, respectively. No significant correlation between HTT and involved liver segments, overall volume of metastases or subject age was found. We conclude that HTT measurements using contrast enhanced MRI with Gd-BOPTA can detect hemodynamic changes due to metastatic liver disease from colorectal cancer.

Liver vessel enhancement by gd-bopta and gd-eob-dtpa: a comparison in healthy volunteers

A thorough understanding of magnetic resonance (MR) contrast media dynamics makes it possible to choose the optimal contrast media for each investigation. Differences in visualizing hepatobiliary function between Gd-BOPTA and Gd-EOB-DTPA have previously been demonstrated, but less has been published regarding differences in liver vessel visualization. To compare the liver vessel and liver parenchymal enhancement dynamics of Gd-BOPTA (MultiHance) and Gd-EOB-DTPA (Primovist). The signal intensity of the liver parenchyma, the common hepatic artery, the middle hepatic vein, and a segmental branch of the right portal vein was obtained in 10 healthy volunteers before contrast media administration, during arterial and portal venous phases, and 10, 20, 30, 40, and 130 min after intravenous contrast medium injection, but, due to scanner limitations, not during the hepatic venous phase. The doses of contrast media were 0.1 mmol/kg for Gd-BOPTA and 0.025 mmol/kg for Gd-EOB-DTPA. Maximum enhancement of liver parenchyma was observed from the portal venous phase until 130 min after Gd-BOPTA administration and from 10 min to 40 min after Gd-EOB-DTPA. There was no difference in maximum enhancement of liver parenchyma between the two contrast media. When using Gd-BOPTA, the vascular contrast enhancement was still apparent 40 min after injection, but had vanished 10 min after Gd-EOB-DTPA injection. The maximum difference in signal intensity between the vessels and the liver parenchyma was significantly greater with Gd-BOPTA than with Gd-EOB-DTPA (P<0.0001). At the dosage used in this study, Gd-BOPTA yields higher maximum enhancement of the hepatic artery, portal vein, and middle hepatic vein during the arterial and the portal venous phase and during the delayed phases than Gd-EOB-DTPA does, whereas there is no difference in liver parenchymal enhancement between the two contrast agents.

Evaluation of intraaxial enhancing brain tumors on magnetic resonance imaging: intraindividual crossover comparison of gadobenate dimeglumine and gadopentetate dimeglumine for visualization and assessment, and implications for surgical intervention

The goal in this article was to compare 0.1 mmol/kg doses of gadobenate dimeglumine (Gd-BOPTA) and gadopentetate dimeglumine, also known as gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA), for enhanced magnetic resonance (MR) imaging of intraaxial brain tumors. Eighty-four patients with either intraaxial glioma (47 patients) or metastasis (37 patients) underwent two MR imaging examinations at 1.5 tesla, one with Gd-BOPTA as the contrast agent and the other with Gd-DTPA. The interval between fully randomized contrast medium administrations was 2 to 7 days. The T1-weighted spin echo and T2-weighted fast spin echo images were acquired before administration of contrast agents and T1-weighted spin echo images were obtained after the agents were administered. Acquisition parameters and postinjection acquisition times were identical for the two examinations in each patient. Three experienced readers working in a fully blinded fashion independently evaluated all images for degree and quality of available information (lesion contrast enhancement, lesion border delineation, definition of disease extent, visualization of the lesion's internal structures, global diagnostic preference) and quantitative enhancement (that is, the extent of lesion enhancement after contrast agent administration compared with that seen before its administration [hereafter referred to as percent enhancement], lesion/brain ratio, and contrast/noise ratio). Differences were tested with the Wilcoxon signed-rank test. Reader agreement was assessed using kappa statistics. Significantly better diagnostic information/imaging performance (p < 0.0001, all readers) was obtained with Gd-BOPTA for all visualization end points. Global preference for images obtained with Gd-BOPTA was expressed for 42 (50%), 52 (61.9%), and 56 (66.7%) of 84 patients (readers 1, 2, and 3, respectively) compared with images obtained with Gd-DTPA contrast in four (4.8%), six (7.1%), and three (3.6%) of 84 patients. Similar differences were noted for all other visualization end points. Significantly greater quantitative contrast enhancement (p < 0.04) was noted after administration of Gd-BOPTA. Reader agreement was good (kappa > 0.4). Lesion visualization, delineation, definition, and contrast enhancement are significantly better after administration of 0.1 mmol/kg Gd-BOPTA, potentially allowing better surgical planning and follow up and improved disease management.

Determinants of Myocardial Response in CMR Perfusion Imaging Using Gd-BOPTA (Multihance®)

Different centers and vendors use different sequences and contrast agent application schemes for MR myocardial perfusion imaging. The purpose of this study was to evaluate the role of different sequences, dosages, and injection speeds of contrast media for semiquantitative MR-perfusion assessment. In a pilot study with 58 consecutive patients three of the most commonly used sequences for MR myocardial perfusion imaging (T1-GrE, GrE-EPI or SSFP) were compared to each other in terms of peak myocardial enhancement and image quality. For the main part of the study dynamic first pass MR perfusion imaging (Philips Intera CV, Best, Tthe Netherlands) was performed in 24 patients using the most favorable sequence from the pilot study (SSFP) after peripheral i.v. administration of Gd-BOPTA during adenosine stress. Two doses (0.05 mmol/kg bw and 0.025 mmol/kg bw) and four different injection speeds (8, 4, 3, 2 ml/s) were used. Signal intensity time curves were determined in the LV and myocardial segments supplied by normal coronary arteries and correlation between LV and myocardial upslope as well as peak enhancement were noted. The SSFP-sequence showed a higher peak enhancement when using 0.05 mmol/kg bw of Gd-BOPTA and a superior image quality for both dosage regimen compared with the other sequences and was consequently applied for the main study. A significant correlation was found between the upslopes in the LV and the myocardium (r square = 0.85, p < 0.001). However, LV and myocardial upslopes were largely independent of the dosage. Myocardial upslope was significantly slower at an injection rate of 2 ml/s compared to 3 and 4 ml/s. Higher Gd-doses led to significantly higher enhancement (p < 0.001). In healthy myocardial segments, the myocardial upslope is mainly determined from the LV upslope. Both myocardial enhancement and upslope are largely independent from the injection rate of a contrast agent bolus as long as the injection speed is not below 3 ml/s. Myocardial enhancement, however, is dose dependent. Thus, a simple correction for LV upslope allows to normalize a wide variety of input parameters. Differences of myocardial upslope or peak signal intensity after correction should be mainly dependent on blood flow.

3D MR colonography after intravenous administration of the hepatobiliary contrast agent Gd-BOPTA: bile tagging

3D MR colonography after intravenous administration of the hepatobiliary contrast agent Gd-BOPTA: bile tagging

Hepatocellular carcinoma: correlation between gadobenate dimeglumine-enhanced MRI and pathologic findings.

To correlate the appearance of hepatocellular carcinoma on delayed (60 minutes) postcontrast T1-weighted gradient echo images with the mode of action of gadobenate dimeglumine (Gd-BOPTA) and the anatomic and pathologic characteristics of the lesions. A total of 34 patients with hepatocellular carcinoma and varying degrees of diffuse liver disease were studied. T2-weighted spin echo and T1-weighted spin echo and gradient echo images were acquired before and 60 minutes after the intravenous administration of 0.1 mmol/kg Gd-BOPTA. Qualitative and quantitative evaluations of the images were performed and correlated with histologic findings. The quantitative evaluation, performed on T1-weighted gradient echo images, looked at the percentage increase of liver enhancement after Gd-BOPTA administration, the lesion-to-liver contrast/noise (C/N) ratio before and after Gd-BOPTA administration, and the C/N variation after Gd-BOPTA administration. Qualitative assessment considered the morphologic features of the lesions as well as the visual variation of contrast before and after Gd-BOPTA administration. Finally, a histologic evaluation was made of the degree of differentiation of the lesions and of the presence of fatty metaplasia, necrosis, bile, or intratumoral peliosis. Among the parameters affecting lesion identification were the extent of liver function, degree of vascularization, residual functionality of the tumor cells, and characteristics of the neoplastic tissue. Positive correlations (Spearman coefficients = 0.359 and 0.393, respectively) were observed precontrast between the degree of liver failure and the amount of contrast noise, and postcontrast between the amount of intralesional fatty metaplasia and the extent to which lesion conspicuity worsened after Gd-BOPTA administration. An inverse correlation (Spearman coefficient = -0.330) was observed between the degree of lesion differentiation and the visible appearance after Gd-BOPTA administration, with well-differentiated lesions tending toward worsened conspicuity postcontrast. A statistically significant difference (P = 0.001) was observed in the mean precontrast C/N ratio for lesions later showing unchanged conspicuity and worse conspicuity on postcontrast images, respectively. Marked variation (P = 0.019) was also observed between Child A and B cirrhotic patients for the degree of hepatic enhancement on postcontrast images. The results suggest that liver parenchyma signal intensity is influenced by the extent to which liver function is compromised, that residual hepatocytic functionality permits Gd-BOPTA uptake by certain lesions and that this uptake might subsequently impair the observed C/N ratio on delayed images, and that the worsening of lesion conspicuity on postcontrast images is influenced also by high quantities of intralesional fatty metaplasia.

939-82 Efficacy of Gadolinium-BOPTA in Magnetic Resonance Imaging to Assess Acute Myocardial Infarction in Man

To assess the efficacy of the newly developed contrast agent gadolinium (Gd) benzyloxy propionic tetraacetic-acid BOPTA to detect acute myocardial infarction in patients using magnetic resonance imaging (MRI), 24 patients (age 53.3 ± 8.3) were examined 9.3 ± 3.7 days after a first myocardial infarction. Short axis Tl weighted images were obtained at 3 slice levels, before, immediately after injection of Gd-BOPTA, and after 15 min, 30 min, 45 min. Patients were divided into 2 groups according to the dose of Gd-BOPTA (0.05 mmol/kg and 0.1 mmol/kg). Contrast to noise ratio, signal intensity enhancement of normal and infarcted myocardium and signal intensity of infarcted to signal intensity of normal myocardium (SI inf/norm) was quantified. Contrast to noise ratio was not affected by the type of dosage (0.05 mmol/kg, 5.75 ± 0.85 vs. 0.1 mmol/kg, 5.32 ± 0.69). Enhancement of normal and infarcted myocardium increased immediately after administration of 0.05 mmol/kg Gd-BOPTA and gradually decreased thereafter (p &lt; 0.002 for normal myocardium) (see Figure). After 0.1 mmol/kg Gd-BOPTA administration, myocardial enhancement increased rapidly but showed no decrease within 45 minutes after administration (see Figure). Mean SI inf/norm was significantly improved after Gd-BOPTA administration (p &lt; 0.0005 for either dosage), and 0.05 mmol/kg produced significantly higher SI inf/norm than 0.1 mmol/kg (1.42 ± 0.069 vs. 1.34 ± 0.055 respectively, p = 0.015). Gd BOPTA is a useful contrast agent to assess myocardial infarction. Optimal results are obtained with a dosage of 0.05 mmol/kg body weight Gd-BOPTA. Persistent enhancement of infarcted and normal myocardium suggests an affinity of Gd-BOPTA for myocytes, making it a promising tool in MR imaging of ischemic heart disease.