Comparison between a linear versus a macrocyclic contrast agent for whole body MR angiography in a clinical routine setting

Background: Previous experiences of whole body MR angiography are predominantly available in linear 0.5 M gadolinium-containing contrast agents. The aim of this study was to compare image quality on a four-point scale (range 1-4) and diagnostic accuracy of a 1.0 M macrocyclic contrast agent (gadobutrol, n = 80 patients) with a 0.5 M linear contrast agent (gadopentetate dimeglumine, n = 85 patients) on a 1.5 T whole body MR system. Digital subtraction angiography served as standard of reference. Results: All examinations yielded diagnostic image quality. There was no significant difference in image quality (3.76 +/- 0.3 versus 3.78 +/- 0.3, p = n.s.) and diagnostic accuracy observed. Sensitivity and specificity of the detection of hemodynamically relevant stenoses was 93%/95% in the gadopentetate dimeglumine group and 94%/94% in the gadobutrol group, respectively. Conclusion: The high diagnostic accuracy of gadobutrol in the clinical routine setting is of high interest as medical authorities (e. g. the European Agency for the Evaluation of Medicinal Products) recommend macrocyclic contrast agents especially to be used in patients with renal failure or dialysis.