Albumin-binding MR blood pool contrast agent improves diagnostic performance in human brain tumour: comparison of two contrast agents for glioblastoma

We qualitatively and quantitatively compared MRI enhancement obtained with gadofosveset, an albumin-binding blood-pool contrast agent, and with gadobutrol, an extracellular contrast agent, in patients with glioblastoma. Thirty-five patients (25 men; 64 +/- 14 years) with histologically proven glioblastoma underwent MRI including pre- and post-contrast T1-weighted SE images acquired 5 min after gadobutrol (0.1 mmol/kg) and, 48 h later, images acquired with identical parameters 5 min and 3, 6, and 24 h after gadofosveset (0.03 mmol/kg). Lesion extent, delineation, internal morphology, multifocality, and global diagnostic preference were evaluated quantitatively for the signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and contrast enhancement (CE). Mean values of SNR, CNR, and tumour CE were highest 6 h after gadofosveset. Multifocality was seen in 17 (48.6 %) patients; additional lesions had stronger enhancement 6 h after gadofosveset in 12 patients (70.6 %). In 21 (60 %) patients, radiologists' global preference was highest in images acquired 6 h after gadofosveset (kappa = 0.764). In 22 patients (62.8 %), all qualitative endpoints were better at 5 min after gadobutrol than in images acquired 5 min after gadofosveset injection. Gadobutrol gives significant tumour enhancement in early postcontrast imaging. However, images acquired 6 h after gadofosveset injection have significantly better diagnostic information endpoints and contrast enhancement. aEuro cent We compared MRI enhancement with gadofosveset and gadobutrol in patients with glioblastoma. aEuro cent Gadobutrol provides better enhancement in early enhanced imaging at 5 min. aEuro cent Gadofosveset at 6 h post-injection provides optimal enhancement and diagnostic information endpoints. aEuro cent Gadofosveset is feasible for diagnostic quality contrast-enhanced MRI in glioblastoma. aEuro cent The contrast medium dose can be reduced without disminishing the image quality using gadofosveset.