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1 M Gd-chelate (gadobutrol) for multislice first-pass magnetic resonance myocardial perfusion imaging

Departments of ¹ Diagnostic Radiology and² Internal Medicine, Eberhard-Karls-University, Tuebingen and³ Schering AG, Berlin, Germany

Correspondence: Michael Fenchel, Department of Diagnostic Radiology, Eberhard-Karls-University Tuebingen, Hoppe-Seyler-Str 3, 72076 Tuebingen, Germany. E-mail: michael.fenchel{at}med.uni-tuebingen.de

The aim of the study was to evaluate a 1 M gadolinium-chelate (gadobutrol) for first-pass MR myocardial perfusion examinations in patients with suspected coronary artery disease (CAD). In phantom studies, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) values of gadobutrol were compared with gadopentetate (Gd-DTPA). 25 consecutive patients with clinically suspected CAD were examined with dynamic rest/stress MR perfusion examinations using 0.05 mmol kg^–1 gadobutrol. Semi-quantitative evaluation of the myocardial perfusion was performed by calculating the myocardial perfusion reserve index (MPRI). Hypoperfused regions were correlated with data from X-ray coronary angiography. In phantom studies, SNR/CNR of gadobutrol-doped blood samples were consistently higher for all applied flip angles at concentrations 1.0 mmol L^–1 compared with Gd-DTPA. Assessment of 81 stress perfusion series with gadobutrol in 25 patients yielded a sensitivity of 82% and specificity of 91% for significant CAD. Combining the information from all perfusion series of one patient yielded a sensitivity of 89% and specificity of 94% on a per-vessel basis. Gadobutrol exhibited favourable signal properties in phantom studies. Rest/stress myocardial perfusion examinations using 1 M gadobutrol yielded high sensitivity and specificity in detection of malperfused areas (82% and 91%, respectively). This is comparable with recently published perfusion data using 0.5 M Gd-DTPA.