CMR myocardial infarct evaluation in a canine model by three different contrast agents
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POSTER PRESENTATION
Open Access
CMR myocardial infarct evaluation in a canine model by three different contrast agents Roberto Sarnari1*, Alejandro Aquino2, Brandon Benefield1, Octavia Biris3, Kathleen R Harris1, Daniel C Lee1,4 From 15th Annual SCMR Scientific Sessions Orlando, FL, USA. 2-5 February 2012 Summary We evaluated R1 curves, CNR and scar visualization and quantification in a dog model of myocardial infarction by CMR, using three different contrast agents: Gadopentate dimeglumine (Gd-DTPA, Magnevist), Gadobenate dimeglumine (Gd-BOPTA, MultiHance), and Gadofosveset (Ablavar). Gd-DTPA showed better characteristics for myocardial scar visualization and quantification. Gadofosveset demonstrated lower CNR and underestimation of infarct size when compared to Gd-DTPA. Background Several contrast agents (CA) are currently available for cardiac magnetic resonance (CMR) imaging. CAs have different blood protein binding capacity, tissue relaxivity, and potential risk for development of nephrogenic systemic fibrosis. Late gadolinium enhanced (LGE) CMR is the gold standard for visualizing myocardial infarction (MI), but the impact of different CAs on LGE visualization and quantification is unknown. Methods MI was induced in 4 dogs by left anterior descending (LAD) coronary artery ligation for 90 minutes with reperfusion. CMR cine, pre- and serial post-contrast T1 mapping and LGE imaging were performed in the acute and chronic setting. Standard clinical dosage of the CAs was used for LGE imaging (Gd-DTPA:0.2 mmol/lkg; Gd-BOPTA:0.1 mmol/kg; Gadofosveset:0.03 mmol/kg). MI % was quantified, T1 map was obtained by modified Look-Locker sequence, R1 was calculated as 1/T1. For each five minute interval following injection, mean and standard deviation for R1 were calculated. Contrast to noise ratio (CNR) was calculated as [(Inf SI)-(Myo SI)]/ 1 Feinberg Cardiovascular Research Institute, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA Full list of author information is available at the end of the article
[stdev(Noise SI)] for segmented and single shot LGE images at 15 and 30 minutes after CA injection.
Results Gd-DTPA showed the widest difference in R1 values between healthy and infarcted myocardium, the difference being the widest at 10 minutes and remaining significant up to 60 minutes after injection. Gadofosveset showed the narrowest difference in R1 between healthy and infarcted myocardium, which lost significance the earliest of all three agents (p>0.05 at 20 minutes after contrast injection). Gd-BOPTA had an intermediate R1 difference which remained significant up to 60 minutes. Gd-BOPTA CNR was significantly lower than GdDTPA CNR at 15 and 30 minutes on single-shot imaging, and trended lower on segmented imaging. Gadofosveset CNR trended lower than Gd-DTPA, but did not reach statistical significance. CNR values fell significantly from 10 to 30 minutes after CA injection when using Gd-BOPTA(28.5±5.7 vs 16.5±6.8; mean±SD, p
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