Article Figures & Data
Figures
- Fig 1.
Flow chart outlining patient enrollment, drop-out rates, and lesion study populations.
- Fig 2.
Bar graphs show reader preference and diagnostic results from 3 independent blinded readers for the following: global diagnostic preference (A), border delineation (B), internal morphology (C), lesion extent (D), and qualitative contrast enhancement (E). Comparisons are based on 198 patients for reader 1, 194 patients for reader 2, and 196 patients for reader 3. Each reader expressed no preference for either agent in the overwhelming number of cases for all 5 assessments. The small number of cases in which 1 agent is preferred is nearly equally distributed for gadobutrol versus gadoteridol. Note the very high reader agreement for all measures.
- Fig 3.
A 61-year-old man with brain metastases from primary lung cancer. Images were acquired before (A, unenhanced T1 SE) and after (B, T1 SE; C, high-resolution T1 GRE) administration of gadoteridol and before (D, unenhanced T1 SE) and after (E, T1 SE; F, high-resolution T1 GRE) administration of gadobutrol. Two lesions clearly seen in both examinations show no differences in contrast enhancement or in the size of lesions.
- Fig 4.
A 51-year-old woman with glioblastoma multiforme. Images were acquired before (A, unenhanced T1 SE) and after (B, T1 SE; C, high-resolution T1 GRE) administration of gadoteridol and before (D, unenhanced T1 SE) and after (E, T1 SE; F, high-resolution T1 GRE) administration of gadobutrol. A rim-enhancing mass in the right thalamus with extension into the posterior interhemispheric region is clearly seen in both examinations. No differences in contrast enhancement or in the size of lesions are apparent.
- Fig 5.
Blinded reader comparison of mean postcontrast-precontrast lesion-to-background ratio on T1 SE sequences after 0.1-mmol/kg doses of gadoteridol and gadobutrol. No significant differences were noted by any reader.
Tables
Specific Diagnosis N = 444 (%) Malignant tumor diagnoses (n = 293) (66%) Anaplastic astrocytoma (grade III) 12 (2.7) Glioblastoma multiforme (grade IV) 55 (12.4) Anaplastic oligodendroglioma (grade III) 4 (0.9) Anaplastic oligoastrocytoma (grade III) 8 (1.8) Ependymoastrocytoma 2 (0.5) Malignant lymphoma 1 (0.2) Metastatic tumors 211 (47.5) Benign tumor diagnoses (n = 80) (18%) Astrocytoma (grade II) 2 (0.5) Pilocytic astrocytoma (noninvasive, grade I) 1 (0.2) Oligodendroglioma (grade II) 1 (0.2) Ependymoma (grade II) 1 (0.2) Mixed oligoastrocytoma (grade II) 1 (0.2) Pineocytoma (grade I) 1 (0.2) Pituitary adenoma 5 (1.1) Craniopharyngioma (grade I) 1 (0.2) Meningioma (grade I) 38 (8.6) Atypical meningioma (grade II) 9 (2.0) Benign mesenchymal tumor 1 (0.2) Melanocytoma 1 (0.2) Hemangioblastoma (grade I) 1 (0.2) Schwannoma (neurinoma, neurilemmoma) (grade I) 16 (3.6) Cysts and tumorlike lesions (epidermoid) 1 (0.2) Nontumor diagnoses (n = 71) (16%) White matter disease 1 (0.2) Vascular lesion 10 (2.3) Infective/inflammatory disease 2 (0.5) Infarct 1 (0.2) Hemorrhage 1 (0.2) Postoperative/posttreatment changes 56 (12.6) - Table 2:
Detection of histologically confirmed brain tumors on MR images acquired after administration of 0.1-mmol/kg gadoteridol or 0.1-mmol/kg gadobutrol in 139 patients with 308 brain lesions subsequently confirmed at biopsy or surgery
Lesion Detection Reader 1 Reader 2 Reader 3 Gadoteridol Gadobutrol Gadoteridol Gadobutrol Gadoteridol Gadobutrol No. patients with tumors detected at MRI 133 (95.7%) 135 (97.1%) 137 (98.6%) 136 (97.8%) 136 (97.8%) 132 (95.0%) P value (95% CI of difference, %) .317 (−4.2 to 1.4) .564 (−1.7 to 3.2) .046 (0.1 to 5.7) No. tumors detected at MRI 240 (77.9%) 236 (76.6%) 269 (87.3%) 263 (85.4%) 230 (74.7%) 220 (71.4%) P value (95% CI of difference, %) 0.480 (−2.3 to 4.9) 0.239 (−1.3 to 5.2) 0.018 (0.6 to 5.9) - Table 3:
Accuracy for brain tumor characterization on MR images acquired after administration of 0.1-mmol/kg gadoteridol or 0.1-mmol/kg gadobutrol in 128 patients with 246 histologically confirmed brain tumors
Lesion Characterization Reader 1 Reader 2 Reader 3 Gadoteridol Gadobutrol Gadoteridol Gadobutrol Gadoteridol Gadobutrol No. patients with tumors correctly characterized at MRI 94 (73.4%) 96 (75.0%) 106 (82.8%) 101 (78.9%) 93 (72.7%) 83 (64.8%) P value (95% CI of difference, %) .695 (−9.4 to 6.2) .132 (−1.1 to 8.9) .012 (1.8 to 13.8) No. tumors correctly characterized at MRI 169 (68.7%) 164 (66.7%) 198 (80.5%) 188 (76.4%) 166 (67.5%) 148 (60.2%) P value (95% CI of difference, %) .492 (−3.8 to 7.8) .059 (−0.1 to 8.3) .001 (3.0 to 11.6)
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