Dynamic magnetic resonance imaging of the breast: Comparison of gadobutrol vs. Gd-DTPA.

Objective: To compare the pharmacokinetic profile of gadobutrol versus Gd-DTPA in dynamic contrast-enhanced MRI (DCE-MRI) in patients with breast cancer. Secondary objectives included comparing the safety profiles and diagnostic efficacy of the two contrast agents for detecting additional malignant lesions.

Material And Methods: This retrospective observational study included 400 patients with histologically confirmed breast cancer; 200 underwent DCE-MRI with Gd-DTPA (Magnevist®) and 200 underwent DCE-MRI with gadobutrol (Gadovist®). Pharmacokinetic parameters and signal intensity were analyzed in a region of interest placed in the area within the lesion that had greatest signal intensity in postcontrast sequences. We compared the two groups on pharmacokinetic variables (K, K, and V), time-signal intensity curves, and the number of additional malignant lesions detected.

Results: The relative signal intensity (enhancement) was higher with gadobutrol than with Gd-DTPA. Washout was lower with gadobutrol than with Gd-DTPA (46% vs. 58,29%, respectively; p=0,0323). Values for K and K were higher for gadobutrol (p=0,001). There were no differences in the number of histologically confirmed additional malignant lesions detected (p=0,387).

Conclusions: Relative enhancement is greater with gadobutrol, but washout is more pronounced with Gd-DTPA. The number of additional malignant lesions detected did not differ between the two contrast agents. Both contrasts are safe.