Comparison between a linear versus a macrocyclic contrast agent for whole body MR angiography in a clinical routine setting

All examinations yielded diagnostic image quality. There was no significant difference in image quality (3.76 ± 0.3 versus 3.78 ± 0.3, p = n.s.) and diagnostic accuracy observed. Sensitivity and specificity of the detection of hemodynamically relevant stenoses was 93%/95% in the gadopentetate dimeglumine group and 94%/94% in the gadobutrol group, respectively.The high diagnostic accuracy of gadobutrol in the clinical routine setting is of high interest as medical authorities (e.g. the European Agency for the Evaluation of Medicinal Products) recommend macrocyclic contrast agents especially to be used in patients with renal failure or dialysis.Atherosclerosis is one of the leading challenges of health care in developed countries. Due to the complex pathophysiology and systemic nature of the cardiovascular system [1] there is a need for accurate assessment of the manifestations in order to offer best treatment, including surgical and percutaneous catheter-based interventions as well as pharmacological therapy. In this setting, Cardiovascular Magnetic Resonance (CMR) is increasingly used [2-4].Current imaging strategies have been developed with linear 0.5 M contrast agents, for example gadopentetate dimeglumine [2,4,5]. In the context of nephrogenic systemic fibrosis (NSF) macrocyclic contrast agents are recommended to be used for contrast-enhanced MRI in patients at risk [6-8]. The very high complex stability of macrocyclic contrast agents decrease the risk to release gadolinium ions in vivo. Gadobutrol (Gadovist？, Bayer Schering Pharma, Germany) became the first macrocyclic 1.0 M contrast agent to receive approval from the European Union for contrast-enhanced MR angiography. Due to its more compact bolus profile gadobutrol is well suited for dynamic imaging (for example perfusion imaging). As it is increasingly used in clinical routine for CMR imaging, the diagnostic value of gadobutrol is of high interest.Using gadobutrol requires modifications with regard to volume