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European Radiology

, Volume 30, Issue 1, pp 281–290 | Cite as

Gadoxetate disodium-related event during image acquisition: a prospective multi-institutional study for better MR practice

  • Marie-Luise Kromrey
  • Masatoshi Hori
  • Satoshi Goshima
  • Kazuto Kozaka
  • Tomoko Hyodo
  • Yuko Nakamura
  • Akihiro Nishie
  • Tsutomu Tamada
  • Tatsuya Shimizu
  • Akihiko Kanki
  • Utaroh MotosugiEmail author
Contrast Media

Abstract

Purpose

To acknowledge the facts of gadoxetate disodium-related events in Japan and to achieve better MR practice by analyzing large cohort data with various MR parameters.

Materials and methods

This prospective multi-institutional study included 1993 patients (1201 men, mean age 66.4 ± 12.8 years), who received dynamic MRI with gadoxetate disodium (gadoxetate group, n = 1646) or extracellular gadolinium-based contrast agents (other-GBCAs group, n = 347) between January and November 2016. Recorded data covered adverse reactions including dyspnea, breath-hold failure during acquisition, respiratory artifacts rated with a four-point scale, and MR parameters. We compared data between the two groups in whole cohort and age-, gender-, and institution-matched subcohort using χ2 test (n = 640). Logistic regression model was used to reveal independent associates of substantial artifacts in arterial phase imaging.

Results

Transient dyspnea rarely occurred in gadoxetate or other-GBCAs group (both < 1%). Gadoxetate group (vs other-GBCAs group) showed higher rates of breath-hold failure (whole cohort, 18.2% vs 7.7%, p < 0.001; subcohort, 17.6% vs 6.3%, p < 0.001) and substantial artifacts in arterial phase (7.2% vs 2.2%, p = 0.001; 7.4% vs 1.7%, p = 0.001). With single arterial phase protocol, substantial artifacts under gadoxetate were independently associated with age (odds ratio [OR] = 1.04, p < 0.001), hearing difficulty (OR = 2.92, p = 0.008), breath-hold practice required (OR = 1.61, p = 0.039), and short acquisition time (OR = 0.43, p = 0.005). Multiple arterial phase acquisition did not reduce the incident rate of substantial artifacts.

Conclusion

Gadoxetate disodium was associated with breath-hold failure and substantial artifacts in arterial phase imaging, but not with dyspnea in Japan. Shorter acquisition time should be used to sustain image quality in gadoxetate disodium-enhanced arterial phase imaging.

Key Points

Gadoxetate disodium administration leads to breath-hold failure and substantial imaging artifacts in arterial phase MRI in Japan.

Contrast agent-induced dyspnea in arterial phase and adverse reactions are rare in Japan, without showing differences between gadoxetate disodium or other extracellular gadolinium-based contrast agents.

Shorter acquisition time significantly reduces gadoxetate-induced imaging artifacts in the arterial phase.

Keywords

Dyspnea Breath-holding Magnetic resonance imaging Gadoxetate disodium 

Abbreviations

BMI

Body mass index

CI

Confidence interval

COPD

Chronic obstructive pulmonary disease

GBCA

Gadolinium-based contrast agent

MRI

Magnetic resonance imaging

OR

Odds ratio

PVP

Portal venous phase

SD

Standard deviation

TSM

Transient severe motion

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Utaroh Motosugi, MD PhD.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was not required for this study because of the retrospective study design.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• observational

• performed at one institution

Supplementary material

330_2019_6358_MOESM1_ESM.docx (40 kb)
ESM 1 (DOCX 39 kb)

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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Marie-Luise Kromrey
    • 1
    • 2
  • Masatoshi Hori
    • 3
  • Satoshi Goshima
    • 4
  • Kazuto Kozaka
    • 5
  • Tomoko Hyodo
    • 6
  • Yuko Nakamura
    • 7
  • Akihiro Nishie
    • 8
  • Tsutomu Tamada
    • 9
  • Tatsuya Shimizu
    • 1
  • Akihiko Kanki
    • 9
  • Utaroh Motosugi
    • 1
    Email author
  1. 1.Department of RadiologyUniversity of YamanashiYamanashiJapan
  2. 2.Department of Diagnostic Radiology and NeuroradiologyUniversity Medicine GreifswaldGreifswaldGermany
  3. 3.Department of Diagnostic and Interventional RadiologyOsaka University Graduate School of MedicineSuitaJapan
  4. 4.Department of Diagnostic Radiology and Nuclear MedicineHamamatsu University School of MedicineHamamatsuJapan
  5. 5.Department of RadiologyKanazawa UniversityKanazawaJapan
  6. 6.Department of RadiologyKindai University Faculty of MedicineOsakaJapan
  7. 7.Diagnostic RadiologyHiroshima UniversityHiroshimaJapan
  8. 8.Department of Clinical Radiology, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  9. 9.Department of RadiologyKawasaki Medical SchoolKurashikiJapan

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