Are All Gadolinium-based Contrast Agents Similar? The Importance of High Stability, High Relaxivity and High Concentration
Are All Gadolinium-based Contrast Agents Similar? The Importance of High Stability, High Relaxivity and High Concentration
European Neurological Review, 2009;4(2):98-102
Abstract
Gadolinium-based contrast agents (GBCAs) are commonly used to enhance image acquisition via magnetic resonance imaging, but they differ in their physicochemical characteristics and therefore their function. The stability, concentration and relaxivity of a GBCA can have a major impact on clinical efficacy. Stability is related to safety. GBCAs can be categorised into three stability classes: non-ionic linear agents, ionic linear agents and macrocyclic agents, in order of increasing stability. Relaxivity and concentration are contributing factors to the level of enhancement that can be achieved with any given GBCA. Gadobutrol, gadobenate and gadoxetic acid have relatively high relaxivities. Among these compounds, only gadobutrol is commercially available at a higher concentration of 1.0M, whereas the others are used at a standardconcentration of 0.5M. With high stability, relaxivity and concentration, gadobutrol has been shown in a number of clinical studies to be safe while improving image enhancement with increased conspicuity and sensitivity over other commonly used GBCAs.
Keywords
Gadolinium-based contrast agent (GBCA), contrast-enhanced magnetic resonance imaging, stability, relaxivity, concentration
Disclosure: Editorial assistance was provided by Touch Briefings and supported by Bayer Schering Pharma AG.
Received: 30 November 2009 Accepted: 11 January 2010
Correspondence: Nicoletta Anzalone, Department of Neuroradiology, Scientific Institute H.S. Raffaele, Via Olgettina 60, 20132, Milan, Italy. E: anzalone.nicoletta@hsr.it
Since the original conception and introduction of magnetic resonance imaging (MRI) gadolinium-based contrast agents (GBCAs) in the 1980s, many such contrast agents have been approved for use in contrast-enhanced MRI. These contrast agents have been used extensively in a large range of indications, particularly central nervous system examinations, as well as neurodegenerative diseases and tumoural disease processes, among others.
Contrast enhancement has enabled improved tissue contrast and lesion characterisation and more sensitive detection of even very small lesions. The differences between the molecular structures of the gadolinium chelates affect their physicochemical characteristics. Greater importance has recently been placed on GBCAs and chelate stability, particularly with the possible association between the development of nephrogenic systemic fibrosis (NSF) in patients with kidney failure.1–3
In response to the growing interest in this topic, this article will address the differences between gadolinium-based MRI contrast agents with regard to their molecular structure and physicochemical properties, providing evidence of the advantages of some compounds in terms of stability, relaxivity and concentration.
Molecular Structure and Physicochemical Characteristics
GBCAs consist of the active substance gadolinium and a chelating agent. They can be categorised by their chemical structures into linear and macrocyclic agents and further subdivided by theircharge (ionic or non-ionic). While differences do exist among the gadolinium compounds in terms of various physicochemical characteristics, stability, concentration and relaxivity appear to have a major clinical impact.
Gadolinium-based contrast agent (GBCA), contrast-enhanced magnetic resonance imaging, stability, relaxivity, concentration, mri contrast agent, intravenous contrast agent, imgaging contrast agent, gadolinium contrast agent,
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