Phase 3 efficacy and safety trial of gadobutrol, a 1.0 molar macrocyclic MR imaging contrast agent, in patients referred for contrast-enhanced MR imaging of the central nervous system

Juan E. Gutierrez, Martin Rosenberg, Michael Duhaney, Jeffrey A. Simon, Guenther Brueggenwerth, Jacob M. Agris, Edmond A. Knopp

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Purpose: Gadobutrol is a 1.0 M macrocyclic magnetic resonance imaging (MRI) contrast agent. A study was performed to evaluate the efficacy and safety of gadobutrol-enhanced versus unenhanced imaging for central nervous system (CNS) lesion visualization and detection. Materials and Methods: An international, multicenter, open-label, Phase III clinical trial. Patients underwent unenhanced and gadobutrol 1.0 M-enhanced (0.1 mmol/kg BW) MR imaging using a standardized protocol. Unenhanced and combined unenhanced/gadobutrol-enhanced images were scored by three independent, blinded readers for degree of lesion enhancement, border delineation, internal morphology, and total number of lesions detected (primary efficacy variables). Exact match of the MR diagnoses with the final clinical diagnosis, detection of malignant CNS lesions, and confidence in diagnosis were secondary efficacy variables. Results: Of 343 enrolled patients, 321 were evaluated for efficacy. All primary efficacy endpoints were met: superiority was demonstrated for gadobutrol-enhanced versus unenhanced MR images (P < 0.0001 in all cases) for lesion enhancement, border delineation, and internal morphology. Noninferiority was met for mean number of lesions detected. There were improvements in the sensitivity of malignant lesion detection, without a loss in specificity, exact-match diagnostic accuracy, and reader confidence. Treatment-related adverse events were reported in 4.1% (n = 14); all were nonserious. Conclusion: Gadobutrol 1.0M is an effective and well-tolerated contrast agent for CNS MRI.

Original languageEnglish (US)
Pages (from-to)788-796
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Volume41
Issue number3
DOIs
StatePublished - Mar 1 2015

Keywords

  • Contrast-enhanced
  • Gadobutrol
  • MRI
  • Unenhanced imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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