• Juan E Gutierrez, Martin Rosenberg, Michael Duhaney, Jeffrey A Simon, Guenther Brueggenwerth, Jacob M Agris, and Edmond A Knopp.
• Neuroradiology Section, The University of Texas Health Science Center at San Antonio, Texas, USA.
• J Magn Reson Imaging. 2015 Mar 1; 41 (3): 788-96.

PurposeGadobutrol 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 MethodsAn 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.ResultsOf 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.ConclusionGadobutrol 1.0M is an effective and well-tolerated contrast agent for CNS MRI.© 2014 Wiley Periodicals, Inc.

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