Efficacy of gadopiclenol in contrast-enhanced MRI of the breast: a post-hoc analysis.

Motivation: Gadolinium dose reduction while maintaining MRI diagnostic efficacy is crucial. Goal(s): Compare gadopiclenol (0.05 mmol/kg) and gadobutrol (0.1 mmol/kg) in breast MRI. Approach: Post-hoc analysis on 70 patients with breast lesions from the PROMISE phase III study. Lesion visualization was qualitatively (border delineation, internal morphology, contrast enhancement) and quantitatively (enhancement percentage [E%], lesion-to-background ratio [LBR]) evaluated by three blinded readers. Three additional readers assessed diagnostic preference. Results: Gadopiclenol was non-inferior to gadobutrol for all qualitative visualization parameters. E% was higher with gadopiclenol, while LBR was similar between the two GBCAs. Readers had in most cases no preference between images with the two GBCAs. Impact: Gadopiclenol at half the gadolinium dose compared to current GBCAs can be particularly beneficial in patients receiving multiple lifetime doses, such as high-risk women undergoing breast cancer screening.