Efficacy of gadopiclenol in contrast-enhanced MRI of the liver: 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 liver MRI. Approach: Post-hoc analysis on patients with liver lesions from the PROMISE phase III study (N=66). Lesion visualization was qualitatively (border delineation, internal morphology, contrast enhancement) and quantitatively (enhancement percentage, lesion-to-background ratio) evaluated by three blinded readers. Three additional readers assessed diagnostic preference. Results: Gadopiclenol was non-inferior to gadobutrol for all qualitative visualization parameters and all readers. Quantitative parameters did not differ between the two GBCAs. Readers had in most cases no preference between images with the two GBCAs. Impact: The reduction in the injected gadolinium dose achieved with gadopiclenol may be particularly important in patients undergoing multiple contrast-enhanced MRI examinations. This will also reduce the amount of gadolinium released into wastewater systems, limiting any potential ecological impact.