Pulmonary MR angiography with gadopiclenol can reduce gadolinium exposure while maintaining signal enhancement.

Motivation: Pulmonary magnetic resonance angiography (MRA) using gadolinium-based contrast agents (GBCAs) is an established method for exclusion of pulmonary embolism. The high relaxivity GBCA gadopiclenol presents an opportunity to reduce gadolinium exposure, potentially improving safety and sustainability of gadolinium-enhanced MRA. Goal(s): To evaluate enhancement performance of 0.05 mmol/kg gadopiclenol for pulmonary MRA compared to 0.10 mmol/kg gadobenate dimeglumine. Approach: Pulmonary MRA from 152 patients with gadopiclenol or gadobenate dimeglumine were evaluated retrospectively. Signal enhancement was analyzed quantitatively. Image quality was assessed qualitatively. Results: Pulmonary arterial enhancement was significantly higher with gadopiclenol compared to gadobenate dimeglumine. Subjective image quality was equivalent. Impact: The use of high relaxivity gadopiclenol can reduce gadolinium exposure by 50% while maintaining adequate contrast enhancement. This may improve the safety and sustainability of gadolinium-enhanced MRA.