Work

ΔR1blood, a surrogate of blood-pool gadolinium concentration, is related to body mass index, gender, left ventricular end-diastolic volume index, cardiac index, and field strength at cardiac magnetic resonance late enhancement imaging

Year: 2025

Type: article

Abstract: Background Late Gadolinium Enhancement (LGE) imaging is the cornerstone of tissue characterization via cardiac magnetic resonance imaging. The contrast-enhancing effect of gadolinium is caused by a linear increase of tissue longitudinal R1 relaxation rates (R1=1/T1). The change in R1 of blood pre- and post-contrast (ΔR1 blood ) is therefore a surrogate for the blood-pool gadolinium concentration, which in turn correlates linearly to the tissue gadolinium concentration. The total volume of distribution for gadolinium is the extracellular volume of the body, which differs with body composition, potentially leading to variations in blood-pool and tissue gadolinium concentrations. Methods This study is a hypothesis-generating secondary analysis of a dataset of 1098 patients who underwent contrast CMR between August 2014 and November 2020 at a tertiary center. ΔR1 blood was calculated from T1 relaxation time maps acquired before and approx. 15 minutes after application of 0.15 mmol/kg gadobutrol. Explorative data analysis and multiple linear regression was performed to assess the influence of body mass index (BMI), gender, age, cardiac index (CI), Hematocrit (HCT) and left ventricular end-diastolic volume index (LVEDVi) on ΔR1 blood . Results In bivariate analysis, ΔR1 blood showed moderate correlation to BMI and weak correlation to LVEDVi, Hct and CI. The correlation to BMI was higher in women (r=0.52 at 1.5 T and r=0.47 at 3 T) than in men (r=0.27 at 1.5 T and r=0.37 at 3 T). Multiple linear regression showed independent predictive value of BMI, BMI:gender, gender, cardiac index (CI), field strength (FS) and LVEDVi (R² =.268, P <.001), with BMI remaining the strongest individual predictor (b = 0.032 [0.025; 0.040], η² = 0.13, P <.001). Conclusion ΔR1 blood , a measurement of gadolinium contrast enhancement in the blood-pool and a surrogate of plasma C Gd at the time of late enhancement imaging, showed moderate association with BMI, FS and gender and weak association with LVEDVi and CI. Further research is necessary to assess the need for individualized gadolinium dosing.

Source: Journal of Cardiovascular Magnetic Resonance

DOI: 10.1016/j.jocmr.2025.101929