Impact of the Novel Contrast Agent Gadopiclenol on Decision Making in Patients With Brain Metastases.

Abstract

PURPOSE/OBJECTIVE(S)\nTo evaluate the impact on decision making and radiotherapy (RT) treatment planning of brain metastases (BM) using gadopiclenol, a new gadolinium-based contrast agent (GBCA).\n\n\nMATERIALS/METHODS\nPatients who underwent two separate magnetic resonance imaging (MRI) examinations, one with gadopiclenol and one with gadobenate dimeglumine, both at 0.1 mmol/kg were included in the analysis. Those with ≥1 BM detected in any of both scans were subjected to a blinded reader analysis and contouring. For each patient, treatment plans (stereotactic radiosurgery [SRS] or whole-brain radiotherapy [WBRT]) were determined for both MRIs, with the gross target volume (GTV) indicating the contrast-enhancing aspects of the tumor. Mean GTVs and normal tissue volumes receiving 12 Gy (as well as the Dice similarity coefficient (DSC) were obtained for the paired contours. The Spearman´s rank (ρ) correlation was additionally calculated. Furthermore, 3 experts blindly of each lesion for contouring purposes and subjectively qualified them as better , in detriment of the counterpart, or equal .\n\n\nRESULTS\nA total of 13 adult patients (31% females) presenting with at least one BM were analyzed. Gadopiclenol depicted additional BM as compared with gadobenate dimeglumine in 7 patients (54%). Treatment indication was changed in 2 (15%) patients, from no treatment to SRS and SRS to WBRT. The mean GTVs and V12 were comparable between gadopiclenol and gadobenate dimeglumine (P\u202f=\u202f0.694, P\u202f=\u202f1.974). The mean DSC was 0.70 (± 0.14, ρ 0.82). From a total 36 answers, an improvement in enhancement was qualified in 58.3% (n\u202f=\u202f21) with g, while no difference was obtained in 19.4% (n\u202f=\u202f7).\n\n\nCONCLUSION\nGadopiclenol improved BM detection and characterization with impact on RT treatment decisions. Further trials are warranted to determine the impact of this novel MRI contrast agent on a clinical setting.\n\n\nAUTHOR DISCLOSURE\nG.R. Sarria: Honoraria; Roche Pharma AG. Travel Expenses; Carl Zeiss Meditec AG. Volunteer; Rayos Contra Cancer Inc. J. Fleckenstein: None. M. Eckl: None. F. Stieler: None. M. Bendszus: None. L.C. Schmeel: None. D. Koch: None. A. Feißt: None. M. Essig: None. F. Wenz: Honoraria; Carl Zeiss Meditec AG, Celgene GmbH, Roche Pharma AG, Eli Lilly and Co., Ipsen Pharma GmbH, Elekta AB.F.A. Giordano: Research Grant; Carl Zeiss Meditec AG, NOXXON Pharma AG. Honoraria; Implacit GmbH, Oncare GmbH, Roche Pharma AG, AstraZeneca GmbH.