Gadobutrol 1 . 0 - molar in Cardiac Magnetic Resonance Imaging ( MRI ) – Further Enhancing the Capabilities of Contrast - enhanced MRI in Ischaemic and Non - ischaemic Heart Disease

There are many things in life everybody wants more of, and this is particularly true for magnetic resonance imaging (MRI). The major challenge in the daily life of an MRI professional is gaining maximal image signal and contrast in a reasonable amount of time. The application of gadolinium (Gd)-based MR contrast material has offered contrast features in MRI that have been used and appreciated for almost 20 years in both neurological and whole-body MRI. For example, state-of-the-art MRI is not possible in brain tumours, vascular pathologies or focal liver disease without the use of Gd. Cardiac MRI has also benefited enormously from Gd enhancement; indeed, some of the most important and established cardiac MRI applications are based on the use of Gd contrast.1,2 Although there are strong data in support of the superiority of dedicated contrast-enhanced MRI techniques over other modalities in many clinical indications, there is still a need for improvements in image quality and stability, whether in terms of the hardware, software or ‘wetware’ (contrast agents). In terms of cardiac MRI, in general more contrast would be preferable since many cardiac pathologies are difficult to distinguish from normal myocardium. Therefore, the use of higher-concentration Gd compounds could improve the reliability of cardiac MRI. The aim of this article is to summarise recent knowledge about gadobutrol, the only approved 1.0-molar Gd contrast agent, in MR angiography (MRA) and neurological and whole-body MRI, and to provide an outlook on expected future developments in cardiac MRI.