Mn‐DPDP–enhanced MR imaging of malignant liver lesions: Efficacy and safety in 20 patients

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Abstract
Twenty patients with malignant liver lesions underwent magnetic resonance (MR) imaging with manganese (II) DPDP [N,N′‐dipyridoxylethylenediamine‐N,N′‐diacetate 5,5′‐bis(phosphate)] to evaluate the safety and efficacy of the contrast agent. In two groups of 10 patients each, 5 μmol/kg Mn‐DPDP was administered intravenously (3 mL/min) at a concentration of either 50 or 10 μmol/mL. T1‐ and T2‐weighted images were obtained with a 1.5‐T imager. Six patients reported a total of eight instances of side effects (flush, feeling of warmth, metallic taste) of which seven occured at the 50 μmol/mL concentration. A significant decrease in alkaline phosphatase levels 2 hours after injection was recorded. On T1‐weighted images, the 10 μmol/mL formulation yielded significantly greater increases in contrast‐to‐noise ratio (79.8%–137.5%) than the 50 μmol/mL formulation (46.2%–86.6%). In a blinded reader study of 10 patients with one to five lesions each, no lesion was missed on Mn‐DPDP–enhanced T1‐weighted images; however, four false‐positive foci were identified. The authors conclude that slow administration of 5 μmol/kg Mn‐DPDP at a concentration of 10 μmol/mL is safe and efficient enough to proceed to further clinical trials.