Eiichi Kanai 1, Motohiro Yoshinari 1, Kouki Yoshikawa 2, Kazutaka Yamada 1
Background
The lymphatic system is essential for fluid homeostasis and immune function. Evaluating lymphatic pathways is critical in diagnosing and managing diseases, especially cancer. Indirect lymphography, involving subcutaneous contrast injection, is more practical than direct methods requiring vessel cannulation. Although previously used with extracellular gadolinium agents, these contrast media are quickly cleared and non-specific. Gadoxetate disodium (Gd-EOB-DTPA), being fat-soluble and albumin-binding, may provide improved lymph node visualization compared to conventional gadodiamide hydrate (Gd-DTPA-BMA). This study aimed to compare their efficacy in indirect MRLG in dogs.
Methods
Six healthy beagles underwent MRI imaging with two contrast agents—Gd-EOB-DTPA and Gd-DTPA-BMA—administered subcutaneously at the lateral malleolus of the right fibula. MRI scans were performed at multiple time points up to 60 minutes post-injection. Contrast enhancement in the popliteal and medial iliac lymph nodes was assessed both qualitatively and quantitatively. Imaging sessions were separated by at least one week per dog. The contrast enhancement ratio and duration were analyzed statistically using a one-sample t-test, with significance set at P < 0.05.
Results
Both agents successfully enhanced lymph node visibility. Gd-EOB-DTPA showed superior contrast enhancement at 10 and 15 minutes post-injection in popliteal lymph nodes and exhibited longer enhancement durations (40 minutes in popliteal, 38 minutes in medial iliac LNs) compared to Gd-DTPA-BMA (15 and 30 minutes, respectively). No adverse effects were observed from either agent. Gd-EOB-DTPA consistently produced higher contrast enhancement ratios across all time points, although statistical significance was limited to certain intervals.
Limitations
This pilot study involved only healthy young dogs, limiting generalizability to clinical populations, such as older dogs with tumors or impaired lymphatic function. Additional studies incorporating diseased models and broader physiological conditions are necessary.
Conclusions
Gd-EOB-DTPA provided stronger and more sustained lymph node enhancement than Gd-DTPA-BMA, suggesting its clinical potential for indirect MRLG in dogs. Its properties make it a promising contrast agent for detailed lymphatic system imaging in veterinary practice.
Maximum intensity projection, sagittal images of dog No. 6.
Gadoxetate disodium (Gd-EOB-DTPA) and gadodiamide hydrate (Gd-DTPA-BMA) were injected into
the same dog. The popliteal lymph nodes (arrow) and medial iliac lymph nodes (arrowhead) were
enhanced. Gd-EOB-DTPA was more effective in clearly revealing the lymph nodes and lymphatic
vessels than Gd-DTPA-BMA. In addition, Gd-EOB-DTPA had a longer contrast duration than GdDTPA-BMA.
How did we do?
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