Gadobenate dimeglumine (MultiHance, Gd-BOPTA; Bracco Imaging Spa, Milan, Italy) is an extracellular gadolinium (Gd) contrast agent with the capacity for transient interaction with serum proteins, notably serum albumin. The result of this interaction is markedly higher r1 and r2 relaxivities at all magnetic field strengths compared with conventional Gd contrast agents [1,2]. Gadobenate dimeglumine was originally approved for contrast-enhanced magnetic resonance (MR) imaging of the liver in Europe in 1997 and was first administered as part of routine clinical practice in 1998 [3]. A decade later, gadobenate dimeglumine is now approved in the United States for MR imaging of the central nervous system (CNS) and related tissues, as well as in Europe, Canada, and various countries in Asia and Australasia for MR imaging of the liver, CNS, and MR angiography (MRA).

To date, more than 4,500 subjects have been administered gadobenate dimeglumine as part of clinical studies to compare the safety and efficacy of this agent with those of available standard-relaxivity Gd agents for the above indications, as well as for clinical MRI of the breast and heart, and for CNS imaging in children. In addition, more than 2 million patients have received gadobenate dimeglumine as part of a routine clinical imaging study. The present review summarizes the experience gained in the ten years that gadobenate dimeglumine has been available for clinical use. Data are presented on the efficacy and safety of gadobenate dimeglumine and the potential clinical value of this agent in light of its unique physicochemical properties.