Dentate Nucleus Signal Intensity Decrease on T1-weighted MR Images                     after Switching from Gadopentetate Dimeglumine to Gadobutrol

Behzadi, Ashkan Heshmatzade; Farooq, Zerwa; Zhao, Yize; Shih, George; Prince, Martin R.

doi:10.1148/radiol.2018184014

Cited by 11 publications

(18 citation statements)

References 5 publications

(5 reference statements)

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“…Our study also revealed a good correlation between the number gadoterate meglumine administrations and the T 1 W SI increase for the DN, pons, GP, and T as well. Many studies used pons or thalamus as a reference anatomical location for standardization and dentate nucleus‐to‐pons or thalamus, GP‐to‐pons or thalamus ratios were assessed and compared . However, in the current study the T 1 W SI of both the pons and thalamus were also found to be increased compared with those of the control group.…”

Section: Discussioncontrasting

confidence: 62%

“…In rat study, Rasschaert et al reported no SI increase with gadoterate meglumine compared with the linear agents gadobenate dimeglumine and gadodiamide. Behzadi et al reported that the T 1 W SI decreased in the DN by changing the GBCA from linear gadopentetate to macrocyclic gadobutrol. Nevertheless, from all those articles it is well understood that the SI increase depended on the type and structure of the GBCA, but, to conclude robust and reproducible results, more studies containing a large group of patients are still needed.…”

Section: Discussionmentioning

confidence: 99%

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Does Gadoterate Meglumine Cause Gadolinium Retention in the Brain of Children? A Case–Control Study

Topcuoğlu

Topçuoğlu

Semiz-Oysu

et al. 2019

Magnetic Resonance Imaging

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Background: Accumulation of macrocyclic gadolinium agents in children's brains remain to be determined. Purpose: To demonstrate whether there is an intracranial macrocyclic gadolinium deposition after multiple contrastenhanced MRI with gadoterate meglumine in a pediatric population. Study Type: Retrospective case-control. Population: In all, 45 children (age range: 5-17 years; mean, 13.7 AE 3.4 years) for the study group and 45 healthy children (age range: 5-17 years; mean, 13.7 AE 3.4 years) for the control group. Field Strength/Sequence: T 1 -and T 2 -weighted axial images on a 1.5T scanner. Assessment: Children with at least three enhanced brain MRIs and an age-and sex-matched control group with an unenhanced brain MRIs were compared in terms of T 1 signal intensity (SI). All patients in the study group received gadoterate meglumine intravenously (0.1 mmol/kg). SI measurements were made by drawing six regions of interest (ROIs): dentate nuclei (DN), pons, globus pallidi (GP), frontal white matter (FWM), thalamus (T), clivus, and cerebrospinal fluid (CSF) for both groups on unenhanced T 1 -weighted images. Statistical Tests: Student's t-test was used for comparison of SI. The Pearson correlation was calculated for the correlation between the SI and the number of gadolinium administrations. Results: A significant difference was detected between two groups for DN/CSF, pons/CSF, GP/CSF, thalamus/CSF, and FWM/CSF (P < 0.001, P < 0.001, P = 0.002, P = 0.002, P = 0.024, respectively). There was no significant difference between the two groups for clivus/CSF (P = 0.15). A good correlation between the number of gadoterate meglumine administrations and the SI for DN/CSF, pons/CSF, GP/CSF, and T/CSF (r = 0.80, r = 0.73, r = 0.91, and r = 0.90, respectively) was found. Data Conclusion: A significant T 1 SI increase reflecting gadolinium retention in the brain was detected for children with at least three gadoterate meglumine administrations in this series. The number of administrations correlated well with the increased SI. Level of Evidence: 3 Technical Efficacy Stage: 5

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Section: Discussioncontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Does Gadoterate Meglumine Cause Gadolinium Retention in the Brain of Children? A Case–Control Study

Topcuoğlu

Topçuoğlu

Semiz-Oysu

et al. 2019

Magnetic Resonance Imaging

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“…Therefore, the contrast agent in this study was injected for two purposes: enhancing the cauda equina and improving the nerve-background contrast by using the paramagnetic effect to shorten the T2 relaxation time, as demonstrated previously (15). To avoid gadolinium deposition, a macrocyclic gadolinium-based contrast agent was adopted (20).…”

Section: Discussionmentioning

confidence: 99%

Use of Magnetic Resonance Neurography for Evaluating the Distribution and Patterns of Chronic Inflammatory Demyelinating Polyneuropathy

Kong

et al. 2020

Korean J Radiol

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Objective: To evaluate the distribution and characteristics of peripheral nerve abnormalities in chronic inflammatory demyelinating polyneuropathy (CIDP) using magnetic resonance neurography (MRN) and to examine the diagnostic efficiency. Materials and Methods: Thirty-one CIDP patients and 21 controls underwent MR scans. Three-dimensional sampling perfections with application-optimized contrasts using different flip-angle evolutions and T1-/T2-weighted turbo spinecho sequences were performed for neurography of the brachial and lumbosacral (LS) plexus and cauda equina, respectively. Clinical data and scores of the inflammatory Rasch-built overall disability scale (I-RODS) in CIDP were obtained. Results: The bilateral extracranial vagus (n = 11), trigeminal (n = 12), and intercostal nerves (n = 10) were hypertrophic. Plexus hypertrophies were observed in the brachial plexus of 19 patients (61.3%) and in the LS plexus of 25 patients (80.6%). Patterns of hypertrophy included uniform hypertrophy (17 [54.8%] brachial plexuses and 21 [67.7%] LS plexuses), and multifocal fusiform hypertrophy (2 [6.5%] brachial plexuses and 4 [12.9%] LS plexuses) was present. Enlarged and/or contrast-enhanced cauda equina was found in 3 (9.7%) and 13 (41.9%) patients, respectively. Diameters of the brachial and LS nerve roots were significantly larger in CIDP than in controls (p < 0.001). The largest AUC was obtained for the L5 nerve. There were no significant differences in the course duration, I-RODS score, or diameter between patients with and without hypertrophy. Conclusion: MRN is useful for the assessment of distribution and characteristics of the peripheral nerves in CIDP. Compared to other regions, LS plexus neurography is more sensitive for CIDP.

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“…Recent nonclinical studies suggest that a certain fraction of chronically retained tissue gadolinium may be labile or bioconvertable to a more soluble form of gadolinium. Smith et al (96), Frenzel et al (103), and Behzadi et al (104) have shown a slow washout of detectable tissue gadolinium over many months after gadodiamide or gadobutrol exposure; this washout appears to be more robust with macrocyclic agents, where the amount of retained gadolinium 52 weeks after supradiagnostic exposure was only 13% of the amount retained, as measured with ICP-MS at 5 weeks (103). In comparison, a more attenuated washout phenomenon was observed after gadodiamide administration, with 50% of the initially measured amount retained at 1 week still present 20 weeks after administration (96).…”

Section: Retention Of Gadolinium In Non-cns Tissuesmentioning

confidence: 99%

Gadolinium Retention: A Research Roadmap from the 2018 NIH/ACR/RSNA Workshop on Gadolinium Chelates

et al. 2018

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Gadolinium-based contrast agents (GBCAs) have revolutionized MRI, enabling physicians to obtain crucial life-saving medical information that often cannot be obtained with other imaging modalities. Since initial approval in 1988, over 450 million intravenous GBCA doses have been administered worldwide, with an extremely favorable pharmacologic safety profile; however, recent information has raised new concerns over the safety of GBCAs. Mounting evidence has shown there is long-term retention of gadolinium in human tissues. Further, a small subset of patients have attributed a constellation of symptoms to GBCA exposure, although the association of these symptoms with GBCA administration or gadolinium retention has not been proven by scientific investigation. Despite evidence that macrocyclic GBCAs show less gadolinium retention than linear GBCAs, the safety implications of gadolinium retention are unknown. The mechanism and chemical forms of gadolinium retention, as well as the biologic activity and clinical importance of these retained gadolinium species, remain poorly understood and underscore the need for additional research. In February 2018, an international meeting was held in Bethesda, Md, at the National Institutes of Health to discuss the current literature and knowledge gaps about gadolinium retention, to prioritize future research initiatives to better understand this phenomenon, and to foster collaborative standardized studies. The greatest priorities are to determine (a) if gadolinium retention adversely affects the function of human tissues, (b) if retention is causally associated with short- or long-term clinical manifestations of disease, and (c) if vulnerable populations, such as children, are at greater risk for experiencing clinical disease. The purpose of the research roadmap is to highlight important information that is not known and to identify and prioritize needed research. ©RSNA, 2018 Online supplemental material is available for this article .

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Dentate Nucleus Signal Intensity Decrease on T1-weighted MR Images after Switching from Gadopentetate Dimeglumine to Gadobutrol

Cited by 11 publications

References 5 publications

Does Gadoterate Meglumine Cause Gadolinium Retention in the Brain of Children? A Case–Control Study

Does Gadoterate Meglumine Cause Gadolinium Retention in the Brain of Children? A Case–Control Study

Use of Magnetic Resonance Neurography for Evaluating the Distribution and Patterns of Chronic Inflammatory Demyelinating Polyneuropathy

Gadolinium Retention: A Research Roadmap from the 2018 NIH/ACR/RSNA Workshop on Gadolinium Chelates

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