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

Abstract

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

The switch from Gd-DTPA to Gd-DOTA is not associated with decrease of the T1 signal intensity of the pallidus and dentate in a pediatric population

“…In particular, the association between administration of Gd-DTPA and visually detected T1 hyperintensity along with a correlation between the cumulative dose of this linear GBCA and T1 SI are well established (6). On the other hand, in patients exclusively receiving the macrocyclic GBCA Gd-DOTA, two studies (33,34) observed no increase of the dentate T1 signal, but three studies (24–26) reported an increasing SI in the globus pallidus and dentate nucleus.…”

Increased flow rate of hyperpolarized aqueous solution for DNP-enhanced MRI achieved by an open Fabry-Pérot type microwave resonator

“…Fabry-Pérot resonators are mw resonance structures suitable for larger sample volumes, because different from fundamental mode mw cavities, the sample size is only limited in one dimension (direction of the mw excitation) much less than wavelength to avoid absorption of the E field component (Budil and Earle, 2004). Among known quasi-optical mw resonators (Lynch et al, 1988, Prisner et al, 1992, Barnes and Freed, 1997, Milikisiyants et al, 2018, Blok et al, 2004, van Tol et al, 2005, Neugebauer and Barra, 2010 a semi-confocal Fabry-Pérot resonator with the sample placed on the surface of a massive metal (copper) block acting as the plain mirror can best satisfy heat dissipation conditions (Denysenkov and Prisner, 2012).…”

“…brain are currently under discussion (Semelka et al, 2016, Topcuoglu et al, 2020. As an alternative, hyperpolarization methods have been explored to improve sensitivity and contrast for MRI applications.…”

Increased flow rate of hyperpolarized aqueous solution for dynamic nuclear polarization-enhanced magnetic resonance imaging achieved by an open Fabry–Pérot type microwave resonator

“…However, in few cases, it induces side effects like allergic reactions and nephrogenic systemic fibrosis (Perazella, 2009;Thomsen, 2008;Kuo et al, 2007). Besides, potential long-term implications arising from the permanent deposition of the Gd-complexes in the brain are currently under discussion (Semelka et al, 2016;Topcuoglu et al, 2020). As an alternative, hyperpolarization methods have been explored to improve sensitivity and contrast for MRI applications.…”

“…Fabry-Pérot resonators are mw resonance structures suitable for larger sample volumes, because different from fundamental mode mw cavities, the sample size is only limited in one dimension (direction of the mw excitation) much less than wavelength to avoid absorption of the E field component (Budil and Earle, 2004). Among known quasi-optical mw resonators (Lynch et al, 1988;Prisner et al, 1992; Barnes and Freed, 1997;Milikisiyants et al, 2018;Blok et al, 2004;van Tol et al, 2005; Neugebauer and Barra, 2010) a semi-confocal Fabry-Pérot resonator with the sample placed on the surface of a massive metal (copper) block acting as the plain mirror can best satisfy heat dissipation conditions (Denysenkov and Prisner, 2012).…”