MRI Brain Signal Intensity and Relaxation Times in Individuals with Prior Exposure to Gadobutrol

Abstract

To perform follow-up brain MRI in volunteer participants who had previously received multiple doses of gadobutrol and to assess for changes in signal intensities and relaxation times. Materials and Methods: This prospective study included 160 participants who received gadobutrol only between 2007 and 2017. The participants were separated into two groups, including participants with at least five contrast agent-enhanced examinations and normal kidney function (group 1) or at least one examination and impaired renal function (group 2). Control groups with normal and impaired renal function (groups 3 and 4) without history of contrast agent exposure were included for comparison. Unenhanced brain MRI was performed in 220 participants (76, 84, 25, and 35 participants in groups 1-4, respectively) with T1weighted spin-echo and T1 and T2 mapping to determine visual signal intensity changes, signal intensity ratios (globus pallidus-tothalamus and dentate nucleus-to-pons ratios), and T1 and T2 relaxation times. Results: In groups 1 and 2, neither visual signal alterations nor differences in signal intensity ratio or T2 mapping were found. T1 mapping showed no changes for dentate nucleus, pons, and thalamus. However, shorter T1 relaxation times in the globus pallidus were found in group 1 compared with group 3 (difference of 226.2 msec; P = .002), which correlated with the number of previous gadobutrol doses in this group (P = .001). Conclusion: In study participants who had previously received gadobutrol, brain MRI showed no differences relative to healthy control participants without gadobutrol exposure. However, quantitative T1 measurements might indicate gadolinium retention in the globus pallidus.

Influence of aging and gadolinium exposure on T1, T2, and T2*-relaxation in healthy women with an increased risk of breast cancer with and without prior exposure to gadoterate meglumine at 3.0-T brain MR imaging

“…Our results regarding quantitative T1 mapping with a 3.0-T MRI system are in accordance with the findings of Saake et al who, using a 1.5-T scanner, investigated 160 patients with multiple GBCA administrations and 60 GBCA-naïve control subjects and found significantly shortened T1 relaxation times in the GP in the exposed group [34]. Our findings also confirm those of Quattrocchi et al [24], who assessed the effect of age and number of previous injections of linear GBCA on signal intensity of unenhanced T1-weighted images of the DN and GP in 892 patients with prior GBCA exposure and 1906 subjects without.…”

Gadolinium-based contrast agents: What we learned from acute adverse events, nephrogenic systemic fibrosis and brain retention

“…In contrast, Deike-Hoffmann et al in a retrospective analysis reported that after multiple administrations of gadobutrol there was no change in the T1 relaxation time, neither in globus pallidus nor in other core regions [33]. In a prospective study with 220 individuals who did not show brain pathologies on MRI, there was a significant reduction in T1 relaxation times in the globus pallidus after multiple gadobutrol doses, analogous to the above-mentioned study by Kang et al, where the number of gadobutrol doses correlated inversely with the T1 relaxation time, as a possible correlate to Gd retention in this core region [34]. Corresponding to these results Choi et al reports in a recent paper on Quantitative Susceptibility Mapping (QSM) in the globus pallidus after multiple administrations of gadobutrol, whereby the magnetic susceptibility in this core correlated with the number of gadobutrol injections [35].…”

“…Corresponding to these results Choi et al reports in a recent paper on Quantitative Susceptibility Mapping (QSM) in the globus pallidus after multiple administrations of gadobutrol, whereby the magnetic susceptibility in this core correlated with the number of gadobutrol injections [35]. A visual correlation of shortened T1 relaxation times or magnetic susceptibility after gadobutrol was not detectable in the T1-weighted image of patients in these studies [34,35].…”

“…Dagegen berichteten Deike-Hoffmann et al, dass es in einer retrospektiven Analyse nach Gadobutrol-Mehrfachgaben weder in Globus pallidus noch in anderen Kerngebieten zu einer Veränderung der T1-Relaxationszeit kam [33]. In einer prospektiven Studie mit 220 Individuen, welche keine Hirnpathologien im MRT aufwiesen, kam esanalog zur o. g. Studie von Kang et alim Globus pallidus zu einer signifikanten Verkürzung der T1-Relaxationszeiten nach Gadobutrol-Mehrfachgaben, wobei die Anzahl der Gadobutrol-Gaben mit der T1-Relaxationszeit invers korrelierte, als mögliches Korrelat zur Gd-Retention in diesem Kerngebiet [34]. Korrespondierend zu diesen Ergebnissen berichtet Choi et al in einer aktuellen Arbeit über quantitativ erfassbare Suszeptibilitäten (Quantitative Susceptibility Mapping, QSM) im Globus pallidus nach Mehrfachgaben von Gadobutrol, wobei die magnetische Suszeptibilität in diesem Kern mit der Anzahl der Gadobutrol-Injektionen korrelierte [35].…”

“…Korrespondierend zu diesen Ergebnissen berichtet Choi et al in einer aktuellen Arbeit über quantitativ erfassbare Suszeptibilitäten (Quantitative Susceptibility Mapping, QSM) im Globus pallidus nach Mehrfachgaben von Gadobutrol, wobei die magnetische Suszeptibilität in diesem Kern mit der Anzahl der Gadobutrol-Injektionen korrelierte [35]. Ein visuelles Korrelat der verkürzten T1-Relaxationszeiten oder magnetischen Suszeptibilität nach Gadobutrol war in Patienten dieser Studien im T1-gewichteten Bild nicht nachweisbar [34,35].…”