Role of gadolinium-based contrast agents in neurological disorders

Golec, Weronika; Jakimów-Kostrzewa, Aleksandra; Mruk, Bartosz; Jóźwiak, Sergiusz

doi:10.5603/pjnns.a2020.0070

Cited by 5 publications

(9 citation statements)

References 94 publications

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“…Recently, gadolinium deposition in the brain has drawn attention, 25 although newer macrocyclic gadolinium agents lower the risk of depositions compared with older linear gadolinium agents 26,27 and the long-term clinical implications are unknown. 25,28 Although gadolinium can be used to better demonstrate SEGAs, in light of the need for repeated scans during childhood and potential side effects of contrast agents, combined with noncontrast imaging sequences generally sufficient for screening for SEGA, we recommend avoiding contrast agents until there is a growing lesion or clinical suspicion of SEGA. In the latter circumstances, gadolinium can better define the lesion size, characteristics, and margins and nearby anatomical structures, which may be important for decision-making and for planning and monitoring treatment response.…”

Section: Brainmentioning

confidence: 99%

Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations

Northrup¹,

Aronow²,

Bebin³

et al. 2021

Pediatric Neurology

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258

231

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Background: Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disease affecting multiple body systems with wide variability in presentation. In 2013, Pediatric Neurology published articles outlining updated diagnostic criteria and recommendations for surveillance and management of disease manifestations. Advances in knowledge and approvals of new therapies necessitated a revision of those criteria and recommendations. Methods: Chairs and working group cochairs from the 2012 International TSC Consensus Group were invited to meet face-to-face over two days at the 2018 World TSC Conference on July 25 and 26 in Dallas, TX, USA. Before the meeting, working group cochairs worked with group members via e-mail and telephone to (1) review TSC literature since the 2013 publication, (2) confirm or amend prior recommendations, and (3) provide new recommendations as required. Results: Only two changes were made to clinical diagnostic criteria reported in 2013: "multiple cortical tubers and/or radial migration lines" replaced the more general term "cortical dysplasias," and sclerotic bone lesions were reinstated as a minor criterion. Genetic diagnostic criteria were reaffirmed, including highlighting recent findings that some individuals with TSC are genetically mosaic for variants in TSC1 or TSC2. Changes to surveillance and management criteria largely reflected increased emphasis on early screening for electroencephalographic abnormalities, enhanced surveillance and management of TSCassociated neuropsychiatric disorders, and new medication approvals. Conclusions: Updated TSC diagnostic criteria and surveillance and management recommendations presented here should provide an improved framework for optimal care of those living with TSC and their families.

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Section: Brainmentioning

confidence: 99%

Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations

Northrup¹,

Aronow²,

Bebin³

et al. 2021

Pediatric Neurology

Self Cite

258

231

View full text Add to dashboard Cite

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“…Neuroimaging employs imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) to assess the structure and function of the CNS, diagnose diseases, determine prognosis and proper treatments, and plan or guide surgical interventions [ 1 – 5 ]. CT detects how X-rays differentially traverse and attenuate through fluids and tissues to construct a series of cross-sectional images in three planes, allowing for synthesis of a three-dimensional image [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Contrast allergies for neurological imaging: When to proceed

Fusco

Pucci

Pierre

et al. 2022

ALLERGY

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<abstract> <p>Contrast-enhanced neuroimaging is often necessary for the diagnosis and care of patients with diseases of the central nervous system. Although contrast is generally well tolerated and allergy to contrast is rare, allergic reactions can be severe and life threatening. Therefore, physicians should take care to prevent severe contrast allergy. In this review, we will discuss contrast allergy as well as potential strategies to reduce the risk of severe reactions in patients who require neuroimaging techniques with contrast. First, we discuss the clinical presentation and pathogenesis of contrast allergy and the risk factors associated with reactions. We then review methods to reduce the risk of future contrast reactions through improved patient education and documentation strategies, use of alternate imaging modalities or contrast media, premedication, and desensitization.</p> </abstract>

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“…The use of gadolinium‐based contrast agents (GBCA) to aid in MRI of brain lesions dates back to 1988 in humans and remains a widely accepted, relatively safe procedure 1 . .…”

Section: Introductionmentioning

confidence: 99%

“…. 2 Adverse events in humans are generally mild with life‐threatening anaphylactic reactions reported in 0.001% to 0.01% of administrations 1 . The role of GBCA in nephrogenic systemic fibrosis in humans was established in 2006, but the effects on the brain are uncertain despite evidence of long‐term gadolinium deposition within certain areas of the brain 1,2 .…”

Section: Introductionmentioning

confidence: 99%

“… 2 Adverse events in humans are generally mild with life‐threatening anaphylactic reactions reported in 0.001% to 0.01% of administrations 1 . The role of GBCA in nephrogenic systemic fibrosis in humans was established in 2006, but the effects on the brain are uncertain despite evidence of long‐term gadolinium deposition within certain areas of the brain 1,2 . Bower et al documented a dose‐dependent toxicity of GBCA on dopaminergic neurons in vitro , but whereas gadodiamide and gadopentetate caused cell death at 50 μM concentrations, macrocyclic agents required 10 mM concentrations to induce cell death 3 .…”

Section: Introductionmentioning

confidence: 99%

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Investigation of suspected gadolinium neurotoxicity in a dog

Fitzgerald

Harkin

Biller

et al. 2021

Vet Radiology Ultrasound

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Gadolinium‐based contrast agents are used across species to better visualize abnormalities during MRI and are considered generally safe in clinical practice. The aim of this study was to investigate central nervous system (CNS) gadolinium deposition in 11 dogs that had an MRI performed, received 0.22 mL/kg (0.1 mmol/kg) of gadopentetate dimeglumine, and were necropsied on the same hospital admission. The index case was a 5‐year‐old castrated male Australian Shepherd that presented for ataxia and following MRI developed seizure‐like activity that became refractory to anticonvulsant therapy. Gadolinium concentration was quantified in CNS tissues by inductively‐coupled plasma mass spectrometry and was 43‐fold higher in the index case. These findings suggest the possibility of gadolinium toxicity in select patients.

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Role of gadolinium-based contrast agents in neurological disorders

Cited by 5 publications

References 94 publications

Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations

Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations

Contrast allergies for neurological imaging: When to proceed

Investigation of suspected gadolinium neurotoxicity in a dog

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