Sensitivity of Immediate and Delayed Gadolinium-Enhanced MRI After Injection of 0.5 M and 1.0 M Gadolinium Chelates for Detecting Multiple Sclerosis Lesions

Uysal, Ender; Ertürk, Şükrü Mehmet; Yıldırım, Hakan; Seleker, Feray; Başak, Muzaffer

doi:10.2214/ajr.05.2212

Cited by 56 publications

(62 citation statements)

References 14 publications

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“…88 This 'dead' time can be used to perform the T2-FLAIR sequences, so that the total acquisition time is not lengthened. Although this strategy might have some disadvantages-including the possibility of increasing blood flow-related ghosting artefacts-it can improve the conspicuousness of enhancing lesions, because of the slight T1 weighting of T2-FLAIR images that results from the long inversion time used to cancel out the water signal intensity.…”

Section: Contrast Enhancementmentioning

confidence: 99%

“…Statements and recommendations ■ Brain MRI should be performed using a magnetic field strength of at least 1.5 T (but preferably 3.0 T), with a slice thickness of 3 mm for 2D sequences [77][78][79][80][81] Nature Reviews | Neurology a c b ■ The standardized protocol for conventional MRI in diagnostic work-up includes axial T1-weighted sequences before and after contrast, axial T2-weighted and proton-density (or T2-FLAIR) sequences, and sagittal 2D or isotropic 3D T2-FLAIR sequences [79][80][81] ■ A single dose (0.1 mmol/kg body weight) of gadolinium-based contrast medium should be used, with a minimum delay of 5 min after contrast injection 88 ■ Conventional 2D spin-echo sequences should be used to detect gadolinium-enhancing MS lesions at 1.5 T, 92 but at 3.0 T, isotropic 3D gradient-echo or fast spin-echo sequences are a potentially valuable alternative to 2D sequences 92,93 ■ Standardized image acquisition and slice positioning between baseline and follow-up are of paramount importance to establish DIT via detection of new T2 lesions 79,80 ■ DWI cannot replace contrast-enhanced T1-weighted images for differentiating between acute and chronic MS lesions 98 Standardized spinal cord MRI protocol MS affects the entire CNS, and more than 90% of patients show focal or diffuse abnormalities in the spinal cord on T2-weighted sequences (Figure 2). Spinal cord lesions are less prevalent in patients with CIS than in patients with clinically definite MS.…”

Section: Follow-up and Longitudinal Scansmentioning

confidence: 99%

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MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

et al. 2015

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| The clinical use of MRI in patients with multiple sclerosis (MS) has advanced markedly over the past few years. Technical improvements and continuously emerging data from clinical trials and observational studies have contributed to the enhanced performance of this tool for achieving a prompt diagnosis in patients with MS. The aim of this article is to provide guidelines for the implementation of MRI of the brain and spinal cord in the diagnosis of patients who are suspected of having MS. These guidelines are based on an extensive review of the recent literature, as well as on the personal experience of the members of the MAGNIMS (Magnetic Resonance Imaging in MS) network. We address the indications, timing, coverage, reporting and interpretation of MRI studies in patients with suspected MS. Our recommendations are intended to help radiologists and neurologists standardize and optimize the use of MRI in clinical practice for the diagnosis of MS.

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Section: Contrast Enhancementmentioning

confidence: 99%

Section: Follow-up and Longitudinal Scansmentioning

confidence: 99%

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

et al. 2015

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“…For detection of multiple lesions, including metastases, higher concentrations (0.2-0.3 mmol/kg of body weight) may identify additional lesions and are widely used at the initial assessment. 4,10,[109][110][111][112][113][114][115][116][117][118][119] Double dosing also improves image quality and data quantitation in MR perfusion studies. 95 Typically, as for all pharmaceuticals, the lowest dose possible should be used.…”

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confidence: 99%

MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice

Essig¹,

Anzalone²,

Combs³

et al. 2011

AJNR Am J Neuroradiol

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SUMMARY: MR imaging is the preferred technique for the diagnosis, treatment planning, and monitoring of patients with neoplastic CNS lesions. Conventional MR imaging, with gadolinium-based contrast enhancement, is increasingly combined with advanced, functional MR imaging techniques to offer morphologic, metabolic, and physiologic information. This article provides updated recommendations to neuroradiologists, neuro-oncologists, neurosurgeons, and radiation oncologists on the practical applications of MR imaging of neoplastic CNS lesions in adults, with particular focus on gliomas, based on a review of the clinical trial evidence and personal experiences shared at a recent international meeting of experts in neuroradiology, neuro-oncology, neurosurgery, and radio-oncology.ABBREVIATIONS: ADC ϭ apparent diffusion coefficient; CBV ϭ cerebral blood volume; CNS ϭ central nervous system; DCE ϭ dynamic contrast-enhanced; DSC ϭ dynamic susceptibility contrast; DTI ϭ diffusion tensor imaging; DWI ϭ diffusion-weighted imaging; FLAIR ϭ fluid-attenuated inversion recovery; FSE ϭ fast spin-echo; GFR ϭ glomerular filtration rate; GRE ϭ gradient recalled-echo; K trans ϭ volume transfer coefficient; MRS ϭ MR spectroscopy; PET ϭ positronemission tomography; PWI ϭ perfusion-weighted imaging; rCBV ϭ relative cerebral blood volume; TSE ϭ turbo spin-echo N eoplastic CNS lesions are a heterogeneous group of diseases with a variable outcome that reflects the precision of diagnosis and the delivery of optimal and specific treatment. CNS imaging has a pivotal role in directing management decisions.The goals and requirements for CNS imaging are multiple and include the establishment of a diagnosis and differential diagnosis, with accurate lesion grading for characterization of tumor biology. Imaging is an essential part of the decisionmaking process for therapy and later for planning of surgical or radiotherapeutic interventions. In the case of neurosurgery, neuroimaging can precisely define the location and accurately delineate the lesion and its relationship to eloquent gray-and white-matter structures, before intervention. In radiation therapy, imaging can define and demarcate margins for therapy planning. Imaging is mandatory after therapeutic intervention for monitoring disease and possible side effects.MR imaging is the standard technique for visualizing and characterizing neoplastic CNS lesions, with superior sensitivity compared with alternative modalities.1-4 Diagnosis and treatment planning are routinely based on conventional MR imaging, such as T2-weighted imaging, FLAIR, and T1 unenhanced FSE or GRE. Following contrast-enhanced T1-weighted imaging, sequences including 3D GRE or 2D TSE or FSE are used routinely for assessment of brain tumors. Through enhancing tissue relaxation, gadolinium-based contrast media improve the sensitivity and specificity of conventional and perfusion-weighted MR imaging examinations, with the capability to identify lesions not visible on unenhanced MR imaging and to provide additional information o...

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“…However studies investigating different pathologies, including brain tumors and metastases, indicate that lesion detection may be improved with higher concentrations (0.2-0.3 mmol/Kg). 10 Thus, many centers, like that of Kim et al,4 use double doses in their routine screening protocols. Frequently, higher doses may be given in cases of diagnostic doubt following the standard 0.1-mmol/Kg dose.…”

mentioning

confidence: 99%

Comparative Studies of Different Gadolinium Agents in Brain Tumors: Differences between Gadolinium Chelates and Their Possible Influence on Imaging Features

Anzalone¹

2010

AJNR Am J Neuroradiol

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Sensitivity of Immediate and Delayed Gadolinium-Enhanced MRI After Injection of 0.5 M and 1.0 M Gadolinium Chelates for Detecting Multiple Sclerosis Lesions

Abstract: The use of 1.0-mol/L gadolinium chelate enables us to detect an increased number of enhancing lesions and patients with active disease. A delay of 5 minutes after the injection of the gadolinium chelate might be sufficient to detect active lesions in patients with MS.

Cited by 56 publications

References 14 publications

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

MAGNIMS consensus guidelines on the use of MRI in multiple sclerosis—clinical implementation in the diagnostic process

MR Imaging of Neoplastic Central Nervous System Lesions: Review and Recommendations for Current Practice

Comparative Studies of Different Gadolinium Agents in Brain Tumors: Differences between Gadolinium Chelates and Their Possible Influence on Imaging Features

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