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Erschienen in: Pediatric Radiology 10/2017

19.05.2017 | Original Article

Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children

verfasst von: Maria Camilla Rossi Espagnet, Bruno Bernardi, Luca Pasquini, Lorenzo Figà-Talamanca, Paolo Tomà, Antonio Napolitano

Erschienen in: Pediatric Radiology | Ausgabe 10/2017

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Abstract

Background

Few studies have been conducted on the relations between T1-weighted signal intensity changes in the pediatric brain following gadolinium-based contrast agent (GBCA) exposure.

Objective

The purpose of this study is to investigate the effect of multiple administrations of a macrocyclic GBCA on signal intensity in the globus pallidus and dentate nucleus of the pediatric brain on unenhanced T1-weighted MR images.

Materials and methods

This retrospective study included 50 patients, mean age: 8 years (standard deviation: 4.8 years), with normal renal function exposed to ≥6 administrations of the same macrocyclic GBCA (gadoterate meglumine) and a control group of 59 age-matched GBCA-naïve patients. The globus pallidus-to-thalamus signal intensity ratio and dentate nucleus-to-pons signal intensity ratio were calculated from unenhanced T1-weighted images for both patients and controls. A mixed linear model was used to evaluate the effects on signal intensity ratios of the number of GBCA administrations, the time interval between administrations, age, radiotherapy and chemotherapy. T-test analyses were performed to compare signal intensity ratio differences between successive administrations and baseline MR signal intensity ratios in patients compared to controls. P-values were considered significant if <0.05.

Results

A significant effect of the number of GBCA administrations on relative signal intensities globus pallidus-to-thalamus (F[8]=3.09; P=0.002) and dentate nucleus-to-pons (F[8]=2.36; P=0.021) was found. The relative signal intensities were higher at last MR examination than at baseline (P<0.001).

Conclusion

Quantitative analysis evaluation of globus pallidus:thalamus and dentate nucleus:pons of the pediatric brain demonstrated an increase after serial administrations of macrocyclic GBCA. Further research is necessary to fully understand GBCA pharmacokinetic in children.
Literatur
1.
Zurück zum Zitat Ramalho J, Semelka RC, Ramalho M et al (2016) Gadolinium-based contrast agent accumulation and toxicity: an update. AJNR Am J Neuroradiol 37:1192–1198CrossRefPubMed Ramalho J, Semelka RC, Ramalho M et al (2016) Gadolinium-based contrast agent accumulation and toxicity: an update. AJNR Am J Neuroradiol 37:1192–1198CrossRefPubMed
2.
Zurück zum Zitat Beomonte Zobel B, Quattrocchi CC, Errante Y et al (2015) Gadolinium-based contrast agents: did we miss something in the last 25 years? Radiol Med 121:478–841CrossRefPubMed Beomonte Zobel B, Quattrocchi CC, Errante Y et al (2015) Gadolinium-based contrast agents: did we miss something in the last 25 years? Radiol Med 121:478–841CrossRefPubMed
3.
Zurück zum Zitat McDonald RJ, McDonald JS, Kallmes DF et al (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 275:772–782CrossRefPubMed McDonald RJ, McDonald JS, Kallmes DF et al (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 275:772–782CrossRefPubMed
4.
Zurück zum Zitat Kanda T, Ishii K, Kawaguchi H et al (2014) High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 270:834–841CrossRefPubMed Kanda T, Ishii K, Kawaguchi H et al (2014) High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 270:834–841CrossRefPubMed
5.
Zurück zum Zitat Radbruch A, Weberling LD, Kieslich PJ et al (2015) Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent. Radiology 275:783–791CrossRefPubMed Radbruch A, Weberling LD, Kieslich PJ et al (2015) Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent. Radiology 275:783–791CrossRefPubMed
6.
Zurück zum Zitat Radbruch A, Weberling LD, Kieslich PJ et al (2015) High-signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted images: evaluation of the macrocyclic gadolinium-based contrast agent gadobutrol. Investig Radiol 50:805–810CrossRef Radbruch A, Weberling LD, Kieslich PJ et al (2015) High-signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted images: evaluation of the macrocyclic gadolinium-based contrast agent gadobutrol. Investig Radiol 50:805–810CrossRef
7.
Zurück zum Zitat Weberling LD, Kieslich PJ, Kickingereder P et al (2015) Increased signal intensity in the dentate nucleus on unenhanced T1-weighted images after gadobenate dimeglumine administration. Investig Radiol 50:743–748CrossRef Weberling LD, Kieslich PJ, Kickingereder P et al (2015) Increased signal intensity in the dentate nucleus on unenhanced T1-weighted images after gadobenate dimeglumine administration. Investig Radiol 50:743–748CrossRef
8.
Zurück zum Zitat Flood TF, Stence NV, Maloney JA et al (2017) Pediatric brain: repeated exposure to linear gadolinium-based contrast material is associated with increased signal intensity at unenhanced T1-weighted MR imaging. Radiology 282:222–228CrossRefPubMed Flood TF, Stence NV, Maloney JA et al (2017) Pediatric brain: repeated exposure to linear gadolinium-based contrast material is associated with increased signal intensity at unenhanced T1-weighted MR imaging. Radiology 282:222–228CrossRefPubMed
9.
Zurück zum Zitat Hu HH, Pokorney A, Towbin RB et al (2016) Increased signal intensities in the dentate nucleus and globus pallidus on unenhanced T1-weighted images: evidence in children undergoing multiple gadolinium MRI exams. Pediatr Radiol 46:1590–1598CrossRefPubMed Hu HH, Pokorney A, Towbin RB et al (2016) Increased signal intensities in the dentate nucleus and globus pallidus on unenhanced T1-weighted images: evidence in children undergoing multiple gadolinium MRI exams. Pediatr Radiol 46:1590–1598CrossRefPubMed
10.
Zurück zum Zitat Roberts DR, Chatterjee AR, Yazdani M et al (2016) Pediatric patients demonstrate progressive T1-weighted hyperintensity in the dentate nucleus following multiple doses of gadolinium-based contrast agent. AJNR Am J Neuroradiol 37:2340–2347CrossRefPubMedPubMedCentral Roberts DR, Chatterjee AR, Yazdani M et al (2016) Pediatric patients demonstrate progressive T1-weighted hyperintensity in the dentate nucleus following multiple doses of gadolinium-based contrast agent. AJNR Am J Neuroradiol 37:2340–2347CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Errante Y, Cirimele V, Mallio CA et al (2014) Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered gadodiamide in patients with normal renal function, suggesting dechelation. Investig Radiol 49:685–690CrossRef Errante Y, Cirimele V, Mallio CA et al (2014) Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered gadodiamide in patients with normal renal function, suggesting dechelation. Investig Radiol 49:685–690CrossRef
12.
Zurück zum Zitat Branson HM (2004) Normal myelination: a practical pictorial review. Neuroimaging Clin N Am 23:183–195CrossRef Branson HM (2004) Normal myelination: a practical pictorial review. Neuroimaging Clin N Am 23:183–195CrossRef
14.
Zurück zum Zitat Kanda T, Osawa M, Oba H et al (2015) High signal intensity in dentate nucleus on unenhanced T1-weighted MR images: association with linear versus macrocyclic gadolinium chelate administration. Radiology 275:803–809CrossRefPubMed Kanda T, Osawa M, Oba H et al (2015) High signal intensity in dentate nucleus on unenhanced T1-weighted MR images: association with linear versus macrocyclic gadolinium chelate administration. Radiology 275:803–809CrossRefPubMed
15.
Zurück zum Zitat Ramalho J, Castillo M, AlObaidy M et al (2015) High signal intensity in globus pallidus and dentate nucleus on unenhanced T1-weighted MR images: evaluation of two linear gadolinium-based contrast agents. Radiology 276:836–844CrossRefPubMed Ramalho J, Castillo M, AlObaidy M et al (2015) High signal intensity in globus pallidus and dentate nucleus on unenhanced T1-weighted MR images: evaluation of two linear gadolinium-based contrast agents. Radiology 276:836–844CrossRefPubMed
16.
Zurück zum Zitat Frenzel T, Lengsfeld P, Schirmer H et al (2008) Stability of gadolinium-based magnetic resonance imaging contrast agents in human serum at 37 degrees C. Investig Radiol 43:817–828CrossRef Frenzel T, Lengsfeld P, Schirmer H et al (2008) Stability of gadolinium-based magnetic resonance imaging contrast agents in human serum at 37 degrees C. Investig Radiol 43:817–828CrossRef
17.
Zurück zum Zitat Aime S, Caravan P (2009) Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J Magn Reson Imaging 30:1259–1267CrossRefPubMedPubMedCentral Aime S, Caravan P (2009) Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J Magn Reson Imaging 30:1259–1267CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Gibby WA, Gibby KA, Gibby WA (2004) Comparison of Gd DTPA-BMA (Omniscan) versus Gd HP-DO3A (ProHance) retention in human bone tissue by inductively coupled plasma atomic emission spectroscopy. Investig Radiol 39:138–142CrossRef Gibby WA, Gibby KA, Gibby WA (2004) Comparison of Gd DTPA-BMA (Omniscan) versus Gd HP-DO3A (ProHance) retention in human bone tissue by inductively coupled plasma atomic emission spectroscopy. Investig Radiol 39:138–142CrossRef
19.
Zurück zum Zitat Stojanov DA, Aracki-Trenkic A, Vojinovic S et al (2016) Increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W magnetic resonance images in patients with relapsing-remitting multiple sclerosis: correlation with cumulative dose of a macrocyclic gadolinium-based contrast age. Eur Radiol 26:807–815CrossRefPubMed Stojanov DA, Aracki-Trenkic A, Vojinovic S et al (2016) Increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W magnetic resonance images in patients with relapsing-remitting multiple sclerosis: correlation with cumulative dose of a macrocyclic gadolinium-based contrast age. Eur Radiol 26:807–815CrossRefPubMed
20.
Zurück zum Zitat Agris J, Pietsch H, Balzer T (2016) What evidence is there that gadobutrol causes increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W MRI in patients with RRMS? Eur Radiol 26:816–817CrossRefPubMed Agris J, Pietsch H, Balzer T (2016) What evidence is there that gadobutrol causes increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W MRI in patients with RRMS? Eur Radiol 26:816–817CrossRefPubMed
21.
Zurück zum Zitat Radbruch A, Bickelhaupt S, Paech D et al (2017) Pediatric brain: no increased signal intensity in the dentate nucleus on unenhanced T1-weighted MR images after consecutive exposure to a macrocyclic gadolinium-based contrast agent. Radiology 8:162980 Radbruch A, Bickelhaupt S, Paech D et al (2017) Pediatric brain: no increased signal intensity in the dentate nucleus on unenhanced T1-weighted MR images after consecutive exposure to a macrocyclic gadolinium-based contrast agent. Radiology 8:162980
22.
Zurück zum Zitat Martin-Duverneuil N, Idbaih A, Hoang-Xuan K et al (2006) MRI features of neurodegenerative Langerhans cell histiocytosis. Eur Radiol 16:2074–2082CrossRefPubMed Martin-Duverneuil N, Idbaih A, Hoang-Xuan K et al (2006) MRI features of neurodegenerative Langerhans cell histiocytosis. Eur Radiol 16:2074–2082CrossRefPubMed
23.
Zurück zum Zitat Kanal E, Tweedle MF (2015) Residual or retained gadolinium: practical implications for radiologists and our patients. Radiology 275:630–634CrossRefPubMed Kanal E, Tweedle MF (2015) Residual or retained gadolinium: practical implications for radiologists and our patients. Radiology 275:630–634CrossRefPubMed
24.
Zurück zum Zitat McDonald RJ, McDonald JS, Kallmes DF et al (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 0:150025 McDonald RJ, McDonald JS, Kallmes DF et al (2015) Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 0:150025
25.
Zurück zum Zitat Kanda T, Fukusato T, Matsuda M et al (2015) Gadolinium-based contrast agent accumulates in the brain even in subjects without severe renal dysfunction: evaluation of autopsy brain specimens with inductively coupled plasma mass spectroscopy. Radiology 276:228–232CrossRefPubMed Kanda T, Fukusato T, Matsuda M et al (2015) Gadolinium-based contrast agent accumulates in the brain even in subjects without severe renal dysfunction: evaluation of autopsy brain specimens with inductively coupled plasma mass spectroscopy. Radiology 276:228–232CrossRefPubMed
26.
Zurück zum Zitat Murata N, Gonzalez-Cuyar LF, Murata K et al (2016) Macrocyclic and other non–group 1 gadolinium contrast agents deposit low levels of gadolinium in brain and bone tissue. Investig Radiol 51:447–453CrossRef Murata N, Gonzalez-Cuyar LF, Murata K et al (2016) Macrocyclic and other non–group 1 gadolinium contrast agents deposit low levels of gadolinium in brain and bone tissue. Investig Radiol 51:447–453CrossRef
27.
Zurück zum Zitat Frenzel T, Apte C, Jost G et al (2017) Quantification and assessment of the chemical form of residual gadolinium in the brain after repeated administration of gadolinium-based contrast agents comparative study in rats. Investig Radiol. doi:10.1097/RLI.0000000000000352 Frenzel T, Apte C, Jost G et al (2017) Quantification and assessment of the chemical form of residual gadolinium in the brain after repeated administration of gadolinium-based contrast agents comparative study in rats. Investig Radiol. doi:10.​1097/​RLI.​0000000000000352​
28.
Zurück zum Zitat Hagberg GE, Scheffler K (2013) Effect of r1 and r2 relaxivity of gadolinium-based contrast agents on the T1-weighted MR signal at increasing magnetic field strengths. Contrast Media Mol Imaging 8:456–465CrossRefPubMed Hagberg GE, Scheffler K (2013) Effect of r1 and r2 relaxivity of gadolinium-based contrast agents on the T1-weighted MR signal at increasing magnetic field strengths. Contrast Media Mol Imaging 8:456–465CrossRefPubMed
29.
Zurück zum Zitat Adin ME, Kleinberg L, Vaidya D et al (2015) Hyperintense dentate nuclei on T1-weighted MRI: relation to repeat gadolinium administration. AJNR Am J Neuroradiol 36:1859–1865 Adin ME, Kleinberg L, Vaidya D et al (2015) Hyperintense dentate nuclei on T1-weighted MRI: relation to repeat gadolinium administration. AJNR Am J Neuroradiol 36:1859–1865
Metadaten
Titel
Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children
verfasst von
Maria Camilla Rossi Espagnet
Bruno Bernardi
Luca Pasquini
Lorenzo Figà-Talamanca
Paolo Tomà
Antonio Napolitano
Publikationsdatum
19.05.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Radiology / Ausgabe 10/2017
Print ISSN: 0301-0449
Elektronische ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-017-3874-1

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