Abstract

ObjectiveTo determine the effect of a linear gadolinium-based contrast agent (GBCA) on the signal intensity (SI) of the deep cerebellar nuclei (DCN) in a retrospective clinical study on dogs after multiple magnetic resonance (MR) examinations with intravenous injections of gadodiamide and LA-ICP-MS analysis of a canine cerebellum after gadodiamide administration.Animals15 client-owned dogs of different breeds and additionally 1 research beagle dog cadaver.ProceduresIn the retrospective study part, 15 dogs who underwent multiple consecutive MR imaging examinations with intravenous injection of linear GBCA gadodiamide were analyzed. SI ratio differences on unenhanced T1-weighted MR images before and after gadodiamide injections was calculated by subtracting SI ratios between DCN and pons of the first examination from the ratio of the last examination. Additionally, 1 research beagle dog cadaver was used for LA-ICP-MS (Laser ablation inductively coupled plasma mass spectrometry) analysis of gadolinium in the cerebellum as an add-on to another animal study. Descriptive and non-parametrical statistical analysis was performed and a p-value of < 0.05 was considered significant.ResultsNo statistically significant differences of SI ratios, between DCN and pons, were detectable based on unenhanced T1-weighted MR images. LA-ICP-MS analyses showed between 1.5 to 2.5 μg gadolinium/g tissue in the cerebellum of the examined dog, 35 months after the last of 3 MRI examination with gadodiamide (two examinations at a dose of 1 x 0.1mmol/kg, last examination at a dose of 3 x 0.05mmol/kg).Conclusion and clinical relevanceAlthough the retrospective MRI study did not indicate any visible effect of SI increase after multiple gadodiamide exposures, further studies based on LA-ICP-MS showed that the optical threshold was not reached for a potential visible effect. Gadolinium was detectable at a level of 1.5 to 2.5 μg gadolinium/g tissue by using LA-ICP-MS in the cerebellum 35 months after last MRI examination. The general importance of gadolinium retention of subvisible contents requires further investigation.

Highlights

  • The retrospective magnetic resonance imaging (MRI) study did not indicate any visible effect of signal intensity (SI) increase after multiple gadodiamide exposures, further studies based on LA-ICP-MS showed that the optical threshold was not reached for a potential visible effect

  • Gadolinium was detectable at a level of 1.5 to 2.5 μg gadolinium/g tissue by using LA-ICP-MS in the cerebellum 35 months after last MRI examination

  • In 2014 Tomori Kanda[1] published his work about signal intensity (SI) increase on unenhanced T1 weighted magnetic resonance imaging (MRI), causing hyperintensities in the dentate nucleus (DN)-to pons and globus pallidus to thalamus after consecutive injections of gadolinium-based contrast agents (GBCAs)

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Summary

Introduction

In 2014 Tomori Kanda[1] published his work about signal intensity (SI) increase on unenhanced T1 weighted magnetic resonance imaging (MRI), causing hyperintensities in the dentate nucleus (DN)-to pons and globus pallidus to thalamus after consecutive injections of gadolinium-based contrast agents (GBCAs). The majority of studies provided evidence that linear GCBAs are stronger correlated with SI increase in the DN.[1, 3,4,5,6,7, 13,14,15, 17, 18, 20, 22,23,24, 26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43] On the other hand, SI increase was described after macrocyclic GBCA administration in a few studies that were controversial discussed between specialists due to their limitations.[3, 5, 7, 8, 17] It seems that the molecular structure of the GBCA ligand, which defines the GBCA subtype, is a crucial factor for the SI increase on unenhanced T1 weighted MRI.[44]

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