T1-Weighted Intensity Increase After a\xa0Single Administration of a\xa0Linear Gadolinium-Based Contrast Agent in Multiple Sclerosis

S Grahl,M Mühlau,B Hemmer,M Bussas,J S Kirschke,A Berthele,V Pongratz,C Zimmer

doi:10.1007/s00062-020-00882-6

S Grahl, M Mühlau + Show 6 more

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https://doi.org/10.1007/s00062-020-00882-6

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Abstract

PurposeThrough analysis of T1-weighted (T1w) images this study investigated gadolinium (Gd) deposition in the brain after administration of a linear (gadopentetic acid) and a cyclic (gadoteric acid) gadolinium-based contrast agent (GBCA) in patients with multiple sclerosis (MS), a disorder frequently requiring magnetic resonance imaging (MRI) scans over years.MethodsA total of 3233 T1w images (unenhanced with respect to the same scanning session) of 881 MS patients were retrospectively analyzed. After spatial normalization and intensity scaling using a sphere within the pons, differences of all pairs of subsequent scans were calculated and attributed to either linear (n = 2718) or cyclic (n = 385) or no GBCA (n = 130) according to the first scan. Regional analyses were performed, focusing on the dentate nucleus, and whole brain analyses. By 1‑sample t‑tests, signal intensity increases within conditions were searched for; conditions were compared by 2‑sample t‑tests. Furthermore, recent hypotheses on the reversibility of GBCA deposition were tested.ResultsIn the dentate nucleus, a significant increase was observed only after administration of linear GBCA even after a single GBCA administration. This increase differed significantly (p < 0.001) from the other conditions (cyclic and no GBCA). Whole brain analyses revealed T1w signal increases only after administration of linear GBCA within two regions, the dentate nucleus and globus pallidus. Additional analyses did not indicate any decline of Gd deposition in the brain.ConclusionThe data point towards Gd deposition in the brain after administration of linear GBCA even after a single administration.

Highlights

Gadolinium-based magnetic resonance imaging (MRI) contrast agents (GBCA) were considered to be the safest contrast agents with a very low rate of ad-K between a linear and a cyclic GBCA and kinetic aspects of Gd deposition were studied and increases of the T1w signal intensity were studied by region of interest analyses of the dentate nucleus area, where Gd deposition seems to be most robust [3, 7, 9,10,11,12,13,14,15] and by whole brain analyses
We did not find any indications that any of the potentially confounding parameters interfered with the signal intensity changes after administration of GBCA in a meaningful way (Fig. 3)
The signal change between subsequent scans was almost independent of the number of GBCA administrations beforehand

Summary

Introduction

Gadolinium-based magnetic resonance imaging (MRI) contrast agents (GBCA) were considered to be the safest contrast agents with a very low rate of ad-. K between a linear and a cyclic GBCA and kinetic aspects of Gd deposition were studied and increases of the T1w signal intensity were studied by region of interest analyses of the dentate nucleus area, where Gd deposition seems to be most robust [3, 7, 9,10,11,12,13,14,15] and by whole brain analyses. Kinetic aspects of Gd deposition were studied, in particular whether a certain number of GBCA administrations are needed for Gd deposition or whether a single administration suffices

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