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Jost G, Lenhard DC, Sieber MA, Lohrke J, Frenzel T, Pietsch H. Signal Increase on Unenhanced T1-Weighted Images in the Rat Brain After Repeated, Extended Doses of Gadolinium-Based Contrast Agents: Comparison of Linear and Macrocyclic Agents. Invest Radiol 2016; 51:83-9. [PMID: 26606548 PMCID: PMC4747981 DOI: 10.1097/rli.0000000000000242] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 11/11/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In this prospective preclinical study, we evaluated T1-weighted signal intensity in the deep cerebellar nuclei (CN) and globus pallidus (GP) up to 24 days after repeated administration of linear and macrocyclic gadolinium-based contrast agents (GBCAs) using homologous imaging and evaluation methods as in the recently published retrospective clinical studies. In a second part of the study, cerebrospinal fluid (CSF) spaces were evaluated for contrast enhancement by fluid-attenuated magnetic resonance imaging (MRI). MATERIALS AND METHODS Sixty adult male Wistar-Han rats were randomly divided into a control and 5 GBCA groups (n = 10 per group). The administered GBCAs were gadodiamide, gadopentetate dimeglumine, and gadobenate dimeglumine (linear GBCAs) as well as gadobutrol and gadoterate meglumine (macrocyclic GBCAs) and saline (control). Over a period of 2 weeks, the animals received 10 intravenous injections at a dose of 2.5 mmol Gd/kg body weight, each on 5 consecutive days per week. Before GBCA administration, as well as 3 and 24 days after the last injection, a whole-brain MRI was performed using a standard T1-weighted 3-dimensional turbo spin echo sequence on a clinical 1.5 T scanner. The ratios of signal intensities in deep CN to pons (CN/Po) and GP to thalamus (GP/Th) were determined. For the evaluation of the CSF spaces, 18 additional rats were randomly divided into 6 groups (n = 3 per group) that received the same GBCAs as in the first part of the study. After MR cisternography for anatomical reference, a fluid-attenuated inversion recovery sequence was performed before and 1 minute after intravenous injection of a dose of 1 mmol Gd/kg body weight GBCA or saline. RESULTS A significantly increased signal intensity ratio of CN/Po was observed 3 and 24 days after the last injection of gadodiamide and gadobenate dimeglumine. No significant changes were observed between the 2 time points. Gadopentetate dimeglumine injection led to a moderately elevated but statistically not significant CN/Po signal intensity ratio. No increased CN/Po signal intensity ratios were determined in the MRI scans of rats that received macrocyclic GBCAs gadobutrol and gadoterate meglumine or saline. The ratio of signal intensity in GP/Th was not elevated in any group injected with GBCAs or saline. Enhanced signal intensities of CSF spaces were observed in the postcontrast fluid-attenuated inversion recovery images of all animals receiving GBCAs but not for saline. CONCLUSIONS In this animal study in rats, increased signal intensity in the CN was found up to 24 days after multiple, extended doses of linear GBCAs. However, in contrast to clinical reports, the signal enhancement in the GP was not reproduced, demonstrating the limitations of this animal experiment. The elevated signal intensities remained persistent over the entire observation period. In contrast, no changes of signal intensities in either the CN or the GP were observed for macrocyclic GBCAs. However, all GBCAs investigated were able to pass the blood-CSF barrier in rats to a certain, not yet quantified extent.
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Affiliation(s)
- Gregor Jost
- From the *MR and CT Contrast Media Research, Bayer Healthcare; †Institute of Vegetative Physiology, Charité; and ‡Clinical Project Management, Bayer Healthcare, Berlin, Germany
| | - Diana Constanze Lenhard
- From the *MR and CT Contrast Media Research, Bayer Healthcare; †Institute of Vegetative Physiology, Charité; and ‡Clinical Project Management, Bayer Healthcare, Berlin, Germany
| | - Martin Andrew Sieber
- From the *MR and CT Contrast Media Research, Bayer Healthcare; †Institute of Vegetative Physiology, Charité; and ‡Clinical Project Management, Bayer Healthcare, Berlin, Germany
| | - Jessica Lohrke
- From the *MR and CT Contrast Media Research, Bayer Healthcare; †Institute of Vegetative Physiology, Charité; and ‡Clinical Project Management, Bayer Healthcare, Berlin, Germany
| | - Thomas Frenzel
- From the *MR and CT Contrast Media Research, Bayer Healthcare; †Institute of Vegetative Physiology, Charité; and ‡Clinical Project Management, Bayer Healthcare, Berlin, Germany
| | - Hubertus Pietsch
- From the *MR and CT Contrast Media Research, Bayer Healthcare; †Institute of Vegetative Physiology, Charité; and ‡Clinical Project Management, Bayer Healthcare, Berlin, Germany
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Ramalho J, Semelka RC, Ramalho M, Nunes RH, AlObaidy M, Castillo M. Gadolinium-Based Contrast Agent Accumulation and Toxicity: An Update. AJNR Am J Neuroradiol 2015; 37:1192-8. [PMID: 26659341 DOI: 10.3174/ajnr.a4615] [Citation(s) in RCA: 294] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
In current practice, gadolinium-based contrast agents have been considered safe when used at clinically recommended doses in patients without severe renal insufficiency. The causal relationship between gadolinium-based contrast agents and nephrogenic systemic fibrosis in patients with renal insufficiency resulted in new policies regarding the administration of these agents. After an effective screening of patients with renal disease by performing either unenhanced or reduced-dose-enhanced studies in these patients and by using the most stable contrast agents, nephrogenic systemic fibrosis has been largely eliminated since 2009. Evidence of in vivo gadolinium deposition in bone tissue in patients with normal renal function is well-established, but recent literature showing that gadolinium might also deposit in the brain in patients with intact blood-brain barriers caught many individuals in the imaging community by surprise. The purpose of this review was to summarize the literature on gadolinium-based contrast agents, tying together information on agent stability and animal and human studies, and to emphasize that low-stability agents are the ones most often associated with brain deposition.
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Affiliation(s)
- J Ramalho
- From the Departments of Neuroradiology (J.R., R.H.N., M.C.) Centro Hospitalar de Lisboa Central (J.R.), Lisbon, Portugal
| | - R C Semelka
- Radiology (R.C.S., M.R., R.H.N., M.A.), University of North Carolina Hospital, Chapel Hill, North Carolina
| | - M Ramalho
- Radiology (R.C.S., M.R., R.H.N., M.A.), University of North Carolina Hospital, Chapel Hill, North Carolina Hospital Garcia de Orta (M.R.), Almada, Portugal
| | - R H Nunes
- From the Departments of Neuroradiology (J.R., R.H.N., M.C.) Radiology (R.C.S., M.R., R.H.N., M.A.), University of North Carolina Hospital, Chapel Hill, North Carolina Santa Casa de Misericórdia de São Paulo (R.H.N.), São Paulo, Brazil
| | - M AlObaidy
- Radiology (R.C.S., M.R., R.H.N., M.A.), University of North Carolina Hospital, Chapel Hill, North Carolina King Faisal Specialist Hospital and Research Center (M.A.), Riyadh, Saudi Arabia
| | - M Castillo
- From the Departments of Neuroradiology (J.R., R.H.N., M.C.)
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Kanda T, Oba H, Toyoda K, Kitajima K, Furui S. Brain gadolinium deposition after administration of gadolinium-based contrast agents. Jpn J Radiol 2015; 34:3-9. [PMID: 26608061 DOI: 10.1007/s11604-015-0503-5] [Citation(s) in RCA: 125] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/09/2015] [Indexed: 01/05/2023]
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Wáng YXJ, Schroeder J, Siegmund H, Idée JM, Fretellier N, Jestin-Mayer G, Factor C, Deng M, Kang W, Morcos SK. Total gadolinium tissue deposition and skin structural findings following the administration of structurally different gadolinium chelates in healthy and ovariectomized female rats. Quant Imaging Med Surg 2015; 5:534-45. [PMID: 26435917 DOI: 10.3978/j.issn.2223-4292.2015.05.03] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To assess the retention of gadolinium (Gd) in skin, liver, and bone following gadodiamide or gadoteric acid administration. METHODS Gd was measured in skin, liver and femur bone in female rats 10 weeks after administration of 17.5 mmol Gd/kg over 5 days of Gd agents. Rat skin microscopy, energy filtering transmission electron microscopy and elemental analysis were performed, and repeated after receiving the same dosage of gadodiamide in rats with osteoporosis induced with bilateral ovariectomy (OVX). The OVX was performed 60 days after the last injection of gadodiamide and animals sacrificed 3 weeks later. RESULTS Gd concentration was 180-fold higher in the skin, 25-fold higher in the femur, and 30-fold higher in the liver in rats received gadodiamide than rats received gadoteric acid. The retention of Gd in the skin with gadodiamide was associated with an increase in dermal cellularity, and Gd encrustation of collagen fibers and deposition inside the fibroblasts and other cells. No differences in Gd concentration in liver, skin, and femur were observed between rats receiving gadodiamide with or without OVX. CONCLUSIONS Gd tissue retention with gadodiamide was higher than gadoteric acid. Tissues Gd deposition did not alter following gadodiamide administration to ovariectomized rats.
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Affiliation(s)
- Yì-Xiáng J Wáng
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Joseph Schroeder
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Heiko Siegmund
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Jean-Marc Idée
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Nathalie Fretellier
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Gaëlle Jestin-Mayer
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Cecile Factor
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Min Deng
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Wei Kang
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
| | - Sameh K Morcos
- 1 Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 2 Central EM Laboratory, Institute of Pathology, Uniklinikum Regensburg, The University of Regensburg, Germany ; 3 Guerbet, Research and Innovation Division, BP 57400, 95943 Roissy-Charles de Gaulle cedex, France ; 4 Department of Anatomical and Cellular Pathology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, New Territories, Hong Kong SAR, China ; 5 Department of Diagnostic Imaging, The University of Sheffield, Sheffield, UK
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Ramalho J, Castillo M, AlObaidy M, Nunes RH, Ramalho M, Dale BM, Semelka RC. High Signal Intensity in Globus Pallidus and Dentate Nucleus on Unenhanced T1-weighted MR Images: Evaluation of Two Linear Gadolinium-based Contrast Agents. Radiology 2015; 276:836-44. [PMID: 26079490 DOI: 10.1148/radiol.2015150872] [Citation(s) in RCA: 191] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Joana Ramalho
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
| | - Mauricio Castillo
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
| | - Mamdoh AlObaidy
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
| | - Renato H Nunes
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
| | - Miguel Ramalho
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
| | - Brian M Dale
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
| | - Richard C Semelka
- From the Department of Radiology, University of North Carolina at Chapel Hill, CB 7510, 2001 Old Clinic Bldg, Chapel Hill, NC 27599-7510 (J.R., M.C., M.A., R.H.N., M.R., R.C.S.); Department of Radiology. King Faisal Specialist Hospital & Research Center, Riyadh. Saudi Arabia (M.A.); and Siemens Healthcare, Cary, NC (B.M.D.)
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106
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Oh KY, Roberts VHJ, Schabel MC, Grove KL, Woods M, Frias AE. Gadolinium Chelate Contrast Material in Pregnancy: Fetal Biodistribution in the Nonhuman Primate. Radiology 2015; 276:110-8. [PMID: 25763829 PMCID: PMC4485748 DOI: 10.1148/radiol.15141488] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To determine the extent to which gadolinium chelate is found in nonhuman primate fetal tissues and amniotic fluid at 19-45 hours after intravenous injection of a weight-appropriate maternal dose of the contrast agent gadoteridol. MATERIALS AND METHODS Gravid Japanese macaques (n = 14) were maintained as approved by the institutional animal care and utilization committee. In the 3rd trimester of pregnancy, the macaques were injected with gadoteridol (0.1 mmol per kilogram of maternal weight). Fetuses were delivered by means of cesarean section within 24 hours of maternal injection (range, 19-21 hours; n = 11) or 45 hours after injection (n = 3). Gadolinium chelate levels in the placenta, fetal tissues, and amniotic fluid were obtained by using inductively coupled plasma mass spectrometry. The Wilcoxon rank sum test was used for quantitative comparisons. RESULTS Gadoteridol was present in the fetoplacental circulation at much lower quantities than in the mother. At both time points, the distribution of gadolinium chelate in the fetus was comparable to that expected in an adult. The highest concentration of the injected dose (ID) was found in the fetal kidney (0.0161% ID per gram in the 19-21-hour group). The majority of the in utero gadolinium chelate was found in the amniotic fluid and the placenta (mean, 0.1361% ID per organ ± 0.076 [standard deviation] and 0.0939% ID per organ ± 0.0494, respectively). Data acquired 45 hours after injection showed a significant decrease in the gadolinium chelate concentration in amniotic fluid compared with that in the 19-21-hour group (from 0.0017% to 0.0007% ID per gram; P = .01). CONCLUSION Amounts of gadolinium chelate in the fetal tissues and amniotic fluid were minimal compared with the maternal ID. This may impact future clinical studies on the safety of gadolinium contrast agent use in pregnancy.
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Affiliation(s)
- Karen Y. Oh
- From the Department of Radiology (K.Y.O.), Advanced Imaging Research Center (M.C.S., M.W.), and Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (A.E.F.), Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MC L340, Portland, OR 97239; Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Ore (V.H.J.R., K.L.G., A.E.F.); and Department of Chemistry, Portland State University, Portland, Ore (M.W.)
| | - Victoria H. J. Roberts
- From the Department of Radiology (K.Y.O.), Advanced Imaging Research Center (M.C.S., M.W.), and Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (A.E.F.), Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MC L340, Portland, OR 97239; Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Ore (V.H.J.R., K.L.G., A.E.F.); and Department of Chemistry, Portland State University, Portland, Ore (M.W.)
| | - Matthias C. Schabel
- From the Department of Radiology (K.Y.O.), Advanced Imaging Research Center (M.C.S., M.W.), and Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (A.E.F.), Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MC L340, Portland, OR 97239; Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Ore (V.H.J.R., K.L.G., A.E.F.); and Department of Chemistry, Portland State University, Portland, Ore (M.W.)
| | - Kevin L. Grove
- From the Department of Radiology (K.Y.O.), Advanced Imaging Research Center (M.C.S., M.W.), and Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (A.E.F.), Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MC L340, Portland, OR 97239; Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Ore (V.H.J.R., K.L.G., A.E.F.); and Department of Chemistry, Portland State University, Portland, Ore (M.W.)
| | - Mark Woods
- From the Department of Radiology (K.Y.O.), Advanced Imaging Research Center (M.C.S., M.W.), and Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (A.E.F.), Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MC L340, Portland, OR 97239; Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Ore (V.H.J.R., K.L.G., A.E.F.); and Department of Chemistry, Portland State University, Portland, Ore (M.W.)
| | - Antonio E. Frias
- From the Department of Radiology (K.Y.O.), Advanced Imaging Research Center (M.C.S., M.W.), and Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine (A.E.F.), Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, MC L340, Portland, OR 97239; Division of Diabetes, Obesity and Metabolism, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, Ore (V.H.J.R., K.L.G., A.E.F.); and Department of Chemistry, Portland State University, Portland, Ore (M.W.)
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Stojanov DA, Aracki-Trenkic A, Vojinovic S, Benedeto-Stojanov D, Ljubisavljevic S. 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 agent, gadobutrol. Eur Radiol 2015; 26:807-15. [PMID: 26105022 DOI: 10.1007/s00330-015-3879-9] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 05/23/2015] [Accepted: 06/03/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Dragan A Stojanov
- Faculty of Medicine, University of Nis, Nis, Serbia, Bul. Dr. Z. Djindjica 82.
- Center for Radiology, Clinical Center Nis, Nis, Serbia, Bul. Dr. Z. Djindjica 48.
| | | | - Slobodan Vojinovic
- Faculty of Medicine, University of Nis, Nis, Serbia, Bul. Dr. Z. Djindjica 82.
- Clinic for Neurology, Clinical Center Nis, Nis, Serbia, Bul. Dr. Z. Djindjica 48.
| | | | - Srdjan Ljubisavljevic
- Faculty of Medicine, University of Nis, Nis, Serbia, Bul. Dr. Z. Djindjica 82.
- Clinic for Neurology, Clinical Center Nis, Nis, Serbia, Bul. Dr. Z. Djindjica 48.
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Kanal E, Tweedle MF. Residual or Retained Gadolinium: Practical Implications for Radiologists and Our Patients. Radiology 2015; 275:630-4. [DOI: 10.1148/radiol.2015150805] [Citation(s) in RCA: 185] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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109
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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. Invest Radiol 2014; 49:685-90. [PMID: 24872007 DOI: 10.1097/rli.0000000000000072] [Citation(s) in RCA: 349] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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110
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Idée JM, Fretellier N, Robic C, Corot C. The role of gadolinium chelates in the mechanism of nephrogenic systemic fibrosis: A critical update. Crit Rev Toxicol 2014; 44:895-913. [PMID: 25257840 DOI: 10.3109/10408444.2014.955568] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Jean-Marc Idée
- Guerbet, Research & Innovation Division , Aulnay-sous-Bois , France
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Do C, Barnes JL, Tan C, Wagner B. Type of MRI contrast, tissue gadolinium, and fibrosis. Am J Physiol Renal Physiol 2014; 307:F844-55. [PMID: 25100280 DOI: 10.1152/ajprenal.00379.2014] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
It has been presupposed that the thermodynamic stability constant (K(therm)) of gadolinium-based MRI chelates relate to the risk of precipitating nephrogenic systemic fibrosis. The present study compared low-K(therm) gadodiamide with high-K(therm) gadoteridol in cultured fibroblasts and rats with uninephrectomies. Gadolinium content was assessed using scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy in paraffin-embedded tissues. In vitro, fibroblasts demonstrated dose-dependent fibronectin generation, transforming growth factor-β production, and expression of activated myofibroblast stress fiber protein α-smooth muscle actin. There were negligible differences with respect to toxicity or proliferation between the two contrast agents. In the rodent model, gadodiamide treatment led to greater skin fibrosis and dermal cellularity than gadoteridol. In the kidney, both contrast agents led to proximal tubule vacuolization and increased fibronectin accumulation. Despite large detectable gadolinium signals in the spleen, skin, muscle, and liver from the gadodiamide-treated group, contrast-induced fibrosis appeared to be limited to the skin and kidney. These findings support the hypothesis that low-K(therm) chelates have a greater propensity to elicit nephrogenic systemic fibrosis and demonstrate that certain tissues are resistant to these effects.
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Affiliation(s)
- Catherine Do
- University of Texas Health Science Center at San Antonio, San Antonio, Texas; and
| | - Jeffrey L Barnes
- University of Texas Health Science Center at San Antonio, San Antonio, Texas; and South Texas Veterans Health Care System, San Antonio, Texas
| | - Chunyan Tan
- University of Texas Health Science Center at San Antonio, San Antonio, Texas; and
| | - Brent Wagner
- South Texas Veterans Health Care System, San Antonio, Texas
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112
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Koçyiğit A, Yüksel S, Bayram R, Yılmaz İ, Karabulut N. Efficacy of magnetic resonance urography in detecting renal scars in children with vesicoureteral reflux. Pediatr Nephrol 2014; 29:1215-1220. [PMID: 24500707 DOI: 10.1007/s00467-014-2766-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 12/28/2013] [Accepted: 01/13/2014] [Indexed: 12/18/2022]
Abstract
BACKGROUND The detection of renal scars is of paramount importance for optimal clinical management of patients with urinary tract infection (UTI) and vesicoureteral reflux (VUR). The aim of our study was to compare the efficacy of unenhanced magnetic resonance urography (MRU) and Tc-99(m) dimercaptosuccinic acid (Tc-DMSA) scintigraphy to dectect renal scars. METHODS Unenhanced MRU and Tc-DMSA scintigraphy were performed in 49 children (10 boys, 39 girls; mean age 7.4 ± 4.2 years, range 1-15 years) with documented VUR. MR imaging scans were obtained within 7 days after voiding cystourethrogram (VCUG) and Tc-DMSA scintigraphy. The diagnostic performance of MRU in renal scar detection was calculated relative to that of the Tc-DMSA scan. RESULTS The renal scar detection rate of Tc-DMSA scintigraphy and unenhanced MRU in kidneys with VUR was 32.4 and 25.9%, respectively. The sensitivity and specificity of MRU in the detection of renal scars was 80 and 82.6% in kidneys with VUR, respectively. There was no statistically significant difference in lesion detection between MRU and Tc-DMSA scintigraphy (P > 0.05). MRU and Tc-DMSA scintigraphy showed good agreement (κ = 0.60). CONCLUSIONS Unenhanced MRU is a robust technique for the morphologic assessment of the urinary system and detection of renal scars. The lack of radiation and contrast material makes this technique a much safer alternative to scintigraphy in children with VUR, particularly in those who require follow-up scanning and, consequently, considerable radiation exposure.
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Affiliation(s)
- Ali Koçyiğit
- Department of Radiology, Pamukkale University Faculty of Medicine, Denizli, Turkey
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113
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Cova MA, Stacul F, Quaranta R, Guastalla P, Salvatori G, Banderali G, Fonda C, David V, Gregori M, Zuppa AA, Davanzo R. Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy. Eur Radiol 2014; 24:2012-22. [PMID: 24838733 DOI: 10.1007/s00330-014-3198-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/24/2014] [Accepted: 04/22/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Breastfeeding is a well-recognised investment in the health of the mother-infant dyad. Nevertheless, many professionals still advise breastfeeding mothers to temporarily discontinue breastfeeding after contrast media imaging. Therefore, we performed this review to provide health professionals with basic knowledge and skills for appropriate use of contrast media. METHODS A joint working group of the Italian Society of Radiology (SIRM), Italian Society of Paediatrics (SIP), Italian Society of Neonatology (SIN) and Task Force on Breastfeeding, Ministry of Health, Italy prepared a review of the relevant medical literature on the safety profile of contrast media for the nursing infant/child. RESULTS Breastfeeding is safe for the nursing infant of any post-conceptional age after administration of the majority of radiological contrast media to the mother; only gadolinium-based agents considered at high risk of nephrogenic systemic fibrosis (gadopentetate dimeglumine, gadodiamide, gadoversetamide) should be avoided in the breastfeeding woman as a precaution; there is no need to temporarily discontinue breastfeeding or to express and discard breast milk following the administration of contrast media assessed as compatible with breastfeeding. CONCLUSIONS Breastfeeding women should receive unambiguous professional advice and clear encouragement to continue breastfeeding after imaging with the compatible contrast media. KEY POINTS • Breastfeeding is a well-known investment in the health of the mother-infant dyad. • Breastfeeding is safe after administration of contrast media to the mother. • There is no need to temporarily discontinue breastfeeding following administration of contrast media.
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Affiliation(s)
- Maria Assunta Cova
- Department of Radiology, Cattinara Hospital, University of Trieste, Azienda Ospedaliero-Universitaria "Ospedali Riuniti" Trieste, Strada di Fiume 447, 34149, Trieste, Italy
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114
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Bruckman M, Jiang K, Simpson EJ, Randolph LN, Luyt LG, Yu X, Steinmetz NF. Dual-modal magnetic resonance and fluorescence imaging of atherosclerotic plaques in vivo using VCAM-1 targeted tobacco mosaic virus. NANO LETTERS 2014; 14:1551-8. [PMID: 24499194 PMCID: PMC4169141 DOI: 10.1021/nl404816m] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Revised: 02/02/2014] [Indexed: 05/04/2023]
Abstract
The underlying cause of major cardiovascular events, such as myocardial infarctions and strokes, is atherosclerosis. For accurate diagnosis of this inflammatory disease, molecular imaging is required. Toward this goal, we sought to develop a nanoparticle-based, high aspect ratio, molecularly targeted magnetic resonance (MR) imaging contrast agent. Specifically, we engineered the plant viral nanoparticle platform tobacco mosaic virus (TMV) to target vascular cell adhesion molecule (VCAM)-1, which is highly expressed on activated endothelial cells at atherosclerotic plaques. To achieve dual optical and MR imaging in an atherosclerotic ApoE(-/-) mouse model, TMV was modified to carry near-infrared dyes and chelated Gd ions. Our results indicate molecular targeting of atherosclerotic plaques. On the basis of the multivalency and multifunctionality, the targeted TMV-based MR probe increased the detection limit significantly; the injected dose of Gd ions could be further reduced 400x compared to the suggested clinical use, demonstrating the utility of targeted nanoparticle cargo delivery.
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Affiliation(s)
- Michael
A. Bruckman
- Department of Biomedical Engineering, Department of Radiology, Department of Materials
Science and Engineering, and Department of Macromolecular Engineering, Case Western Reserve University Schools of Medicine
and Engineering, 10900
Euclid Avenue, Cleveland, Ohio 44106, United
States
| | - Kai Jiang
- Department of Biomedical Engineering, Department of Radiology, Department of Materials
Science and Engineering, and Department of Macromolecular Engineering, Case Western Reserve University Schools of Medicine
and Engineering, 10900
Euclid Avenue, Cleveland, Ohio 44106, United
States
| | - Emily J. Simpson
- Departments
of Chemistry, Oncology, Medical Imaging, The University of Western Ontario, London, Ontario N6A 4L6, Canada
| | - Lauren N. Randolph
- Department of Biomedical Engineering, Department of Radiology, Department of Materials
Science and Engineering, and Department of Macromolecular Engineering, Case Western Reserve University Schools of Medicine
and Engineering, 10900
Euclid Avenue, Cleveland, Ohio 44106, United
States
| | - Leonard G. Luyt
- Departments
of Chemistry, Oncology, Medical Imaging, The University of Western Ontario, London, Ontario N6A 4L6, Canada
| | - Xin Yu
- Department of Biomedical Engineering, Department of Radiology, Department of Materials
Science and Engineering, and Department of Macromolecular Engineering, Case Western Reserve University Schools of Medicine
and Engineering, 10900
Euclid Avenue, Cleveland, Ohio 44106, United
States
| | - Nicole F. Steinmetz
- Department of Biomedical Engineering, Department of Radiology, Department of Materials
Science and Engineering, and Department of Macromolecular Engineering, Case Western Reserve University Schools of Medicine
and Engineering, 10900
Euclid Avenue, Cleveland, Ohio 44106, United
States
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115
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Thomsen HS. Nephrogenic Systemic Fibrosis and Gadolinium-Based Contrast Media. MEDICAL RADIOLOGY 2014. [DOI: 10.1007/174_2013_903] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Bruckman MA, Yu X, Steinmetz NF. Engineering Gd-loaded nanoparticles to enhance MRI sensitivity via T(1) shortening. NANOTECHNOLOGY 2013; 24:462001. [PMID: 24158750 PMCID: PMC3895399 DOI: 10.1088/0957-4484/24/46/462001] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Magnetic resonance imaging (MRI) is a noninvasive imaging technique capable of obtaining high-resolution anatomical images of the body. Major drawbacks of MRI are the low contrast agent sensitivity and inability to distinguish healthy tissue from diseased tissue, making early detection challenging. To address this technological hurdle, paramagnetic contrast agents have been developed to increase the longitudinal relaxivity, leading to an increased signal-to-noise ratio. This review focuses on methods and principles that enabled the design and engineering of nanoparticles to deliver contrast agents with enhanced ionic relaxivities. Different engineering strategies and nanoparticle platforms will be compared in terms of their manufacturability, biocompatibility properties, and their overall potential to make an impact in clinical MR imaging.
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Affiliation(s)
- Michael A. Bruckman
- Department of Biomedical Engineering, Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Xin Yu
- Department of Biomedical Engineering, Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Radiology, Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Nicole F. Steinmetz
- Department of Biomedical Engineering, Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Radiology, Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
- Department of Materials Science and Engineering, Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
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118
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Thorsen F, Fite B, Mahakian LM, Seo JW, Qin S, Harrison V, Johnson S, Ingham E, Caskey C, Sundstrøm T, Meade TJ, Harter PN, Skaftnesmo KO, Ferrara KW. Multimodal imaging enables early detection and characterization of changes in tumor permeability of brain metastases. J Control Release 2013; 172:812-22. [PMID: 24161382 DOI: 10.1016/j.jconrel.2013.10.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 10/14/2013] [Accepted: 10/15/2013] [Indexed: 12/31/2022]
Abstract
Our goal was to develop strategies to quantify the accumulation of model therapeutics in small brain metastases using multimodal imaging, in order to enhance the potential for successful treatment. Human melanoma cells were injected into the left cardiac ventricle of immunodeficient mice. Bioluminescent, MR and PET imaging were applied to evaluate the limits of detection and potential for contrast agent extravasation in small brain metastases. A pharmacokinetic model was applied to estimate vascular permeability. Bioluminescent imaging after injecting d-luciferin (molecular weight (MW) 320 D) suggested that tumor cell extravasation had already occurred at week 1, which was confirmed by histology. 7T T1w MRI at week 4 was able to detect non-leaky 100 μm sized lesions and leaky tumors with diameters down to 200 μm after contrast injection at week 5. PET imaging showed that (18)F-FLT (MW 244 Da) accumulated in the brain at week 4. Gadolinium-based MRI tracers (MW 559 Da and 2.066 kDa) extravasated after 5 weeks (tumor diameter 600 μm), and the lower MW agent cleared more rapidly from the tumor (mean apparent permeabilities 2.27 × 10(-5)cm/s versus 1.12 × 10(-5)cm/s). PET imaging further demonstrated tumor permeability to (64)Cu-BSA (MW 65.55 kDa) at week 6 (tumor diameter 700 μm). In conclusion, high field T1w MRI without contrast may improve the detection limit of small brain metastases, allowing for earlier diagnosis of patients, although the smallest lesions detected with T1w MRI were permeable only to d-luciferin and the amphipathic small molecule (18)F-FLT. Different-sized MR and PET contrast agents demonstrated the gradual increase in leakiness of the blood tumor barrier during metastatic progression, which could guide clinicians in choosing tailored treatment strategies.
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Affiliation(s)
- Frits Thorsen
- Department of Biomedicine, University of Bergen, Bergen, Norway.
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119
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Affiliation(s)
- Judith AW Webb
- Retired Consultant, Diagnostic Radiology Department, St Bartholomews Hospital, West Smithfield, London EC1A 7BE, UK
| | - Henrik S Thomsen
- Department of Diagnostic Radiology, Copenhagen University Hospital Herlev, DK-2730 Herlev, Denmark
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120
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Hao D, Ai T, Goerner F, Hu X, Runge VM, Tweedle M. MRI contrast agents: basic chemistry and safety. J Magn Reson Imaging 2013; 36:1060-71. [PMID: 23090917 DOI: 10.1002/jmri.23725] [Citation(s) in RCA: 225] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Magnetic resonance imaging (MRI) contrast agents are pharmaceuticals used widely in MRI examinations. Gadolinium-based MRI contrast agents (GBCAs) are by far the most commonly used. To date, nine GBCAs have been commercialized for clinical use, primarily indicated in the central nervous system, vasculature, and whole body. GBCAs primarily lower the T(1) in vivo to create higher signal in T(1)-weighted MRI scans where GBCAs are concentrated. GBCAs are unique among pharmaceuticals, being water proton relaxation catalysts whose effectiveness is characterized by a rate constant known as relaxivity. The relaxivity of each GBCAs depends on a variety of factors that are discussed in terms of both the existing agents and future molecular imaging agents under study by current researchers. Current GBCAs can be divided into four different structural types (macrocyclic, linear, ionic, and nonionic) based on the chemistry of the chelating ligands whose primary purpose is to protect the body from dissociation of the relatively toxic Gd(3+) ion from the ligand. This article discusses how the chemical structure influences inherent and in vivo stability toward dissociation, and how it affects important formulation properties. Although GBCAs have a lower rate of serious adverse events than iodinated contrast agents, they still present some risk.
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Affiliation(s)
- Dapeng Hao
- Department of Radiology, Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong, China
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121
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Polasek M, Caravan P. Is macrocycle a synonym for kinetic inertness in Gd(III) Complexes? Effect of coordinating and noncoordinating substituents on inertness and relaxivity of Gd(III) chelates with DO3A-like ligands. Inorg Chem 2013; 52:4084-96. [PMID: 23517079 PMCID: PMC3640422 DOI: 10.1021/ic400227k] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Gadolinium chelates with octadentate ligands are widely used as contrast agents for magnetic resonance imaging (MRI), with macrocyclic ligands based on DO3A being preferred for the high kinetic inertness of their Gd chelates. A major challenge in the design of new bifunctional MRI probes is the need to control the rotational motion of the chelate, which greatly affects its relaxivity. In this work we explored facile alkylation of a secondary amine in macrocyclic DO3A-like ligands to create a short, achiral linkage to limit the undesired internal motion of chelates within larger molecular constructs. The acetate moiety on the trans nitrogen was also replaced with either a bidentate (ethoxyacetate, L1 or methyl picolinate, L2) or bulky monodentate (methyl phosphonate, L3) donor arm to give octa- or heptadentate ligands, respectively. The resultant Gd(III) complexes were all monohydrated (q = 1) and exhibited water residency times that spanned 2 orders of magnitude (τM = 2190 ± 170, 3500 ± 90, and 12.7 ± 3.8 ns at 37 °C for GdL1, GdL2, and GdL3, respectively). Alkylation of the secondary amine with a noncoordinating biphenyl moiety resulted in coordinatively saturated q = 0 complexes of octadentate ligands L1 and L2. Relaxivities were limited by slow water exchange and/or lack of water coligand. All complexes showed decreased inertness compared to [Gd(DO3A)] despite higher ligand denticity, and inertness was further decreased upon N-alkylation. These results demonstrate that high kinetic inertness and in vivo safety of Gd chelates with macrocyclic ligands should not be generalized.
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Affiliation(s)
- Miloslav Polasek
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 Thirteenth Street, Suite 2301, Charlestown, MA 02129
| | - Peter Caravan
- The Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 Thirteenth Street, Suite 2301, Charlestown, MA 02129
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122
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Wagner B, Tan C, Barnes JL, Ahuja S, Davis TL, Gorin Y, Jimenez F. Nephrogenic systemic fibrosis: evidence for oxidative stress and bone marrow-derived fibrocytes in skin, liver, and heart lesions using a 5/6 nephrectomy rodent model. THE AMERICAN JOURNAL OF PATHOLOGY 2012; 181:1941-52. [PMID: 23041060 DOI: 10.1016/j.ajpath.2012.08.026] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Revised: 08/09/2012] [Accepted: 08/23/2012] [Indexed: 10/27/2022]
Abstract
Nephrogenic systemic fibrosis (NSF) is associated with gadolinium-based magnetic resonance imaging (MRI) contrast exposure in the setting of acute or chronic renal compromise. It has been proposed that circulating fibrocytes mediate the disease. A study was conducted to determine whether bone marrow-derived fibroblast precursors are involved in contributing to organ fibrosis in MRI contrast-treated rodents with renal insufficiency. Rats status post 5/6 nephrectomy underwent bone marrow transplant from human placental alkaline phosphatase (hPAP)-expressing donors. After engraftment, animals were treated with gadolinium-based MRI contrast (2.5 mmol/kg IP), during weekdays for 4 weeks, or an equivalent volume of normal saline. Dermal cellularity in the contrast-treated group was fourfold that of control. Skin cells from the contrast-treated group demonstrated greater hPAP expression with co-expression of pro-collagen I and α-smooth muscle actin-positive stress fibers. Donor and host cells expressed CD34. Dihydroethidium staining of skin was greater in the contrast-treated animals, indicating oxidative stress. This was abrogated when the animals were co-administered the superoxide dismutase mimetic tempol. In conclusion, a bone marrow-derived cell population is increased in the dermis of MRI contrast-treated rodents. The cell markers are consistent with fibrocytes mediating the disease. These changes correlate with oxidative stress and expression of Nox4, suggestive of a novel therapeutic target. Elucidation of the mechanisms of MRI contrast-induced fibrosis may aid in discovering therapies to this devastating disease.
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Affiliation(s)
- Brent Wagner
- VA Research, South Texas Veterans Health Care System, University of Texas Health Science Center at San Antonio, TX 78229, USA.
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123
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Baranyai Z, Pálinkás Z, Uggeri F, Maiocchi A, Aime S, Brücher E. Dissociation Kinetics of Open-Chain and Macrocyclic Gadolinium(III)-Aminopolycarboxylate Complexes Related to Magnetic Resonance Imaging: Catalytic Effect of Endogenous Ligands. Chemistry 2012; 18:16426-35. [DOI: 10.1002/chem.201202930] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Indexed: 11/08/2022]
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Abstract
OBJECTIVE The purpose of this article is to discuss nephrogenic systemic fibrosis (NSF) in detail regarding its history, possible pathophysiology, clinical and pathologic presentations, diagnosis, and implications for the radiology community. CONCLUSION NSF is a potentially lethal disorder that occurs in patients with reduced kidney function. Current evidence suggests a strong association with gadolinium-based contrast agents--mostly used in MRI--in this patient group. This has urged the radiology community to emphasize careful screening for the presence of renal dysfunction among patients for whom gadolinium-enhanced MRI is contemplated. Appropriate selection of gadolinium-based contrast agent type, avoidance of nonstandard dosage, patient education, and informed consent have been recommended by authorities.
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125
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Molecular MR imaging of liver fibrosis: a feasibility study using rat and mouse models. J Hepatol 2012; 57:549-55. [PMID: 22634342 PMCID: PMC3423553 DOI: 10.1016/j.jhep.2012.04.035] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 03/23/2012] [Accepted: 04/02/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Liver biopsy, the current clinical gold standard for fibrosis assessment, is invasive and has sampling errors, and is not optimal for screening, monitoring, or clinical decision-making. Fibrosis is characterized by excessive accumulation of extracellular matrix proteins including type I collagen. We hypothesize that molecular magnetic resonance imaging (MRI) with a probe targeted to type I collagen could provide a direct and non-invasive method of fibrosis assessment. METHODS Liver fibrosis was induced in rats with diethylnitrosamine and in mice with carbon tetrachloride. Animals were imaged prior to and immediately following i.v. administration of either collagen-targeted probe EP-3533 or non-targeted control Gd-DTPA. Magnetic resonance (MR) signal washout characteristics were evaluated from T1 maps and T1-weighted images. Liver tissue was subjected to pathologic scoring of fibrosis and analyzed for gadolinium and hydroxyproline. RESULTS EP-3533-enhanced MR showed greater signal intensity on delayed imaging (normalized signal enhancement mice: control=0.39 ± 0.04, fibrotic=0.55 ± 0.03, p<0.01) and slower signal washout in the fibrotic liver compared to controls (liver t(1/2)=51.3 ± 3.6 vs. 42.0 ± 2.5 min, p<0.05 and 54.5 ± 1.9 vs. 44.1 ± 2.9 min, p<0.01 for fibrotic vs. controls in rat and mouse models, respectively). Gd-DTPA-enhanced MR could not distinguish fibrotic from control animals. EP-3533 gadolinium concentration in the liver showed strong positive correlations with hydroxyproline levels (r=0.74 (rats), r=0.77 (mice)) and with Ishak scoring (r=0.84 (rats), r=0.79 (mice)). CONCLUSIONS Molecular MRI of liver fibrosis with a collagen-specific probe identifies fibrotic tissue in two rodent models of disease.
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126
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Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 2012; 23:307-18. [PMID: 22865271 DOI: 10.1007/s00330-012-2597-9] [Citation(s) in RCA: 300] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Revised: 06/17/2012] [Accepted: 06/21/2012] [Indexed: 01/03/2023]
Abstract
PURPOSE To update the guidelines of the Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) on nephrogenic systemic fibrosis and gadolinium-based contrast media. AREAS COVERED Topics reviewed include the history, clinical features and prevalence of nephrogenic systemic fibrosis and the current understanding of its pathophysiology. The risk factors for NSF are discussed and prophylactic measures are recommended. The stability of the different gadolinium-based contrast media and the potential long-term effects of gadolinium in the body have also been reviewed.
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127
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Reiter T, Ritter O, Prince MR, Nordbeck P, Wanner C, Nagel E, Bauer WR. Minimizing risk of nephrogenic systemic fibrosis in cardiovascular magnetic resonance. J Cardiovasc Magn Reson 2012; 14:31. [PMID: 22607376 PMCID: PMC3409035 DOI: 10.1186/1532-429x-14-31] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 05/20/2012] [Indexed: 02/08/2023] Open
Abstract
Nephrogenic Systemic Fibrosis is a rare condition appearing only in patients with severe renal impairment or failure and presents with dermal lesions and involvement of internal organs. Although many cases are mild, an estimated 5% have a progressive debilitating course. To date, there is no known effective treatment thus stressing the necessity of ample prevention measures. An association with the use of Gadolinium based contrast agents (GBCA) makes Nephrogenic Systemic Fibrosis a potential side effect of contrast enhanced magnetic resonance imaging and offers the opportunity for prevention by limiting use of gadolinium based contrast agents in renal failure patients. In itself toxic, Gadolinium is embedded into chelates that allow its safe use as a contrast agent. One NSF theory is that Gadolinium chelates distribute into the extracellular fluid compartment and set Gadolinium ions free, depending on multiple factors among which the duration of chelates exposure is directly related to the renal function. Major medical societies both in Europe and in North America have developed guidelines for the usage of GBCA. Since the establishment of these guidelines and the increased general awareness of this condition, the occurrence of NSF has been nearly eliminated. Giving an overview over the current knowledge of NSF pathobiochemistry, pathogenesis and treatment options this review focuses on the guidelines of the European Medicines Agency, the European Society of Urogenital Radiology, the FDA and the American College of Radiology from 2008 up to 2011 and the transfer of this knowledge into every day practice.
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Affiliation(s)
- Theresa Reiter
- Department of Internal Medicine I, Divisions of Cardiology and Nephrology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Oliver Ritter
- Department of Internal Medicine I, Divisions of Cardiology and Nephrology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Martin R Prince
- Department of Radiology, Cornell & Columbia Universities, New York, USA
| | - Peter Nordbeck
- Department of Internal Medicine I, Divisions of Cardiology and Nephrology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Christoph Wanner
- Department of Internal Medicine I, Divisions of Cardiology and Nephrology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Eike Nagel
- Division of Imaging Sciences, King’s College London, London, UK
| | - Wolfgang Rudolf Bauer
- Department of Internal Medicine I, Divisions of Cardiology and Nephrology, University Hospital Wuerzburg, Wuerzburg, Germany
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Garcia J, Kuda-Wedagedara ANW, Allen MJ. Physical Properties of Eu(2+)-Containing Cryptates as Contrast Agents for Ultra-High Field Magnetic Resonance Imaging. Eur J Inorg Chem 2012; 2012:2135-2140. [PMID: 22639543 PMCID: PMC3358779 DOI: 10.1002/ejic.201101166] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Indexed: 11/06/2022]
Abstract
The kinetic stabilities and relaxivities of a series of Eu(2+)-containing cryptates have been investigated. Transmetallation studies that monitored the change in the longitudinal relaxation rate of water protons in the presence of Ca(2+), Mg(2+), and Zn(2+) demonstrated that cryptate structure influences stability, and two of the cryptates studied were inert to transmetallation in the presence of these endogenous ions. The efficacy of these cryptates was determined at different magnetic field strengths, temperatures, and pH values. Cryptate relaxivity was found to be higher at ultra-high field strengths (7 and 9.4 T) relative to clinically relevant field strengths (1.4 and 3 T), but the efficiency of these cryptates decreased as temperature increased. In addition, variation in pH did not yield significant changes in the efficacy of the cryptates. These studies establish a foundation of important properties that are necessary to develop effective positive contrast agents for magnetic resonance imaging from Eu(2+)-containing cryptates.
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Affiliation(s)
- Joel Garcia
- Department of Chemistry, Wayne State University, 5101 Cass Avenue, Detroit, MI 48202, USA, Fax: 313-577-8822
| | | | - Matthew J. Allen
- Department of Chemistry, Wayne State University, 5101 Cass Avenue, Detroit, MI 48202, USA, Fax: 313-577-8822
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Haylor J, Schroeder J, Wagner B, Nutter F, Jestin G, Idée JM, Morcos S. Skin Gadolinium Following Use of MR Contrast Agents in a Rat Model of Nephrogenic Systemic Fibrosis. Radiology 2012; 263:107-16. [DOI: 10.1148/radiol.12110881] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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130
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Lux F, Mignot A, Mowat P, Louis C, Dufort S, Bernhard C, Denat F, Boschetti F, Brunet C, Antoine R, Dugourd P, Laurent S, Vander Elst L, Muller R, Sancey L, Josserand V, Coll JL, Stupar V, Barbier E, Rémy C, Broisat A, Ghezzi C, Le Duc G, Roux S, Perriat P, Tillement O. Ultrasmall rigid particles as multimodal probes for medical applications. Angew Chem Int Ed Engl 2011; 50:12299-303. [PMID: 22057640 DOI: 10.1002/anie.201104104] [Citation(s) in RCA: 137] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Revised: 09/12/2011] [Indexed: 11/08/2022]
Affiliation(s)
- François Lux
- Laboratoire de Physico-Chimie des Matériaux Luminescents, UMR 5620 CNRS-Université Claude Bernard Lyon 1, Université de Lyon, 69622 Villeurbanne Cedex, France
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Lux F, Mignot A, Mowat P, Louis C, Dufort S, Bernhard C, Denat F, Boschetti F, Brunet C, Antoine R, Dugourd P, Laurent S, Elst LV, Muller R, Sancey L, Josserand V, Coll JL, Stupar V, Barbier E, Rémy C, Broisat A, Ghezzi C, Le Duc G, Roux S, Perriat P, Tillement O. Ultrasmall Rigid Particles as Multimodal Probes for Medical Applications. Angew Chem Int Ed Engl 2011. [DOI: 10.1002/ange.201104104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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132
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Sheth VR, Li Y, Chen LQ, Howison CM, Flask CA, Pagel MD. Measuring in vivo tumor pHe with CEST-FISP MRI. Magn Reson Med 2011; 67:760-8. [PMID: 22028287 DOI: 10.1002/mrm.23038] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 04/17/2011] [Accepted: 05/18/2011] [Indexed: 11/10/2022]
Abstract
Paramagnetic chemical exchange saturation transfer (PARACEST) MRI contrast agents have been developed that can measure pH in solution studies, but these agents have not previously been detected in vivo. To use the PARACEST agent Yb-DO3A-oAA to measure the extracellular pH (pHe) in tumor tissue, a chemical exchange saturation transfer fast imaging with steady state precession MRI protocol was developed, the saturation period was optimized for sensitive chemical exchange saturation transfer (CEST) detection, and median filtering was used to remove artifacts in CEST spectra. These improvements were used to correlate pH with a ratio of two CEST effects of Yb-DO3A-oAA at a 7 T magnetic field strength (R(2) = 0.99, standard deviation of precision = 0.011 pH units). The PARACEST agent could not be detected in tumor tissue following i.v. injection due to the low sensitivity of in vivo CEST MRI. Yb-DO3A-oAA was detected in tumor tissue and leg muscle after directly injecting the PARACEST agent into these tissues. The measured CEST effects were used to measure a tumor pH of 6.82 ± 0.21 and a leg muscle pH of 7.26 ± 0.14, and parametric pH maps were also generated from these tissue regions. These results demonstrated that tumor pHe can be measured with a PARACEST agent and a rapid CEST-MRI protocol.
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Affiliation(s)
- Vipul R Sheth
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
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Comparative in vivo dissociation of gadolinium chelates in renally impaired rats: a relaxometry study. Invest Radiol 2011; 46:292-300. [PMID: 21263333 DOI: 10.1097/rli.0b013e3182056ccf] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE Investigation of dissociated versus chelated gadolinium (Gd) in plasma, skin, and bone of rats with impaired renal function after administration of ionic macrocyclic (gadoterate or Dotarem) or nonionic linear (gadodiamide or Omniscan) Gd chelates. MATERIALS AND METHODS Subtotally nephrectomized Wistar rats were subjected to receive daily injections of 2.5 mmol/kg of Omniscan, gadodiamide without excess ligand caldiamide, Dotarem, or saline (n = 7-10 rats/group) for 5 consecutive days. The Gd concentration was measured by inductively coupled plasma mass spectrometer in skin, femur epiphysis, and plasma on completion of the study (day 11), and dissociated Gd(3+) was measured in the plasma at day 11 (liquid chromatography inductively coupled plasma mass spectrometry). The r(1) relaxivity constant was measured in skin (at day 4 and day 11) and bone (day 11) to investigate the dissociated or chelated form of Gd found in tissue samples. Clinical and skin histopathologic studies were performed. RESULTS Subtotal nephrectomy decreased creatinine clearance by 60%. No macroscopic skin lesions were observed in the Dotarem and Omniscan groups in contrast with the gadodiamide group (2 rats survived the study period and 4 of 10 rats showed skin ulcerations and scabs). Skin histopathologic lesions were in the range gadodiamide > Omniscan > Dotarem (similar to control rats). At day 11, the skin Gd concentration was lower in the Dotarem group (161.0 ± 85.5 nmol/g) as compared with the Omniscan (490.5 ± 223.2 nmol/g) and gadodiamide groups (mean value, 776.1 nmol/g; n = 2 survivors). The total Gd concentration in the femur was significantly higher in the Omniscan group than in the Dotarem group. At day 11, the dissociated Gd(3+) concentration in plasma was below the limit of detection in the Dotarem group and was 1.5 ± 0.7 μmol/L in the Omniscan group corresponding to 62% ± 15% of the total Gd concentration. The dissociated Gd(3+) concentration was 1.1 μmol/L in gadodiamide rats (n = 2 survivors). In the skin, the in vivo r1 relaxivity value increased from 4.8 ± 0.7 mM(-1)s(-1) at day 4 to 10.5 ± 3.9 mM(-1)s(-1) at day 11 in the Omniscan group, P < 0.05 (in vitro r(1) in skin, 3.5 mM(-1)s(-1)) and gadodiamide group, whereas no significant change was observed in the Dotarem group (2.8 ± 0.2 and 4.9 ± 2.8 mM(-1)s(-1) at day 4 and 11, respectively, NS) (in vitro value in the skin, 3.2 mM(-1)s(-1)). In the femur, the in vivo r1 relaxivity was higher in the Omniscan group (8.9 ± 2.1 mM(-1)s(-1)) (in vitro relaxivity, 4.5 mM(-1)s(-1)) and gadodiamide group (8.8 mM(-1)s(-1), n = 2 survivors) than in the Dotarem group (3.8 mM(-1)s(-1), n = 1 rat with measurable r(1), since for 7 rats, 1/T(1) - 1/T(1(diamagnetic)) <10% of 1/T(1(diamagnetic)) because of low Gd concentration) (in vitro relaxivity value in the femur matrix, 3.1 mM(-1)s(-1)). CONCLUSIONS Unlike Dotarem, Omniscan and gadodiamide induced histologic skin lesions. At day 11, a higher Gd concentration was found in both skin and femur of Omniscan- and gadodiamide-treated rats than in Dotarem-treated rats. Relaxometry results indicate gradual in vivo dechelation and release of dissociated Gd(3+) in a soluble form in renally impaired rats receiving Omniscan and gadodiamide, whereas Dotarem remained stable over the study period.
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Soares DCF, de Oliveira MC, de Barros ALB, Cardoso VN, Ramaldes GA. Liposomes radiolabeled with 159Gd: In vitro antitumoral activity, biodistribution study and scintigraphic image in Ehrlich tumor bearing mice. Eur J Pharm Sci 2011; 43:290-6. [DOI: 10.1016/j.ejps.2011.05.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 04/18/2011] [Accepted: 05/07/2011] [Indexed: 12/01/2022]
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Nephrogenic gadolinium biodistribution and skin cellularity following a single injection of Omniscan in the rat. Invest Radiol 2011; 45:507-12. [PMID: 20697223 DOI: 10.1097/rli.0b013e3181eb51f2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The development of nephrogenic systemic fibrosis (NSF) following MRI contrast examination has been associated with gadolinium (Gd) toxicity. Animal models should show the key features of NSF in man where, the only immutable epidemiological feature is renal impairment. A rat model of chronic renal insufficiency has been employed to establish whether tissue gadolinium retention and increased skin cellularity following a gadolinium based contrast agent (GBCA) can be correlated with a reduction in renal function. The GBCA chosen for investigation was Omniscan, the least stable of the commercially available agents. MATERIALS AND METHODS Wistar rats were subjected to 5/6 subtotal nephrectomy (SNx) under isoflurane anesthesia. The glomerular filtration rate (GFR) was assessed from serum creatinine and creatinine clearance. Two SNx rats groups were established, following either 75% or 80% resection of the kidney, which reduced the GFR down to 40% and down to 20%, respectively, of sham-operated controls. Three months after surgery, rats received a single intravenous injection of either saline or Omniscan (gadodiamide 2.5 mmol/kg). Four weeks later, the Gd content of serum, skin, liver, and bone was measured by inductively coupled plasma mass spectrometry and skin cellularity determined. RESULTS In sham-operated rats, Gd was detected in skin < liver < bone. SNx rats with the GFR reduced down to 20% normal, had an increased tissue Gd concentration in bone (2.5-fold), skin (3-fold), and liver (10-fold) compared with sham-operated controls. The Gd concentration in all 3 tissues showed a positive linear correlation with serum creatinine (P < 0.01). No external skin lesions were observed. The skin cellularity of rats with the GFR reduced down to 20% of normal was increased following Omniscan, together with positive immunostain for CD34 and prolyl-4-hydroxylase. CONCLUSIONS The SNx rat is a sensitive model for investigating the pathophysiology of NSF. A positive linear correlation was obtained between tissue Gd and serum creatinine, the major clinical marker of renal function. An increase in skin cellularity, a feature of human NSF, was demonstrated in rats with a level of renal impairment equivalent of stage 4 chronic kidney disease following just a single intravenous dose of Omniscan. This response was obtained in the absence of ulcerogenic skin lesions, at skin Gd concentrations as low as 50 nmol/g.
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Uppal R, Catana C, Ay I, Benner T, Sorensen AG, Caravan P. Bimodal thrombus imaging: simultaneous PET/MR imaging with a fibrin-targeted dual PET/MR probe--feasibility study in rat model. Radiology 2010; 258:812-20. [PMID: 21177389 DOI: 10.1148/radiol.10100881] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To image thrombus by using magnetic resonance (MR) imaging and positron emission tomography (PET) simultaneously in a rat arterial thrombus model with a dual PET/MR probe. MATERIALS AND METHODS Animal studies were approved by the institutional animal use committee. A dual PET/MR probe was synthesized by means of partial exchange of gadolinium for copper 64 ((64)Cu) in the fibrin-targeted MR probe EP-2104R. A preformed 25-mm thrombus was injected into the right internal carotid artery of a rat. Imaging was performed with a clinical 3.0-T MR imager with an MR-compatible human PET imager. Rats (n = 5) were imaged prior to and after systemic administration of the dual probe by using simultaneous PET/MR. The organ distribution of (64)Cu and gadolinium was determined ex vivo (n = 8), 2 hours after injection by using well counting and inductively coupled plasma mass spectrometry, respectively. Signal intensity ratios (SIRs) between the thrombus-containing and contralateral vessel were computed from PET images and MR data before and after probe administration. RESULTS The dual probe was synthesized with greater than 98% radiochemical purity. Thrombus enhancement was observed in all five animals at both MR (SIR([postprobe])/SIR([preprobe]) = 1.71 ± 0.35, P = .0053) and PET (SIR = 1.85 ± 0.48, P = .0087) after injection of the dual PET/MR probe. Ex vivo analysis at 2 hours after injection showed the highest (64)Cu and gadolinium concentrations, after the excretory organs (kidney and liver), to be in the thrombus. CONCLUSION A fibrin-targeted dual PET/MR probe enables simultaneous, direct MR and PET imaging of thrombus.
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Affiliation(s)
- Ritika Uppal
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 149 Thirteenth Street, Suite 2301, Charlestown, MA 02129, USA
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Morcos SK, Haylor J. Pathophysiology of nephrogenic systemic fibrosis: A review of experimental data. World J Radiol 2010; 2:427-33. [PMID: 21179310 PMCID: PMC3006481 DOI: 10.4329/wjr.v2.i11.427] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 09/30/2010] [Accepted: 10/07/2010] [Indexed: 02/06/2023] Open
Abstract
Since the association between nephrogenic systemic fibrosis (NSF) and gadolinium contrast agents (Gd-CAs) was suggested in 2006, several experimental studies have been published to elucidate the role of these agents in the pathogenesis of NSF. Low stability Gd-CAs have a stimulant effect on human skin and fibroblasts in culture and modulate the production of collagen by these cells. Low stability agents have also induced NSF-like skin changes in a rat model with normal renal function after multiple repeat administrations. The role of the 5/6 subtotal nephrectomy rat model in investigating NSF remains under evaluation.
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Mühler MR, Clément O, Salomon LJ, Balvay D, Autret G, Vayssettes C, Cuénod CA, Siauve N. Maternofetal pharmacokinetics of a gadolinium chelate contrast agent in mice. Radiology 2010; 258:455-60. [PMID: 21045181 DOI: 10.1148/radiol.10100652] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the maternofetal pharmacokinetics of gadoterate meglumine in mice during the first 48 hours following maternal intravenous injection of a high dose of 0.5 mmol of gadolinium per kilogram. MATERIALS AND METHODS All the studies complied with French law and the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. Balb/C mice (n = 23) at 16 days of gestation were examined for 48 hours after maternal intravenous administration of 0.5 mmol gadolinium per kilogram of gadoterate meglumine. Gadolinium concentration in the placentas, fetuses, and amniotic fluid was determined by using mass spectrometry, and the total placental and fetal gadolinium content was calculated. Gadoterate meglumine half-life in the different compartments was estimated with one- and two-compartment models. Kruskal-Wallis and Wilcoxon signed-rank tests were used to compare the pharmacokinetic profiles. RESULTS Gadoterate meglumine passed the placental barrier, entering the fetuses and amniotic fluid before being redistributed back to the mother. The placental gadolinium concentration showed two-compartmental decay, with a first half-life of distribution of 47 minutes and a second half-life of elimination of 107 hours. The half-lives in the fetuses and amniotic fluid were, respectively, 4 and 5 hours and followed a monocompartmental model after the initial peak. The maximal gadolinium fetal concentration (31.8 nmol/g) was observed 30 minutes after injection, which corresponded to a total fetal content of 0.077% of the injected dose. CONCLUSION In mice, gadoterate meglumine, an extracellular nonspecific gadolinium chelate contrast medium, passed the placenta before being redistributed back to the mother, resulting in undetectable fetal concentrations after 48 hours.
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Affiliation(s)
- Matthias R Mühler
- INSERM, U970, Paris Cardiovascular Research Center-PARCC, Paris, France.
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Wadas TJ, Sherman CD, Miner JH, Duncan JR, Anderson CJ. The biodistribution of [153Gd]Gd-labeled magnetic resonance contrast agents in a transgenic mouse model of renal failure differs greatly from control mice. Magn Reson Med 2010; 64:1274-80. [PMID: 20648683 PMCID: PMC3180881 DOI: 10.1002/mrm.22553] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2009] [Accepted: 06/02/2010] [Indexed: 12/21/2022]
Abstract
Nephrogenic systemic fibrosis occurs in renally impaired patients who have undergone contrast enhanced MR examination using intravenous gadolinium-based contrast agents. The effect of impaired kidney function on the biodistribution of gadolinium-based contrast agents was investigated using radiolabeled (153/Nat) gadolinium-DOTA, (153/Nat) gadolinium-DTPA, and (153/Nat) gadolinium-DTPA-BMA in a transgenic mouse model of renal impairment. Renally impaired animals had more activity associated with their tissues than did control mice, and this increase varied according to the radiotracer injected. For example, after 7 days, renally impaired animals that received (153/Nat) Gd-DOTA had 3-fold (P < 0.037) more activity in their bone tissue, whereas renally impaired animals receiving (153/Nat) Gd-DTPA and (153/Nat) Gd-DTPA-BMA had 8-fold (P < 0.0001) and 24-fold (P < 0.0001) more activity in their bone tissue, respectively. These findings demonstrate that renal impairment dramatically alters the tissue distribution of Gd(3+) ions in vivo, which are likely a critical factor in the development of nephrogenic systemic fibrosis.
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Affiliation(s)
- Thaddeus J Wadas
- Division of Radiological Sciences, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA.
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Stability and biodistribution of a biodegradable macromolecular MRI contrast agent Gd-DTPA cystamine copolymers (GDCC) in rats. Pharm Res 2010; 27:1390-7. [PMID: 20393871 DOI: 10.1007/s11095-010-0131-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Accepted: 03/22/2010] [Indexed: 02/04/2023]
Abstract
PURPOSE The aim of this study was to evaluate stability and Gd tissue distribution of a biodegradable macromolecular MRI contrast agent, GDCC. METHODS Kinetic stability of GDCC was evaluated based on transmetallation with endogenous metal ions Zn2+ and Cu2+ in rat plasma in comparison with Omniscan, MultiHance and ProHance. In vivo transmetallation of GDCC was evaluated by determining metal content in the urine samples of Spague-Dawley rats. The biodistribution of the agents was determined in rats at 48 h post-injection. RESULTS A new method of using ultrafiltration was developed for study of kinetic stability against transmetallation of Gd(III)-based MRI contrast agents. Both in vitro and in vivo stability of the contrast agents towards transmetallation with Zn2+ were in the order of ProHance > MultiHance approximately GDCC > Omniscan. No significant transmetallation with Cu2+ was observed for the contrast agents. GDCC had comparable retention to the control agents in most organs and tissues with slightly high retention in the liver and kidneys at 48 h post-injection. CONCLUSION Ultrafiltration is efficient and accurate for characterizing the kinetic stability of Gd(III)-based MRI contrast agents. The novel biodegradable macromolecular contrast agent GDCC is promising for further development for contrast enhanced MRI.
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Villaraza AJL, Bumb A, Brechbiel MW. Macromolecules, dendrimers, and nanomaterials in magnetic resonance imaging: the interplay between size, function, and pharmacokinetics. Chem Rev 2010; 110:2921-59. [PMID: 20067234 PMCID: PMC2868950 DOI: 10.1021/cr900232t] [Citation(s) in RCA: 486] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Aaron Joseph L. Villaraza
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ambika Bumb
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Martin W. Brechbiel
- Radiation Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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Baranyai Z, Pálinkás Z, Uggeri F, Brücher E. Equilibrium Studies on the Gd3+, Cu2+ and Zn2+ Complexes of BOPTA, DTPA and DTPA-BMA Ligands: Kinetics of Metal-Exchange Reactions of [Gd(BOPTA)]2-. Eur J Inorg Chem 2010. [DOI: 10.1002/ejic.200901261] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Aime S, Caravan P. Biodistribution of gadolinium-based contrast agents, including gadolinium deposition. J Magn Reson Imaging 2010; 30:1259-67. [PMID: 19938038 DOI: 10.1002/jmri.21969] [Citation(s) in RCA: 396] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The biodistribution of approved gadolinium (Gd)-based contrast agents (GBCAs) is reviewed. After intravenous injection GBCAs distribute in the blood and the extracellular space and transiently through the excretory organs. Preclinical animal studies and the available clinical literature indicate that all these compounds are excreted intact. Elimination tends to be rapid and, for the most part, complete. In renally insufficient patients the plasma elimination half-life increases substantially from hours to days depending on renal function. In patients with impaired renal function and nephrogenic systemic fibrosis (NSF), the agents gadodiamide, gadoversetamide, and gadopentetate dimeglumine have been shown to result in Gd deposition in the skin and internal organs. In these cases, it is likely that the Gd is no longer present as the GBCA, but this has still not been definitively shown. In preclinical models very small amounts of Gd are retained in the bone and liver, and the amount retained correlates with the kinetic and thermodynamic stability of the GBCA with respect to Gd release in vitro. The pattern of residual Gd deposition in NSF subjects may be different than that observed in preclinical rodent models. GBCAs are designed to be used via intravenous administration. Altering the route of administration and/or the formulation of the GBCA can dramatically alter the biodistribution of the GBCA and can increase the likelihood of Gd deposition. J. Magn. Reson. Imaging 2009;30:1259-1267. (c) 2009 Wiley-Liss, Inc.
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Affiliation(s)
- Silvio Aime
- Department of Chemistry IFM and Molecular Imaging Center, University of Torino, Torino, Italy
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Idée JM, Port M, Robic C, Medina C, Sabatou M, Corot C. Role of thermodynamic and kinetic parameters in gadolinium chelate stability. J Magn Reson Imaging 2010; 30:1249-58. [PMID: 19938037 DOI: 10.1002/jmri.21967] [Citation(s) in RCA: 136] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
In recent years there has been a renewed interest in the physicochemical properties of gadolinium chelates (GC). The aim of this review is to discuss the physicochemical properties of marketed GC with regard to possible biological consequences. GC can be classified according to three key molecular features: 1) the nature of the chelating moiety: either macrocyclic molecules in which Gd(3+) is caged in the preorganized cavity of the ligand, or linear, open-chain molecules; 2) ionicity: the ionicity of the molecule varies from neutral to tri-anionic agents; and 3) the presence or absence of an aromatic lipophilic moiety, which has a profound impact on the biodistribution of the GC. These parameters can also explain why GC differ considerably with regard to their thermodynamic stability constants and kinetic stability, as demonstrated by numerous studies. The concept of thermodynamic and kinetic stability is critically discussed, as it remains somewhat controversial, especially in predicting the amount of free gadolinium that may result from decomplexation of chelates in physiologic or pathologic situations. This review examines the possibility that the high kinetic stability provided by the macrocyclic structure combined with a high thermodynamic stability (reinforced by ionicity for macrocyclic chelates) can minimize the amount of free Gd(3+) released in the body. J. Magn. Reson. Imaging 2009;30:1249-1258. (c) 2009 Wiley-Liss, Inc.
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Affiliation(s)
- Jean-Marc Idée
- Guerbet, Research Division, Roissy Charles de Gaulle, France.
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146
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Abstract
Gadolinium is widely known by all practitioners of magnetic resonance imaging (MRI) but few appreciate the basic solution chemistry of this trivalent lanthanide ion. Given the recent linkage between gadolinium contrast agents and nephrogenic systemic fibrosis, some basic chemistry of this ion must be more widely understood. This short primer on gadolinium chemistry is intended to provide the reader the background principles necessary to understand the basics of chelation chemistry, water hydration numbers, and the differences between thermodynamic stability and kinetic stability or inertness. We illustrate the fundamental importance of kinetic dissociation rates in determining gadolinium toxicity in vivo by presenting new data for a novel europium DOTA-tetraamide complex that is relatively unstable thermodynamically yet extraordinarily inert kinetically and also quite nontoxic. This, plus other literature evidence, forms the basis of the fundamental axiom that it is the kinetic stability of a gadolinium complex, not its thermodynamic stability, that determines its in vivo toxicity. J. Magn. Reson. Imaging 2009;30:1240-1248. (c) 2009 Wiley-Liss, Inc.
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Affiliation(s)
- A Dean Sherry
- Department of Chemistry, University of Texas at Dallas, Richardson, Texas, USA.
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Kindberg GM, Uran S, Friisk G, Martinsen I, Skotland T. The fate of Gd and chelate following intravenous injection of gadodiamide in rats. Eur Radiol 2010; 20:1636-43. [PMID: 20157815 PMCID: PMC2882048 DOI: 10.1007/s00330-010-1716-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 12/11/2009] [Accepted: 12/23/2009] [Indexed: 11/30/2022]
Abstract
Objective The biodistribution of gadolinium (Gd) and chelate was studied in rats injected intravenously with a commercially available gadodiamide magnetic resonance contrast agent spiked with trace amounts of 14C-labelled GdDTPA-BMA. Methods Biodistribution of the 14C-labelled ligand in whole animals was visualised using quantitative whole-body autoradiography, and quantified in individual tissue samples by analysing for radioactivity using beta-counting. Biodistribution of Gd was measured by inductively coupled plasma atomic emission spectroscopy (ICP-AES) and inductively coupled plasma sector field mass spectrometry (ICP-SF-MS). Results The injected dose was rapidly excreted, with only 1.0% remaining in the body at 24 h. The radioactivity thereafter was mainly associated with kidney cortex, liver, lung, muscle and skin, with a similar rate of clearance for both ligand and Gd from these tissues. The ratio between 14C-labelled substance and Gd was not significantly different from that of the injected substance in most tissue samples up to 24 h after injection; the ratio then slowly decreased. Conclusions The data clearly show that measurements of Gd concentration alone in tissue samples from animals injected with Gd-based contrast agents (GBCAs) cannot be used as a measure of Gd released from the ligand. To our knowledge, such measurements comparing Gd and ligand concentrations and distribution in tissue samples have not been published previously for any of the commercial GBCAs.
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Chalmers K, Deâ
Luca E, Hogg NH, Kenwright A, Kuprov I, Parker D, Botta M, Wilson JI, Blamire A. Design Principles and Theory of Paramagnetic Fluorine-Labelled Lanthanide Complexes as Probes for19F Magnetic Resonance: A Proof-of-Concept Study. Chemistry 2010; 16:134-48. [DOI: 10.1002/chem.200902300] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kahakachchi CL, Moore DA. Identification and characterization of gadolinium(iii) complexes in biological tissue extracts. Metallomics 2010; 2:490-7. [DOI: 10.1039/b915806e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sieber MA, Steger-Hartmann T, Lengsfeld P, Pietsch H. Gadolinium-based contrast agents and NSF: Evidence from animal experience. J Magn Reson Imaging 2009; 30:1268-76. [PMID: 19938039 DOI: 10.1002/jmri.21971] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Martin A Sieber
- Diagnostic Imaging Research, Bayer Schering Pharma AG, Berlin, Germany.
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