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van Osch MJP, Wåhlin A, Scheyhing P, Mossige I, Hirschler L, Eklund A, Mogensen K, Gomolka R, Radbruch A, Qvarlander S, Decker A, Nedergaard M, Mori Y, Eide PK, Deike K, Ringstad G. Human brain clearance imaging: Pathways taken by magnetic resonance imaging contrast agents after administration in cerebrospinal fluid and blood. NMR IN BIOMEDICINE 2024:e5159. [PMID: 38634301 DOI: 10.1002/nbm.5159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/26/2024] [Accepted: 03/11/2024] [Indexed: 04/19/2024]
Abstract
Over the last decade, it has become evident that cerebrospinal fluid (CSF) plays a pivotal role in brain solute clearance through perivascular pathways and interactions between the brain and meningeal lymphatic vessels. Whereas most of this fundamental knowledge was gained from rodent models, human brain clearance imaging has provided important insights into the human system and highlighted the existence of important interspecies differences. Current gold standard techniques for human brain clearance imaging involve the injection of gadolinium-based contrast agents and monitoring their distribution and clearance over a period from a few hours up to 2 days. With both intrathecal and intravenous injections being used, which each have their own specific routes of distribution and thus clearance of contrast agent, a clear understanding of the kinetics associated with both approaches, and especially the differences between them, is needed to properly interpret the results. Because it is known that intrathecally injected contrast agent reaches the blood, albeit in small concentrations, and that similarly some of the intravenously injected agent can be detected in CSF, both pathways are connected and will, in theory, reach the same compartments. However, because of clear differences in relative enhancement patterns, both injection approaches will result in varying sensitivities for assessment of different subparts of the brain clearance system. In this opinion review article, the "EU Joint Programme - Neurodegenerative Disease Research (JPND)" consortium on human brain clearance imaging provides an overview of contrast agent pharmacokinetics in vivo following intrathecal and intravenous injections and what typical concentrations and concentration-time curves should be expected. This can be the basis for optimizing and interpreting contrast-enhanced MRI for brain clearance imaging. Furthermore, this can shed light on how molecules may exchange between blood, brain, and CSF.
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Affiliation(s)
- Matthias J P van Osch
- C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Anders Wåhlin
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
- Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Paul Scheyhing
- Department of Neuroradiology, University Medical Center Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ingrid Mossige
- Division of Radiology and Nuclear Medicine, Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, The Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lydiane Hirschler
- C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Anders Eklund
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | - Klara Mogensen
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Ryszard Gomolka
- Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
| | - Alexander Radbruch
- Department of Neuroradiology, University Medical Center Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Sara Qvarlander
- Department of Radiation Sciences, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden
| | - Andreas Decker
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Yuki Mori
- Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark
| | - Per Kristian Eide
- Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway
- KG Jebsen Centre for Brain Fluid Research, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Katerina Deike
- Department of Neuroradiology, University Medical Center Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Geir Ringstad
- Department of Radiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway
- Department of Geriatrics and Internal Medicine, Sorlandet Hospital, Arendal, Norway
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Richter H, Verlemann C, Jeibmann A, Martin LF, Luebke AM, Karol A, Sperling M, Radbruch A, Karst U. Elemental Bioimaging of Sheep Bone and Articular Cartilage After Single Application of Gadolinium-Based Contrast Agents. Invest Radiol 2024; 59:287-292. [PMID: 37747456 DOI: 10.1097/rli.0000000000001020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Gadolinium-based contrast agents (GBCAs) are applied to enhance magnetic resonance imaging. Gadolinium (Gd), a rare earth metal, is used in a chelated form when administered as GBCA to patients. There is an ongoing scientific debate about the clinical significance of Gd retention in tissues after administration of GBCAs. It is known that bone serves as Gd reservoir, but only sparse information on localization of Gd in bone is available. PURPOSE The aim of this study was to compare Gd tissue concentration and spatial distribution in femoral epiphysis and diaphysis 10 weeks after single-dose injection of linear and macrocyclic GBCAs in a large animal model. MATERIALS AND METHODS In this prospective animal study, Swiss-Alpine sheep (n = 36; age range, 4-10 years) received a single injection (0.1 mmol/kg) of macrocyclic (gadobutrol, gadoteridol, and gadoterate meglumine), linear (gadodiamide and gadobenate dimeglumine) GBCAs, or saline. Ten weeks after injection, sheep were killed, and femur heads and shafts were harvested. Gadolinium spatial distribution was determined in 1 sample of each treatment group by laser ablation-inductively coupled plasma-mass spectrometry. All bone specimens were analyzed histopathologically. RESULTS Injection of GBCAs in female Swiss-Alpine sheep (n = 36) resulted in Gd localization at the endosteal and periosteal surface and in a subset of GBCAs additionally at the cement lines and the bone cartilage junction. No histopathological alterations were observed in the investigated tissue specimens. CONCLUSIONS Ten weeks after single injection of a clinically relevant dose in adult sheep, both linear species of GBCA resulted in considerably higher accumulation than macrocyclic GBCAs. Gadolinium deposits were restricted to distinct bone and cartilage compartments, such as in bone linings, cement lines, and bone cartilage junctions. Tissue histology remained unaffected.
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Affiliation(s)
- Henning Richter
- From the Diagnostic Imaging Research Unit, Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland (H.R.); Clinic for Neuroradiology, University Hospital Bonn, Bonn, Germany (H.R., A.R.); Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (C.V., M.S., U.K.); Institute of Neuropathology, University Hospital Münster, Münster Germany (A.J.); Clinic for Zoo Animals, Exotic Pets and Wildlife, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland (L.F.M.); Institute of Pathology, University Hospital Hamburg-Eppendorf, Hamburg, Germany (A.M.L.); and Musculoskeletal Research Unit, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland (A.K.)
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Hummel L, Frenzel T, Boyken J, Pietsch H, Seeliger E. Comprehensive Analysis of the Spatial Distribution of Gadolinium, Iron, Manganese, and Phosphorus in the Brain of Healthy Rats After High-Dose Administrations of Gadodiamide and Gadobutrol. Invest Radiol 2024; 59:150-164. [PMID: 38157437 DOI: 10.1097/rli.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
OBJECTIVES After the administration of gadolinium-based contrast agents (GBCAs), residual gadolinium (Gd) has been detected in a few distinct morphological structures of the central nervous system (CNS). However, a systematic, comprehensive, and quantitative analysis of the spatial Gd distribution in the entire brain is not yet available. The first aim of this study is to provide this analysis in healthy rats after administration of high GBCA doses. The second aim is to assess the spatial distributions and possible Gd colocalizations of endogenous iron (Fe), manganese (Mn), and phosphorus (P). In addition, the presence of Gd in proximity to blood vessels was assessed by immunohistochemistry. MATERIALS AND METHODS Male rats were randomly assigned to 3 groups (n = 3/group): saline (control), gadodiamide (linear GBCA), and gadobutrol (macrocyclic GBCA) with cumulative Gd doses of 14.4 mmol/kg of body mass. Five weeks after the last administration, the brains were collected and cryosectioned. The spatial distributions of Gd, Fe, Mn, and P were analyzed in a total of 130 sections, each covering the brain in 1 of the 3 perpendicular anatomical orientations, using laser ablation coupled with inductively coupled plasma mass spectrometry. Quantitative spatial element maps were generated, and the concentrations of Gd, Fe, and Mn were measured in 31 regions of interest covering various distinct CNS structures. Correlation analyses were performed to test for possible colocalization of Gd, Fe, and Mn. The spatial proximity of Gd and blood vessels was studied using metal-tagged antibodies against von Willebrand factor with laser ablation coupled with inductively coupled plasma mass spectrometry. RESULTS After administration of linear gadodiamide, high Gd concentrations were measured in many distinct structures of the gray matter. This involved structures previously reported to retain Gd after linear GBCA, such as the deep cerebellar nuclei or the globus pallidus, but also structures that had not been reported so far including the dorsal subiculum, the retrosplenial cortex, the superior olivary complex, and the inferior colliculus. The analysis in all 3 orientations allowed the localization of Gd in specific subregions and layers of certain structures, such as the hippocampus and the primary somatosensory cortex. After macrocyclic gadobutrol, the Gd tissue concentration was significantly lower than after gadodiamide. Correlation analyses of region of interest concentrations of Gd, Fe, and Mn revealed no significant colocalization of Gd with endogenous Fe or Mn in rats exposed to either GBCA. Immunohistochemistry revealed a colocalization of Gd traces with vascular endothelium in the deep cerebellar nuclei after gadobutrol, whereas the majority of Gd was found outside the vasculature after gadodiamide. CONCLUSIONS In rats exposed to gadodiamide but not in rats exposed to gadobutrol, high Gd concentrations were measured in various distinct CNS structures, and structures not previously reported were identified to contain Gd, including specific subregions and layers with different cytoarchitecture and function. Knowledge of these distinct spatial patterns may pave the way for tailored functional neurological testing. Signs for the localization of the remaining Gd in the vascular endothelium were prominent for gadobutrol but not gadodiamide. The results also indicate that local transmetalation with endogenous Fe or Mn is unlikely to explain the spatial patterns of Gd deposition in the brain, which argues against a general role of these metals in local transmetalation and release of Gd ions in the CNS.
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Affiliation(s)
- Luis Hummel
- From the Institute of Translational Physiology, Charité-University Medicine Berlin, Berlin, Germany (L.H., E.S.); and MR and CT Contrast Media Research, Bayer AG, Berlin, Germany (T.F., J.B., H.P.)
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Piarulli S, Riedel JA, Fossum FN, Kermen F, Hansen BH, Kvæstad B, Olsvik PA, Farkas J. Effects of gadolinium (Gd) and a Gd-based contrast agent (GBCA) on early life stages of zebrafish (Danio rerio). CHEMOSPHERE 2024; 350:140950. [PMID: 38114019 DOI: 10.1016/j.chemosphere.2023.140950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023]
Abstract
Gadolinium (Gd) is one of the rare earth elements (REY) and is widely used in magnetic resonance imaging (MRI) contrast agents. Anthropogenic Gd enrichment has frequently been found in wastewater treatment plant effluents in industrialised countries, rising concerns regarding effects on aquatic biota. This study investigates the acute toxicity and sublethal effects of Gd in two forms, as inorganic salt (GdCl3) and as Gd-based contrast agent (GBCA), on early life stages of zebrafish (Danio rerio). Nominal exposure concentrations ranged from 3 to 3000 μg L-1, with an exposure duration of 96 h. None of the two tested compounds were acutely toxic to embryos and larvae. Similarly, we did not observe any effects on larval development and locomotive behaviour. However, we found significant changes in the brain activity of larvae exposed to the highest concentrations of GdCl3 and the GBCA. Our findings show that Gd can have sublethal effects on developing fish at lower concentrations than reported previously, highlighting the necessity of investigating the long-term fate and effects of GBCAs released into the aquatic environment.
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Affiliation(s)
- Stefania Piarulli
- Department of Climate and Environment, SINTEF Ocean, Brattørkaia 17C, 7010, Trondheim, Norway.
| | - Juliane A Riedel
- Faculty of Biosciences and Aquaculture, Nord University, Universitetsalléen 11, 8026, Bodø, Norway
| | - Frida N Fossum
- Department of Biology, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway
| | - Florence Kermen
- Department of Biology, Norwegian University of Science and Technology, Høgskoleringen 5, 7491, Trondheim, Norway; Department of Neuroscience, University of Copenhagen, Blegdamsvej 3b, 2200, Copenhagen, Denmark
| | - Bjørn Henrik Hansen
- Department of Climate and Environment, SINTEF Ocean, Brattørkaia 17C, 7010, Trondheim, Norway
| | - Bjarne Kvæstad
- Department of Fisheries and New Biomarine Industry, SINTEF Ocean, Brattørkaia 17C, 7010, Trondheim, Norway
| | - Pål A Olsvik
- Faculty of Biosciences and Aquaculture, Nord University, Universitetsalléen 11, 8026, Bodø, Norway
| | - Julia Farkas
- Department of Climate and Environment, SINTEF Ocean, Brattørkaia 17C, 7010, Trondheim, Norway.
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Sommer K, Reuter S, Elinkmann M, Köhrer A, Quarles CD, Hippler M, Karst U. Species-dependent uptake of gadolinium in Chlamydomonas reinhardtii algae. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 905:166909. [PMID: 37689191 DOI: 10.1016/j.scitotenv.2023.166909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
Single cell-inductively coupled plasma-mass spectrometry (sc-ICP-MS) was used in this study as a valuable tool to assess the species-dependent uptake of metallopharmaceuticals into algal cells. Chlamydomonas reinhardtii algae were incubated for 24 h with four Gadolinium-based contrast agents (GBCAs) and GdCl3. A species dependency towards the uptake of the tested Gd species was observed. Using single cell-ICP-MS, a Gd signal corresponding to single cell events was detected for GdCl3 and the linear GBCAs Omniscan® (Gadodiamide, Gd-DTPA-BMA) and Magnevist® (Gadodiamide, Gd-DTPA). For the macrocyclic complexes Dotarem® (Gadoteric acid, Gd-DOTA) and Gadovist® (Gadobutrol, Gd-BT-DO3A), no such Gd signal was visible. Total Gd analysis via ICP-MS confirmed the presence of Gd in the cells only after incubation with GdCl3 and the linear GBCAs, while only small amounts of Gd were detected for the incubations with macrocyclic GBCAs. Furthermore, the results showed that more Gd is bound to cell structures or macromolecules, while smaller amounts are present in the lysate. Using hydrophilic interaction liquid chromatography (HILIC)-ICP-MS, the soluble Gd species in the lysate were analyzed to determine if the initial Gd complexes were still intact. Surprisingly, no intact GBCAs were detected in the lysates of any incubation solution, possibly due to a change in Gd speciation. Further research is needed to assess which Gd species are present in the lysate, while "free" Gd ions or adducts with cell constituents are the most likely explanation. This study highlights the need for species-dependent investigation of elements in aquatic organisms. Moreover, the uptake of linear GBCAs and their species alteration raises the question of a potential accumulation of Gd in the food chain.
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Affiliation(s)
- Karolin Sommer
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149 Münster, Germany
| | - Sarah Reuter
- Institute of Plant Biochemistry and Biotechnology, University of Münster, Schlossplatz 7-8, 48143 Münster, Germany
| | - Matthias Elinkmann
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149 Münster, Germany
| | - Alexander Köhrer
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149 Münster, Germany
| | - C Derrick Quarles
- Elemental Scientific, Inc., 7277 World Communications Dr., Omaha, NE 68022, United States
| | - Michael Hippler
- Institute of Plant Biochemistry and Biotechnology, University of Münster, Schlossplatz 7-8, 48143 Münster, Germany; Institute of Plant Science and Resources, Okayama University, Kurashiki, Okayama 710-0046, Japan
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstr. 48, 48149 Münster, Germany.
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Iyad N, S.Ahmad M, Alkhatib SG, Hjouj M. Gadolinium contrast agents- challenges and opportunities of a multidisciplinary approach: Literature review. Eur J Radiol Open 2023; 11:100503. [PMID: 37456927 PMCID: PMC10344828 DOI: 10.1016/j.ejro.2023.100503] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/09/2023] [Accepted: 06/23/2023] [Indexed: 07/18/2023] Open
Abstract
Contrast agents is used in magnetic resonance imaging (MRI) to improve the visibility of the details of the organ structures. Gadolinium-based contrast agent (GBCA) has been used since 1988 in MRI for diagnostic and follow-up of patients, the gadolinium good properties make it an effective choice for enhance the signal in MRI by increase its intensity and shortening the relaxation time of the proton. Recently, many studies show a gadolinium deposition in different human organs due to release of free gadolinium various body organs or tissue, which led to increased concern about the use of gadolinium agents, in this study, the potential diseases that may affect the patient and side effects that appear on the patient and related to accumulation of gadolinium were clarified, the study focused on the organs such as brain and bones in which gadolinium deposition was found and the lesions associated with it, and the diseases associated with gadolinium retention includes Nephrogenic Systemic Fibrosis (NSF) and Gadolinium deposition disease (GDD). Some studies tended to improve the contrast agents by developing a new non-gadolinium agents or development of next-generation gadolinium agents. In this review article the latest knowledge about MRI contrast agent.
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Affiliation(s)
- Nebal Iyad
- Ibn Rushd Radiology Centre, Hebron, Palestine
| | - Muntaser S.Ahmad
- Ibn Rushd Radiology Centre, Hebron, Palestine
- Department of Medical Imaging, Faculty of Allied Medical Health, Palestine Ahliya University, Dheisha, Bethlehem, Palestine
| | - Sanaa G. Alkhatib
- Department of Medical Imaging, Faculty of Allied Medical Health, Palestine Ahliya University, Dheisha, Bethlehem, Palestine
| | - Mohammad Hjouj
- Medical Imaging Department, Faculty of Health Professions, Al-Quds University, Abu Deis - Main Campus, Jerusalem, Palestine
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Alsogati E, Ghandourah H, Bakhsh A. Review of the Efficacy and Safety of Gadopiclenol: A Newly Emerging Gadolinium-Based Contrast Agent. Cureus 2023; 15:e43055. [PMID: 37680433 PMCID: PMC10480682 DOI: 10.7759/cureus.43055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are one of the most commonly used agents in magnetic resonance imaging. Gadopiclenol is a new GBCA aimed at providing improved diagnostic efficacy with a favorable safety profile. The proposed advantages are due to its specific pharmacological properties, one of which is high relaxivity values. The aim of this review is to assess the efficacy, diagnostic accuracy, and safety of gadopiclenol in comparison to other currently used gadolinium-based contrast agents. PubMed and other database systems were used to identify relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed, resulting in 10 articles that were included in the review. The outcomes were reviewed according to several factors regarding efficacy and accuracy in terms of qualitative and quantitative descriptors relative to properties of enhancement provided by the contrast agent. In terms of safety profile, a number of outcomes were assessed such as the occurrence of serious adverse effects, severe kidney injury, and organ-based contrast retention. Gadopiclenol was found to provide outcomes comparable to other commonly used GBCAs at lower doses with further favorable results at higher doses while maintaining an acceptable safety profile. However, it was found to have high rates of retention within the liver and can cause nonsignificant QT prolongation in healthy individuals, which arguably creates the need for further research regarding more long-term implications of these possible adverse effects.
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Affiliation(s)
- Emad Alsogati
- Department of Radiology, King Fahd General Hospital, Jeddah, SAU
| | | | - Amal Bakhsh
- Department of Radiology, King Fahd General Hospital, Jeddah, SAU
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Bashir MR, Thomas KL. A New Generation of Gadolinium-based MRI Contrast Agents: Higher Relaxivity, Lower Dose. Radiology 2023; 308:e231454. [PMID: 37462492 DOI: 10.1148/radiol.231454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Affiliation(s)
- Mustafa R Bashir
- From the Departments of Radiology and Medicine, Duke University, 2301 Erwin Rd, Box 3808, Durham, NC 27705 (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University, Durham, NC (M.R.B.); and Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC (K.L.T.)
| | - Kerry L Thomas
- From the Departments of Radiology and Medicine, Duke University, 2301 Erwin Rd, Box 3808, Durham, NC 27705 (M.R.B.); Center for Advanced Magnetic Resonance Development, Duke University, Durham, NC (M.R.B.); and Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC (K.L.T.)
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Haubold J, Jost G, Theysohn JM, Ludwig JM, Li Y, Kleesiek J, Schaarschmidt BM, Forsting M, Nensa F, Pietsch H, Hosch R. Contrast Agent Dose Reduction in MRI Utilizing a Generative Adversarial Network in an Exploratory Animal Study. Invest Radiol 2023; 58:396-404. [PMID: 36728299 DOI: 10.1097/rli.0000000000000947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aim of this study is to use virtual contrast enhancement to reduce the amount of hepatobiliary gadolinium-based contrast agent in magnetic resonance imaging with generative adversarial networks (GANs) in a large animal model. METHODS With 20 healthy Göttingen minipigs, a total of 120 magnetic resonance imaging examinations were performed on 6 different occasions, 50% with reduced (low-dose; 0.005 mmol/kg, gadoxetate) and 50% standard dose (normal-dose; 0.025 mmol/kg). These included arterial, portal venous, venous, and hepatobiliary contrast phases (20 minutes, 30 minutes). Because of incomplete examinations, one animal had to be excluded. Randomly, 3 of 19 animals were selected and withheld for validation (18 examinations). Subsequently, a GAN was trained for image-to-image conversion from low-dose to normal-dose (virtual normal-dose) with the remaining 16 animals (96 examinations). For validation, vascular and parenchymal contrast-to-noise ratio (CNR) was calculated using region of interest measurements of the abdominal aorta, inferior vena cava, portal vein, hepatic parenchyma, and autochthonous back muscles. In parallel, a visual Turing test was performed by presenting the normal-dose and virtual normal-dose data to 3 consultant radiologists, blinded for the type of examination. They had to decide whether they would consider both data sets as consistent in findings and which images were from the normal-dose study. RESULTS The pooled dynamic phase vascular and parenchymal CNR increased significantly from low-dose to virtual normal-dose (pooled vascular: P < 0.0001, pooled parenchymal: P = 0.0002) and was found to be not significantly different between virtual normal-dose and normal-dose examinations (vascular CNR [mean ± SD]: low-dose 17.6 ± 6.0, virtual normal-dose 41.8 ± 9.7, and normal-dose 48.4 ± 12.2; parenchymal CNR [mean ± SD]: low-dose 20.2 ± 5.9, virtual normal-dose 28.3 ± 6.9, and normal-dose 29.5 ± 7.2). The pooled parenchymal CNR of the hepatobiliary contrast phases revealed a significant increase from the low-dose (22.8 ± 6.2) to the virtual normal-dose (33.2 ± 6.1; P < 0.0001) and normal-dose sequence (37.0 ± 9.1; P < 0.0001). In addition, there was no significant difference between the virtual normal-dose and normal-dose sequence. In the visual Turing test, on the median, the consultant radiologist reported that the sequences of the normal-dose and virtual normal-dose are consistent in findings in 100% of the examinations. Moreover, the consultants were able to identify the normal-dose series as such in a median 54.5% of the cases. CONCLUSIONS In this feasibility study in healthy Göttingen minipigs, it could be shown that GAN-based virtual contrast enhancement can be used to recreate the image impression of normal-dose imaging in terms of CNR and subjective image similarity in both dynamic and hepatobiliary contrast phases from low-dose data with an 80% reduction in gadolinium-based contrast agent dose. Before clinical implementation, further studies with pathologies are needed to validate whether pathologies are correctly represented by the network.
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Affiliation(s)
| | - Gregor Jost
- MR and CT Contrast Media Research, Bayer AG, Berlin, Germany
| | - Jens Matthias Theysohn
- From the Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen
| | - Johannes Maximilian Ludwig
- From the Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen
| | - Yan Li
- From the Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen
| | - Jens Kleesiek
- Institute of Artificial Intelligence in Medicine, University Hospital Essen, Essen
| | | | - Michael Forsting
- From the Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen
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Froehlich JM, Moussa L, Guirguis N, Gutzeit A, Wu D, Sartoretti-Schefer S, Koh DM, Kolokythas O, Matoori S. Comparison of gadolinium-based contrast agents for MR cholangiography in saline, blood and bile: a phantom study. Eur Radiol Exp 2023; 7:21. [PMID: 37093398 PMCID: PMC10126166 DOI: 10.1186/s41747-023-00331-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 02/15/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND We compared T1- and T2-weighted signal intensities of liver-specific (gadoxetate, gadobenate) and non-specific (gadoterate) gadolinium contrast agents (CAs) in a bile phantom. METHODS In a phantom study, gadoxetate, gadobenate, and gadoterate were diluted in saline, blood, and bile at different concentrations (0, 0.25, 0.5. 1, 2.5, 5, 10, and 25 mM) and imaged in a 3-T magnetic resonance imaging (MRI) system using T1- and T2-weighted sequences. The maximum signal intensities of CAs were compared for each sequence separately and across all T1-weighted sequences using one-way ANOVA. RESULTS Using T1-weighted sequences, CA concentration-dependent signal intensity increase was followed by decrease due to T2* effects. Comparing CAs for each sequence in bile yielded higher maximum signal intensities with gadobenate than gadoxetate and gadoterate using T1-weighted spin-echo (p < 0.010), multiecho gradient- and spin-echo (p < 0.001), and T1-weighted high-resolution isotropic volume excitation (eTHRIVE) sequences (p < 0.010). Comparing across all T1-weighted sequences in the bile phantom, gadobenate imaged using T1-weighted turbo field-echo (TFE) sequence showed the highest signal intensity, significantly higher than that using other CAs agents or sequences (p < 0.004) except for gadobenate and gadoxetate evaluated with three-dimensional multiecho fast field-echo (3D-mFFE) and gadoxetate with T1-weighted TFE sequence (p > 0.141). Signal reduction with CA concentration-dependent decrease was observed on T2-weighted images. CONCLUSION In this bile phantom study of gadolinium-based CA, gadobenate and gadoxetate showed high signal intensity with T1-weighted TFE and 3D-mFFE sequences, which supports their potential utility for contrast-enhanced hepatobiliary MRI. KEY POINTS • Contrast-enhanced magnetic resonance (MR) cholangiography depends on contrast agent type, kinetics, and concentration in bile, • We compared signal intensities of three contrast agents in a bile phantom study. • Gadobenate, gadoxetate, and gadoterate demonstrated different signal intensities at identical concentrations. • Gadoxetate and gadobenate showed high signal intensities on T1-weighted MR sequences.
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Affiliation(s)
| | - Leen Moussa
- Faculté de Pharmacie, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, QC, H3T 1J4, Canada
| | - Natalie Guirguis
- Faculté de Pharmacie, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, QC, H3T 1J4, Canada
| | - Andreas Gutzeit
- Institute of Radiology and Nuclear Medicine and Breast Center St. Anna, Hirslanden Klinik St. Anna, Lucerne, Switzerland
- Department of Health Sciences and Medicine, Universität Luzern, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | - David Wu
- Laboratory for Cell and Tissue Engineering, Harvard John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, 02115, USA
| | | | - Dow-Mu Koh
- Cancer Research UK Clinical Magnetic Resonance Research Group, Institute of Cancer Research, Sutton, Surrey, UK
| | - Orpheus Kolokythas
- Department of Radiology, University of Washington Medical Center, Seattle, WA, USA
| | - Simon Matoori
- Faculté de Pharmacie, Université de Montréal, 2940 Chemin de Polytechnique, Montreal, QC, H3T 1J4, Canada.
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11
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Funke SKI, Factor C, Rasschaert M, Robert P, van Dijk NWM, Hußock M, Sperling M, Karst U. Elemental Imaging of Long-term Gadolinium Retention in Rodent Femur. Radiology 2023; 306:e213107. [PMID: 36194115 DOI: 10.1148/radiol.213107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background The use of gadolinium-based contrast agents (GBCAs) is linked to gadolinium retention in the skeleton of healthy individuals. The mechanism of gadolinium incorporation into bone tissue is not fully understood and requires spatially resolved analysis to locate the gadolinium. Purpose To compare the quantitative distribution of gadolinium retained over time in rodent femur following the administration of gadodiamide and gadobutrol at three different time points. Materials and Methods In this animal study conducted between May 2018 and April 2020, 108 9-week-old healthy rats were repeatedly injected with either gadodiamide, gadobutrol, or saline solution and were killed 1, 3, or 12 months after the last injection. The femurs of six female and six male rats per each group and time point were collected. Quantitative elemental imaging of gadolinium in longitudinal thin sections was performed on one sample per sex with use of laser ablation inductively coupled plasma mass spectrometry (ICP-MS). Gadolinium concentration was determined with use of ICP-MS on the samples of all animals (six per group). Mann-Whitney U tests were applied on pairwise comparisons to determine potential sex effect and GBCA effect on gadolinium concentrations. Results The highest gadolinium retention was observed in the gadodiamide group (concentration, 97-200 nmol · g-1), exceeding the mean concentration in the gadobutrol group (6.5-17 nmol · g-1). However, the gadolinium distribution pattern was similar for both contrast agents, showing prominent gadolinium retention at endosteal surfaces, in the bone marrow, and in small tissue pores. Gadolinium distribution in cortical bone changed over time, initially showing a thin rim of higher concentration close to the periosteum, which appeared to grow wider and move toward the interior of the femur over 1 year. Conclusion For both gadolinium-based contrast agents, gadolinium retention in rat bone was initially located close to the periosteum and bone cavities and changed with bone remodeling processes. The relevance to long-term storage of gadolinium in humans remains to be determined. © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Sabrina K I Funke
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Cécile Factor
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Marlène Rasschaert
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Philippe Robert
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Natasja W M van Dijk
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Michelle Hußock
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Michael Sperling
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
| | - Uwe Karst
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 48, 48149 Münster, Germany (S.K.I.F., M.H., M.S., U.K.); Department of Research and Innovation, Guerbet Group, Roissy, France (C.F., M.R., P.R.); and Department of Dentistry, Dental Research Laboratory, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, the Netherlands (N.W.M.v.D.)
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12
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Tang R, Chen Y, He N, Li Y, Jin Z, Chen KM, Yan F. Effect of gadopentetate dimeglumine on bone growth in zebrafish caudal fins. Toxicol Lett 2023; 374:11-18. [PMID: 36496117 DOI: 10.1016/j.toxlet.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/17/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
Compared with MR plain scanning, gadolinium (Gd)-enhanced MR scanning can provide more diagnostic information. Gadopentetate dimeglumine is generally used as an MR enhancement contrast agent in some countries. It is a member of linear Gd-based contrast agents (GBCAs) which are considered more likely to release free Gd ions (Gd3+) than macrocyclic GBCAs. Gd3+ is one of the most effective known calcium antagonists, and can compete with calcium ions (Ca2+) in Ca2+-related biological reactions. In this study, animal models of tissue regeneration were established by cutting the caudal fins of zebrafish, and the models were exposed with gadopentetate dimeglumine solution for different immersion times of 1, 3, and 5 min. Three GBCA exposures per week were performed in the first 3 weeks of the follow-up time. Morphological parameters such as regenerative area (RA), bone density, bone thickness and regenerative bone volume (RBV) were quantified using a camera and synchrotron radiation micro CT. RA decreased as total Gd intake increased in both the female group (ρ = -0.784, P < 0.0001) and the male group (ρ = -0.471, P = 0.011). The bone density of the regenerated bone increased after Gd exposure in the treated groups. The morphology of the regenerated bone from the treated groups became shorter and thicker. Our results showed that gadopentetate dimeglumine had osteogenic toxicity in zebrafish.
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Affiliation(s)
- Rongbiao Tang
- Department of Radiology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China.
| | - Yi Chen
- Shanghai Institute of Hematology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China
| | - Naying He
- Department of Radiology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China
| | - Yan Li
- Department of Radiology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China
| | - Zhijia Jin
- Department of Radiology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China
| | - Ke-Min Chen
- Department of Radiology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, RuiJin Hospital, Shanghai Jiao Tong University, and School of Medicine, Shanghai, China.
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13
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Tranos J, Das A, Zhang J, Hafeez S, Arvanitakis GN, Thomson SAJ, Khan S, Pandya N, Kim SG, Wadghiri YZ. Rapid In Vitro Quantification of a Sensitized Gadolinium Chelate via Photoinduced Triplet Harvesting. ACS OMEGA 2023; 8:2907-2914. [PMID: 36713694 PMCID: PMC9878670 DOI: 10.1021/acsomega.2c05040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/18/2022] [Indexed: 06/18/2023]
Abstract
Gadolinium (Gd) based contrast agents (GBCAs) are widely used in magnetic resonance imaging (MRI) and are paramount to cancer diagnostics and tumor pharmacokinetic analysis. Accurate quantification of gadolinium concentration is essential to monitoring the biodistribution, clearance, and pharmacodynamics of GBCAs. However, current methods of quantifying gadolinium in blood or plasma (biological media) are both low throughput and clinically unavailable. Here, we have demonstrated the use of a sensitized gadolinium chelate, Gd[DTPA-cs124], as an MRI contrast agent that can be used to measure the concentration of gadolinium via luminescence quantification in biological media following transmetalation with a terbium salt. Gd[DTPA-cs124] was synthesized by conjugating carbostyril-124 (cs124) to diethylenetriaminepentaacetic acid (DTPA) and chelating to gadolinium. We report increases in both stability and relaxivity compared to the clinically approved analog Gd[DTPA] (gadopentetic acid or Magnevist). In vivo MRI experiments were conducted using C57BL6 mice in order to further illustrate the performance of Gd[DTPA-cs124] as an MRI contrast agent in comparison to Magnevist. Our results indicate that similar chemical modification to existing clinically approved GBCA may likewise provide favorable property changes, with the ability to be used in a gadolinium quantification assay. Furthermore, our assay provides a straightforward and high-throughput method of measuring gadolinium in biological media using a standard laboratory plate reader.
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Affiliation(s)
- James
A. Tranos
- Center
for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation
and Research (CAI2R), Department of Radiology, NYU Grossman School of Medicine, New York, New York 10016, United States
| | - Ayesha Das
- Department
of Radiology, Weill Cornell Medical College, New York, New York 10065, United States
| | - Jin Zhang
- Department
of Radiology, Weill Cornell Medical College, New York, New York 10065, United States
| | - Sonia Hafeez
- Center
for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation
and Research (CAI2R), Department of Radiology, NYU Grossman School of Medicine, New York, New York 10016, United States
| | | | | | - Suleiman Khan
- Center
for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation
and Research (CAI2R), Department of Radiology, NYU Grossman School of Medicine, New York, New York 10016, United States
| | - Neelam Pandya
- Center
for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation
and Research (CAI2R), Department of Radiology, NYU Grossman School of Medicine, New York, New York 10016, United States
| | - Sungheon Gene Kim
- Department
of Radiology, Weill Cornell Medical College, New York, New York 10065, United States
| | - Youssef Z. Wadghiri
- Center
for Biomedical Imaging (CBI), Center for Advanced Imaging Innovation
and Research (CAI2R), Department of Radiology, NYU Grossman School of Medicine, New York, New York 10016, United States
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14
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Anderhalten L, Silva RV, Morr A, Wang S, Smorodchenko A, Saatz J, Traub H, Mueller S, Boehm-Sturm P, Rodriguez-Sillke Y, Kunkel D, Hahndorf J, Paul F, Taupitz M, Sack I, Infante-Duarte C. Different Impact of Gadopentetate and Gadobutrol on Inflammation-Promoted Retention and Toxicity of Gadolinium Within the Mouse Brain. Invest Radiol 2022; 57:677-688. [PMID: 35467573 PMCID: PMC9444290 DOI: 10.1097/rli.0000000000000884] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/16/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Using a murine model of multiple sclerosis, we previously showed that repeated administration of gadopentetate dimeglumine led to retention of gadolinium (Gd) within cerebellar structures and that this process was enhanced with inflammation. This study aimed to compare the kinetics and retention profiles of Gd in inflamed and healthy brains after application of the macrocyclic Gd-based contrast agent (GBCA) gadobutrol or the linear GBCA gadopentetate. Moreover, potential Gd-induced neurotoxicity was investigated in living hippocampal slices ex vivo. MATERIALS AND METHODS Mice at peak of experimental autoimmune encephalomyelitis (EAE; n = 29) and healthy control mice (HC; n = 24) were exposed to a cumulative dose of 20 mmol/kg bodyweight of either gadopentetate dimeglumine or gadobutrol (8 injections of 2.5 mmol/kg over 10 days). Magnetic resonance imaging (7 T) was performed at baseline as well as at day 1, 10, and 40 post final injection (pfi) of GBCAs. Mice were sacrificed after magnetic resonance imaging and brain and blood Gd content was assessed by laser ablation-inductively coupled plasma (ICP)-mass spectrometry (MS) and ICP-MS, respectively. In addition, using chronic organotypic hippocampal slice cultures, Gd-induced neurotoxicity was addressed in living brain tissue ex vivo, both under control or inflammatory (tumor necrosis factor α [TNF-α] at 50 ng/μL) conditions. RESULTS Neuroinflammation promoted a significant decrease in T1 relaxation times after multiple injections of both GBCAs as shown by quantitative T1 mapping of EAE brains compared with HC. This corresponded to higher Gd retention within the EAE brains at 1, 10, and 40 days pfi as determined by laser ablation-ICP-MS. In inflamed cerebellum, in particular in the deep cerebellar nuclei (CN), elevated Gd retention was observed until day 40 after last gadopentetate application (CN: EAE vs HC, 55.06 ± 0.16 μM vs 30.44 ± 4.43 μM). In contrast, gadobutrol application led to a rather diffuse Gd content in the inflamed brains, which strongly diminished until day 40 (CN: EAE vs HC, 0.38 ± 0.08 μM vs 0.17 ± 0.03 μM). The analysis of cytotoxic effects of both GBCAs using living brain tissue revealed an elevated cell death rate after incubation with gadopentetate but not gadobutrol at 50 mM. The cytotoxic effect due to gadopentetate increased in the presence of the inflammatory mediator TNF-α (with vs without TNF-α, 3.15% ± 1.18% vs 2.17% ± 1.14%; P = 0.0345). CONCLUSIONS In the EAE model, neuroinflammation promoted increased Gd retention in the brain for both GBCAs. Whereas in the inflamed brains, efficient clearance of macrocyclic gadobutrol during the investigated time period was observed, the Gd retention after application of linear gadopentetate persisted over the entire observational period. Gadopentetate but not gadubutrol appeared to be neurotoxic in an ex vivo paradigm of neuronal inflammation.
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Affiliation(s)
- Lina Anderhalten
- From the Experimental and Clinical Research Center (ECRC), A Cooperation Between the Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin
| | - Rafaela V. Silva
- From the Experimental and Clinical Research Center (ECRC), A Cooperation Between the Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin
- Einstein Center for Neurosciences
| | - Anna Morr
- Department of Radiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin
| | - Shuangqing Wang
- From the Experimental and Clinical Research Center (ECRC), A Cooperation Between the Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin
| | - Alina Smorodchenko
- Institute for Translational Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg
| | - Jessica Saatz
- Bundesanstalt für Materialforschung und -prüfung, Berlin
| | - Heike Traub
- Bundesanstalt für Materialforschung und -prüfung, Berlin
| | - Susanne Mueller
- Department of Experimental Neurology and Center for Stroke Research
- NeuroCure Cluster of Excellence and Charité Core Facility 7T Experimental MRIs, Charité–Universitätsmedizin Berlin, Berlin
| | - Philipp Boehm-Sturm
- Department of Experimental Neurology and Center for Stroke Research
- NeuroCure Cluster of Excellence and Charité Core Facility 7T Experimental MRIs, Charité–Universitätsmedizin Berlin, Berlin
| | - Yasmina Rodriguez-Sillke
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Flow & Mass Cytometry Core Facility, Berlin, Germany
| | - Désirée Kunkel
- Berlin Institute of Health at Charité–Universitätsmedizin Berlin, Flow & Mass Cytometry Core Facility, Berlin, Germany
| | - Julia Hahndorf
- Department of Radiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin
| | - Friedemann Paul
- From the Experimental and Clinical Research Center (ECRC), A Cooperation Between the Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin
| | - Matthias Taupitz
- Department of Radiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin
| | - Ingolf Sack
- Department of Radiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt–Universität zu Berlin, Berlin
| | - Carmen Infante-Duarte
- From the Experimental and Clinical Research Center (ECRC), A Cooperation Between the Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, and Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, Berlin
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15
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Oluwasola IE, Ahmad AL, Shoparwe NF, Ismail S. Gadolinium based contrast agents (GBCAs): Uniqueness, aquatic toxicity concerns, and prospective remediation. JOURNAL OF CONTAMINANT HYDROLOGY 2022; 250:104057. [PMID: 36130428 DOI: 10.1016/j.jconhyd.2022.104057] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/25/2022] [Accepted: 08/06/2022] [Indexed: 06/15/2023]
Abstract
The current toxicity concerns of gadolinium-based contrast agents (GBCAs) have birthed the need to regulate and, sometimes restrict its clinical administration. However, tolerable concentration levels of Gd in the water sector have not been set. Therefore, the detection and speedy increase of the anthropogenic Gd-GBCAs in the various water bodies, including those serving as the primary source of drinking water for adults and children, is perturbing. Nevertheless, the strongly canvassed risk-benefit considerations and superior uniqueness of GBCAs compared to the other ferromagnetic metals guarantees its continuous administration for Magnetic resonance imaging (MRI) investigations regardless of the toxicity concerns. Unfortunately, findings have shown that both the advanced and conventional wastewater treatment processes do not satisfactorily remove GBCAs but rather risk transforming the chelated GBCAs to their free ionic metal (Gd 3+) through inadvertent degradation processes. This unintentional water processing-induced GBCA dechelation leads to the intricate pathway for unintentional human intake of Gd ion. Hence exposure to its probable ecotoxicity and several reported inimical effects on human health such as; digestive symptoms, twitching or weakness, cognitive flu, persistent skin diseases, body pains, acute renal and non-renal adverse reactions, chronic skin, and eyes changes. This work proposed an economical and manageable remediation technique for the potential remediation of Gd-GBCAs in wastewater, while a precautionary limit for Gd in public water and commercial drinks is advocated.
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Affiliation(s)
- Idowu Ebenezer Oluwasola
- School of Chemical Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal 14300, Pulau Pinang, Malaysia; School of Science and Computer Studies, Food Technology Department, The Federal Polytechnic, Ado Ekiti, Ekiti State 360231, Nigeria.
| | - Abdul Latif Ahmad
- School of Chemical Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal 14300, Pulau Pinang, Malaysia.
| | - Noor Fazliani Shoparwe
- Gold, Rare Earth, and Material Technopreneurship Centre (GREAT), Faculty of Bioengineering and Technology, Universiti Malaysia Kelantan, Jeli Campus, 17600 Jeli, Kelantan, Malaysia.
| | - Suzylawati Ismail
- School of Chemical Engineering, Engineering Campus, Universiti Sains Malaysia, Nibong Tebal 14300, Pulau Pinang, Malaysia.
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16
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James AD, Leslie TK, Kaggie JD, Wiggins L, Patten L, Murphy O'Duinn J, Langer S, Labarthe MC, Riemer F, Baxter G, McLean MA, Gilbert FJ, Kennerley AJ, Brackenbury WJ. Sodium accumulation in breast cancer predicts malignancy and treatment response. Br J Cancer 2022; 127:337-349. [PMID: 35462561 PMCID: PMC9296657 DOI: 10.1038/s41416-022-01802-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 03/10/2022] [Accepted: 03/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Breast cancer remains a leading cause of death in women and novel imaging biomarkers are urgently required. Here, we demonstrate the diagnostic and treatment-monitoring potential of non-invasive sodium (23Na) MRI in preclinical models of breast cancer. METHODS Female Rag2-/- Il2rg-/- and Balb/c mice bearing orthotopic breast tumours (MDA-MB-231, EMT6 and 4T1) underwent MRI as part of a randomised, controlled, interventional study. Tumour biology was probed using ex vivo fluorescence microscopy and electrophysiology. RESULTS 23Na MRI revealed elevated sodium concentration ([Na+]) in tumours vs non-tumour regions. Complementary proton-based diffusion-weighted imaging (DWI) linked elevated tumour [Na+] to increased cellularity. Combining 23Na MRI and DWI measurements enabled superior classification accuracy of tumour vs non-tumour regions compared with either parameter alone. Ex vivo assessment of isolated tumour slices confirmed elevated intracellular [Na+] ([Na+]i); extracellular [Na+] ([Na+]e) remained unchanged. Treatment with specific inward Na+ conductance inhibitors (cariporide, eslicarbazepine acetate) did not affect tumour [Na+]. Nonetheless, effective treatment with docetaxel reduced tumour [Na+], whereas DWI measures were unchanged. CONCLUSIONS Orthotopic breast cancer models exhibit elevated tumour [Na+] that is driven by aberrantly elevated [Na+]i. Moreover, 23Na MRI enhances the diagnostic capability of DWI and represents a novel, non-invasive biomarker of treatment response with superior sensitivity compared to DWI alone.
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Affiliation(s)
- Andrew D James
- Department of Biology, University of York, York, UK
- York Biomedical Research Institute, University of York, York, UK
| | | | - Joshua D Kaggie
- Department of Radiology & NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | | | - Lewis Patten
- Department of Mathematics, University of York, York, UK
| | | | - Swen Langer
- Bioscience Technology Facility, Department of Biology, University of York, York, UK
| | | | - Frank Riemer
- Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital Bergen, Bergen, Norway
| | - Gabrielle Baxter
- Department of Radiology & NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Mary A McLean
- Department of Radiology & NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology & NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Aneurin J Kennerley
- York Biomedical Research Institute, University of York, York, UK
- Department of Chemistry, University of York, York, UK
| | - William J Brackenbury
- Department of Biology, University of York, York, UK.
- York Biomedical Research Institute, University of York, York, UK.
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Zhuang D, Zhang H, Hu G, Guo B. Recent development of contrast agents for magnetic resonance and multimodal imaging of glioblastoma. J Nanobiotechnology 2022; 20:284. [PMID: 35710493 PMCID: PMC9204881 DOI: 10.1186/s12951-022-01479-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/29/2022] [Indexed: 11/28/2022] Open
Abstract
Glioblastoma (GBM) as the most common primary malignant brain tumor exhibits a high incidence and degree of malignancy as well as poor prognosis. Due to the existence of formidable blood–brain barrier (BBB) and the aggressive growth and infiltrating nature of GBM, timely diagnosis and treatment of GBM is still very challenging. Among different imaging modalities, magnetic resonance imaging (MRI) with merits including high soft tissue resolution, non-invasiveness and non-limited penetration depth has become the preferred tool for GBM diagnosis. Furthermore, multimodal imaging with combination of MRI and other imaging modalities would not only synergistically integrate the pros, but also overcome the certain limitation in each imaging modality, offering more accurate morphological and pathophysiological information of brain tumors. Since contrast agents contribute to amplify imaging signal output for unambiguous pin-pointing of tumors, tremendous efforts have been devoted to advances of contrast agents for MRI and multimodal imaging. Herein, we put special focus on summary of the most recent advances of not only MRI contrast agents including iron oxide-, manganese (Mn)-, gadolinium (Gd)-, 19F- and copper (Cu)-incorporated nanoplatforms for GBM imaging, but also dual-modal or triple-modal nanoprobes. Furthermore, potential obstacles and perspectives for future research and clinical translation of these contrast agents are discussed. We hope this review provides insights for scientists and students with interest in this area.
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Affiliation(s)
- Danping Zhuang
- The Second Clinical Medical College, Jinan University, Shenzhen, Guangdong, 518020, China
| | - Huifen Zhang
- Department of Radiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China
| | - Genwen Hu
- Department of Radiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, 518020, Guangdong, China.
| | - Bing Guo
- School of Science and Shenzhen Key Laboratory of Flexible Printed Electronics Technology, Harbin Institute of Technology, Shenzhen, 518055, China.
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18
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Bücker P, Funke SKI, Factor C, Rasschaert M, Robert P, Sperling M, Karst U. Combined speciation analysis and elemental bioimaging provides new insight into gadolinium retention in kidney. Metallomics 2022; 14:6527577. [PMID: 35150284 DOI: 10.1093/mtomcs/mfac004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/31/2022] [Indexed: 11/14/2022]
Abstract
This study uses a leaching approach in combination with elemental bioimaging and speciation analysis to obtain insight into the gadolinium species present in the kidney of rats that were treated with either a linear or a macrocyclic gadolinium-based contrast agent. Fresh frozen thin sections of the harvested kidneys were immersed halfway into water to wash out hydrophilic species and subsequently analyzed by laser ablation-inductively coupled plasma-mass spectrometry. The water-extracted gadolinium species were analyzed by means of hydrophilic interaction liquid chromatography-inductively coupled plasma-mass spectrometry. Information on the water-soluble species could not only be obtained from the full kidney, but also be traced back to its localization in the tissue. On longitudinal kidney sections treated with gadobutrol, it was found that water-insoluble, permanent Gd depositions were mainly located in the renal cortex, while water-soluble species were found in the medulla, which contains the intact contrast agent up to one year after injection. Moreover, kidney samples from gadodiamide-treated rats showed more water-insoluble Gd deposition in both cortex and medulla, while the concentration of intact contrast agent in the water-soluble fraction was below the limit of detection after twelve months. In conclusion, this rapid approach allowed the spatially resolved differentiation between water-soluble and insoluble gadolinium deposition and is therefore capable of generating new insight into the retention and transportation behavior of gadolinium.
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Affiliation(s)
- Patrick Bücker
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 28/30, Münster 48149, Germany
| | - Sabrina K I Funke
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 28/30, Münster 48149, Germany
| | - Cécile Factor
- Department of Research and Innovation, Guerbet, Roissy CDG, France
| | | | - Philippe Robert
- Department of Research and Innovation, Guerbet, Roissy CDG, France
| | - Michael Sperling
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 28/30, Münster 48149, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstrasse 28/30, Münster 48149, Germany
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The Effect of Gadolinium-Based Contrast Agents on Longitudinal Changes of Magnetic Resonance Imaging Signal Intensities and Relaxation Times in the Aging Rat Brain. Invest Radiol 2022; 57:453-462. [PMID: 35125411 PMCID: PMC9172901 DOI: 10.1097/rli.0000000000000857] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the study was to investigate the possible influence of changes in the brain caused by age on relaxometric and relaxation time–weighted magnetic resonance imaging (MRI) parameters in the deep cerebellar nuclei (DCN) and the globus pallidus (GP) of Gd-exposed and control rats over the course of 1 year.
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20
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Jacobi A, Ariza de Schellenberger A, Uca YO, Herbig M, Guck J, Sack I. Real-Time Deformability Cytometry Detects Leukocyte Stiffening After Gadolinium-Based Contrast Agent Exposure. Invest Radiol 2021; 56:837-844. [PMID: 34038063 DOI: 10.1097/rli.0000000000000794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Reports on gadolinium (Gd) retention in soft tissues after administration of Gd-based contrast agents (GBCAs) raise concerns about Gd-induced changes in the biophysical properties of cells and tissues. Here, we investigate if clinical GBCAs of both classes of linear and macrocyclic structure cause changes in the mechanical properties of leukocytes in human blood samples. MATERIAL AND METHODS Real-time deformability cytometry was applied to human blood samples from 6 donors. The samples were treated with 1 mM gadoteric acid (Dotarem), gadopentetic acid (Magnevist), gadobutrol (Gadovist), or Gd trichloride at 37°C for 1 hour to mimic clinical doses of GBCAs and exposure times. Leukocyte subtypes-lymphocytes, monocytes, and neutrophils-were identified based on their size and brightness and analyzed for deformability, which is inversely correlated with cellular stiffness. RESULTS We observed significant stiffening (3%-13%, P < 0.01) of all investigated leukocyte subtypes, which was most pronounced for lymphocytes, followed by neutrophils and monocytes, and the effects were independent of the charge and steric structure of the GBCA applied. In contrast, no changes in cell size and brightness were observed, suggesting that deformability and cell stiffness measured by real-time deformability cytometry are sensitive to changes in the physical phenotypes of leukocytes after GBCA exposure. CONCLUSIONS Real-time deformability cytometry might provide a quantitative blood marker for critical changes in the physical properties of blood cells in patients undergoing GBCA-enhanced magnetic resonance imaging.
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Affiliation(s)
| | - Angela Ariza de Schellenberger
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin
| | - Yavuz Oguz Uca
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin
| | | | - Jochen Guck
- From the Max Planck Institute for the Science of Light & Max-Planck-Zentrum für Physik und Medizin, Erlangen
| | - Ingolf Sack
- Department of Radiology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin
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21
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Trapasso G, Chiesa S, Freitas R, Pereira E. What do we know about the ecotoxicological implications of the rare earth element gadolinium in aquatic ecosystems? THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 781:146273. [PMID: 33813143 DOI: 10.1016/j.scitotenv.2021.146273] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/04/2021] [Accepted: 02/28/2021] [Indexed: 06/12/2023]
Abstract
Gadolinium (Gd) is one of the most commercially exploited rare earth elements, commonly employed in magnetic resonance imaging as a contrast agent. The present review was performed aiming to identify the Gd concentrations in marine and freshwater environments. In addition, information on Gd speciation in the environment is discussed, in order to understand how each chemical form affects its fate in the environment. Biological responses caused by Gd exposure and its bioaccumulation in different aquatic invertebrates are also discussed. This review was devoted to aquatic invertebrates, since this group of organisms includes species widely used as bioindicators of pollution and they represent important resources for human socio-economic development, as edible seafood, fishing baits and providing food resources for other species. From the literature, most of the published data are focused on freshwater environments, revealing concentrations from 0.347 to 80 μg/L, with the highest Gd anomalies found close to highly industrialized areas. In marine environments, the published studies identified a range of concentrations between 0.36 and 26.9 ng/L (2.3 and 171.4 pmol/kg), reaching 409.4 ng/L (2605 pmol/kg) at a submarine outfall. Concerning the bioaccumulation and effects of Gd in aquatic species, most of the literature regards to freshwater species, revealing concentration ranging from 0.006 to 0.223 μg/g, with high variability in the bioaccumulation extent according to Gd complexes chemical speciation. Conversely, no field data concerning Gd bioaccumulation in tissues of marine species have been published. Finally, impacts of Gd in invertebrate aquatic species were identified at different biological levels, including alterations on gene expression, cellular homeostasis, shell formation, metabolic capacity and antioxidant mechanisms. The information here presented highlights that Gd may represent an environmental threat and a risk to human health, demonstrating the need for further research on Gd toxicity towards aquatic wildlife and the necessity for new water remediation strategies.
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Affiliation(s)
- Giacomo Trapasso
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, Italy
| | - Stefania Chiesa
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, Italy; ISPRA, The Italian Institute for Environmental Protection and Research, Rome, Italy
| | - Rosa Freitas
- Departamento de Biologia & CESAM, Universidade de Aveiro, Portugal.
| | - Eduarda Pereira
- Departamento de Química & REQUIMTE, Universidade de Aveiro, Portugal
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Lotz M, Ghebremichael M, Chervinsky K, Zorc T, Brenner C, Bousvaros G, Pories SE. Effective Surveillance of High-Risk Women. Clin Breast Cancer 2021; 22:e263-e269. [PMID: 34429241 DOI: 10.1016/j.clbc.2021.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/28/2021] [Accepted: 07/24/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND This study addresses the effectiveness of risk models and screening breast magnetic resonance imaging (MRI) in women who have atypical hyperplasia (AH), lobular carcinoma in situ (LCIS), or a family history of breast cancer, but not a genetic mutation. PATIENTS AND METHODS A retrospective review of 444 women who had 458 breast screening MRIs at a community teaching hospital over a 12-month period between March 25, 2014 and March 31, 2015 was performed. The patients underwent high risk screening with breast MRIs alternating with mammograms every 6 months. After excluding patients with prior breast or ovarian cancer, genetic mutations, and chest wall radiation, 200 remaining patients constituted the study cohort. Over the following 5 years, the patients were screened with MRIs alternating with mammograms every 6 months. A total of 961 total MRI screenings were performed over the entire 5-year period of the study. RESULTS A total of 200 women fit the study criteria. Of these 103 had a prior history of AH or LCIS. Over the 5-year period, 60 women dropped out of the screening regimen, 6 patients were diagnosed with breast cancer on screening MRIs, and 2 additional patients were diagnosed with breast cancer on screening mammograms. Surprisingly, the highest Tyrer-Cuzick (T-C) scores did not correlate with increased development of breast cancers in our population. CONCLUSIONS This study shows that there is wide variation in the results of risk assessment models. Risk models may overestimate breast cancer risk, suggesting that re-evaluation of current risk assessment and screening protocols is warranted.
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Affiliation(s)
- Margaret Lotz
- Hoffman Breast Center, Mount Auburn Hospital, Cambridge, MA
| | - Musie Ghebremichael
- Harvard Medical School, Boston, MA; The Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA
| | | | - Thomas Zorc
- Hoffman Breast Center, Mount Auburn Hospital, Cambridge, MA
| | | | | | - Susan E Pories
- Hoffman Breast Center, Mount Auburn Hospital, Cambridge, MA; Harvard Medical School, Boston, MA.
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Peller M, Lanza A, Wuttke S. MRI‐Active Metal‐Organic Frameworks: Concepts for the Translation from Lab to Clinic. ADVANCED THERAPEUTICS 2021. [DOI: 10.1002/adtp.202100067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Michael Peller
- Department of Radiology University Hospital, LMU Munich Munich 80539 Germany
| | - Arianna Lanza
- Center for Nanotechnology Innovation @NEST Istituto Italiano di Tecnologia Pisa 56127 Italy
| | - Stefan Wuttke
- BCMaterials Basque Center for Materials UPV/EHU Science Park Leioa 48940 Spain
- Ikerbasque‐Basque Foundation for Science Bilbao 48011 Spain
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24
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Influence of aging and gadolinium exposure on T1, T2, and T2*-relaxation in healthy women with an increased risk of breast cancer with and without prior exposure to gadoterate meglumine at 3.0-T brain MR imaging. Eur Radiol 2021; 32:331-345. [PMID: 34218287 PMCID: PMC8660719 DOI: 10.1007/s00330-021-08069-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/30/2021] [Accepted: 05/11/2021] [Indexed: 11/09/2022]
Abstract
Objectives We examined the effects of aging and of gadolinium-based contrast agent (GBCA) exposure on MRI measurements in brain nuclei of healthy women. Methods This prospective, IRB-approved single-center case-control study enrolled 100 healthy participants of our high-risk screening center for hereditary breast cancer, who had received at least six doses of macrocyclic GBCA (exposed group) or were newly entering the program (GBCA-naïve group). The cutoff “at least six doses” was chosen to be able to include a sufficient number of highly exposed participants. All participants underwent unenhanced 3.0-T brain MRI including quantitative T1, T2, and R2* mapping and T1- and T2-weighted imaging. The relaxation times/signal intensities were derived from region of interest measurements in the brain nuclei performed by a radiologist and a neuroradiologist, both board certified. Statistical analysis was based on descriptive evaluations and uni-/multivariable analyses. Results The participants (exposed group: 49, control group: 51) were aged 42 ± 9 years. In a multivariable model, age had a clear impact on R2* (p < 0.001–0.012), T2 (p = 0.003–0.048), and T1 relaxation times/signal intensities (p < 0.004–0.046) for the majority of deep brain nuclei, mostly affecting the substantia nigra, globus pallidus (GP), nucleus ruber, thalamus, and dentate nucleus (DN). The effect of prior GBCA administration on T1 relaxation times was statistically significant for the DN, GP, and pons (p = 0.019–0.037). Conclusions In a homogeneous group of young to middle-aged healthy females aging had an effect on T2 and R2* relaxation times and former GBCA applications influenced the measured T1 relaxation times. Key Points The quantitative T1, T2, and R2* relaxation times measured in women at high risk of developing breast cancer showed characteristic bandwidth for all brain nuclei examined at 3.0-T MRI. The effect of participant age had a comparatively strong impact on R2*, T2, and T1 relaxation times for the majority of brain nuclei examined. The effect of prior GBCA administrations on T1 relaxation times rates was comparatively less pronounced, yielding statistically significant results for the dentate nucleus, globus pallidus, and pons.
Summary statement Healthy women with and without previous GBCA-enhanced breast MRI exhibited age-related T2* and T2 relaxation alterations at 3.0 T-brain MRI. T1 relaxation alterations due to prior GBCA administration were comparatively less pronounced. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-021-08069-4.
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25
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Zarei F, Ghaedian M, Ghaedian T. The role of contrast-enhanced and non-contrast-enhanced MRI in the follow-up of multiple sclerosis. Acta Radiol 2021; 62:916-921. [PMID: 32762243 DOI: 10.1177/0284185120946714] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Magnetic resonance imaging (MRI) is widely used in patients with multiple sclerosis (MS) for different indications. However, frequent administration of gadolinium in these patients can have some potential complications. So, a more limited approach reducing the use of gadolinium should be considered. PURPOSE To evaluate the additional benefits of contrast-enhanced MRI over non-contrast-enhanced MRI in routine follow-up of patients with MS. MATERIAL AND METHODS This is a retrospective cohort study including patients with MS who underwent both contrast-enhanced and non-contrast-enhanced MRI for two time-points with an interval of at least six months. Non-contrast-enhanced images were compared for each patient and interpreted as non-progressive or progressive disease. Then, rate and type of enhancing lesions were analyzed and compared between the groups. All images were reviewed and compared visually by two radiologists. RESULTS A total of 462 patients (392 women; mean age = 36 years) were included. Of these patients, 352 were in the non-progressive group and 112 were in progressive group. Comparison of baseline and follow-up contrast-enhanced MRIs revealed that 13 (3.7%) patients in the non-progressive group and 58 (51.8%) patients in progressive group developed enhancing lesions (P < 0.001). All 58 patients in the progressive group developed new enhancing lesions, whereas all those in the non-progressive group revealed persistent or reactivated enhancing lesions without evidence of new lesions. CONCLUSION According to the very low incidence rate of new enhancing lesions in patients with non-progressive disease on follow-up non-contrast-enhanced MRI, routine administration of contrast in follow-up studies is not suggested.
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Affiliation(s)
- Fariba Zarei
- Department of Radiology, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrnaz Ghaedian
- Department of Radiology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Ghaedian
- Nuclear Medicine and Molecular Imaging Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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26
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Trapasso G, Coppola F, Queirós V, Henriques B, Soares AMVM, Pereira E, Chiesa S, Freitas R. How Ulva lactuca can influence the impacts induced by the rare earth element Gadolinium in Mytilus galloprovincialis? The role of macroalgae in water safety towards marine wildlife. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 215:112101. [PMID: 33765593 DOI: 10.1016/j.ecoenv.2021.112101] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
Rare earth elements (REEs) are gaining growing attention in environmental and ecotoxicological studies due to their economic relevance, wide range of applications and increasing environmental concentrations. Among REEs, special consideration should be given to Gadolinium (Gd), whose wide exploitation as a magnetic resonance imaging (MRI) contrast agent is enhancing the risk of its occurrence in aquatic environments and impacts on aquatic organisms. A promising approach for water decontamination from REEs is sorption, namely through the use of macroalgae and in particular Ulva lactuca that already proved to be an efficient biosorbent for several chemical elements. Therefore, the present study aimed to evaluate the toxicity of Gd, comparing the biochemical effects induced by this element in the presence or absence of algae. Using the bivalve species Mytilus galloprovincialis, Gd toxicity was evaluated by assessing changes on mussels' metabolic capacity and oxidative status. Results clearly showed the toxicity of Gd but further revealed the capacity of U. lactuca to prevent injuries to M. galloprovincialis, mainly reducing the levels of Gd in water and thus the bioaccumulation and toxicity of this element by the mussels. The results will advance the state of the art not only regarding the effects of REEs but also with regard to the role of algae in accumulation of metals and protection of aquatic organisms, generating new insights on water safety towards aquatic wildlife and highlighting the possibility for resources recovery.
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Affiliation(s)
- Giacomo Trapasso
- Departamento de Biologia, Universidade de Aveiro, 3810-193 Aveiro, Portugal; Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, Mestre, 30172 Venice, Italy
| | - Francesca Coppola
- Departamento de Biologia, Universidade de Aveiro, 3810-193 Aveiro, Portugal; CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Vanessa Queirós
- Departamento de Biologia, Universidade de Aveiro, 3810-193 Aveiro, Portugal; CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Bruno Henriques
- CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal; Departamento de Química, Universidade de Aveiro, 3810-193 Aveiro, Portugal; LAVQ-REQUIMTE, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Amadeu M V M Soares
- Departamento de Biologia, Universidade de Aveiro, 3810-193 Aveiro, Portugal; CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Eduarda Pereira
- Departamento de Química, Universidade de Aveiro, 3810-193 Aveiro, Portugal; LAVQ-REQUIMTE, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - Stefania Chiesa
- Department of Molecular Sciences and Nanosystems, Ca' Foscari University of Venice, Mestre, 30172 Venice, Italy; ISPRA, The Italian Institute for Environmental Protection and Research, 00144 Rome, Italy
| | - Rosa Freitas
- Departamento de Biologia, Universidade de Aveiro, 3810-193 Aveiro, Portugal; CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal.
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Affiliation(s)
- Val M Runge
- From the Department of Diagnostic, Interventional, and Pediatric Radiology, University Hospital of Bern, Inselspital, University of Bern, Bern, Switzerland
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Ozturk K, Nascene D. Susceptibility-Weighted Imaging of the Pediatric Brain after Repeat Doses of Gadolinium-Based Contrast Agent. AJNR Am J Neuroradiol 2021; 42:1136-1143. [PMID: 33888459 DOI: 10.3174/ajnr.a7143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/17/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Gadolinium complexes have paramagnetic properties; thus, we aimed to determine the susceptibility changes in the globus pallidus and dentate nucleus following administration of linear or macrocyclic gadolinium-based contrast agents in children. MATERIALS AND METHODS Thirty-three patients with linear gadolinium-based contrast agent gadopentetate dimeglumine administration, 33 age- and sex-matched patients with macrocyclic gadolinium-based contrast agent gadobutrol administration, and 33 age- and sex-matched control subjects without gadolinium exposure were enrolled in this retrospective study. The signal intensity on SWI and T1WI was determined in the dentate nucleus, middle cerebellar peduncle, globus pallidus, and pulvinar of the thalamus in an ROI-based analysis to calculate dentate nucleus-to-middle cerebellar peduncle and globus pallidus-to-thalamus ratios. A repeated measures ANOVA was performed to compare SWIminimum, SWImean, and T1WI signal intensity ratios between gadolinium-based contrast agent groups and control subjects. Pearson correlation analysis was performed to determine any correlation between signal intensity ratios and variables. RESULTS Dentate nucleus-to-middle cerebellar peduncle and globus pallidus-to-thalamus ratios for both SWImean and SWIminimum were lower for the linear gadolinium-based contrast agent group compared with macrocyclic gadolinium-based contrast agent and control groups (P < .05). No significant difference of the SWImean and SWIminimum ratios were noted between the macrocyclic gadolinium-based contrast agent group and the control group (P > .05). Both dentate nucleus-to-middle cerebellar peduncle and globus pallidus-to-thalamus ratios on T1WI in the linear gadolinium-based contrast agent group were higher than in the control group and the macrocyclic gadolinium-based contrast agent group (P < .05). A negative correlation was identified between SWImean and SWIminimum ratios and the number of linear gadolinium-based contrast agent administrations (dentate nucleus-to-middle cerebellar peduncle ratio: SWImean, r = -0.43, P = .005; SWIminimum, r = -0.38, P = .011; globus pallidus-to-thalamus ratio: SWImean, r = -0.39, P = .009; SWIminimum, r = -0.33, P = .017). CONCLUSIONS SWI analysis of the pediatric brain demonstrated a statistically significant decrease in SWIminimum and SWImean values for the dentate nucleus and globus pallidus after administration of linear gadolinium-based contrast agents but not macrocyclic gadolinium-based contrast agents.
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Affiliation(s)
- K Ozturk
- From the Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - D Nascene
- From the Department of Radiology, University of Minnesota, Minneapolis, Minnesota
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Laniyonu A, Ouyang Y, Cohen J, Awe S, Dina O, Biade S, Hargus S, Kokate T. Nonclinical Product Developmental Strategies, Safety Considerations and Toxicity Profiles of Medical Imaging and Radiopharmaceuticals Products. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Molecular magnetic resonance (MR) imaging utilizes molecular probes to provide added biochemical or cellular information to what can already be achieved with anatomical and functional MR imaging. This review provides an overview of molecular MR and focuses specifically on molecular MR contrast agents that provide contrast by shortening the T1 time. We describe the requirements for a successful molecular MR contrast agent and the challenges for clinical translation. The review highlights work from the last 5 years and places an emphasis on new contrast agents that have been validated in multiple preclinical models. Applications of molecular MR include imaging of inflammation, fibrosis, fibrogenesis, thromboembolic disease, and cancers. Molecular MR is positioned to move beyond detection of disease to the quantitative staging of disease and measurement of treatment response.
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Affiliation(s)
| | | | - Peter Caravan
- The Institute for Innovation in Imaging, A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts 02129, USA
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Use of Superparamagnetic Iron Oxide Nanoparticles (SPIONs) via Multiple Imaging Modalities and Modifications to Reduce Cytotoxicity: An Educational Review. JOURNAL OF NANOTHERANOSTICS 2020. [DOI: 10.3390/jnt1010008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The aim of the present educational review on superparamagnetic iron oxide nanoparticles (SPIONs) is to inform and guide young scientists and students about the potential use and challenges associated with SPIONs. The present review discusses the basic concepts of magnetic resonance imaging (MRI), basic construct of SPIONs, cytotoxic challenges associated with SPIONs, shape and sizes of SPIONs, site-specific accumulation of SPIONs, various methodologies applied to reduce cytotoxicity including coatings with various materials, and application of SPIONs in targeted delivery of chemotherapeutics (Doxorubicin), biotherapeutics (DNA, siRNA), and positron emission tomography (PET) imaging applications.
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Cloverleaf Sign in Pelvic Magnetic Resonance Imaging for Deep Infiltrating Endometriosis: Association With Longer Operation Times, Greater Blood Loss, and Higher Rates of Bowel Resection. Invest Radiol 2020; 55:53-59. [PMID: 31633573 DOI: 10.1097/rli.0000000000000612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the significance of a new imaging sign, the "cloverleaf sign," in diagnosing deep infiltrating endometriosis (DIE) with magnetic resonance imaging (MRI) in concordance to intraoperative findings. MATERIALS AND METHODS This retrospective study included 103 patients operated during the January 2016 to June 2018 period with preoperative 1.5 T and 3 T MRI, with or without vaginal and rectal gel filling. Magnetic resonance imaging scans were read blinded to intraoperative findings by a specialized gynecologic radiologist and a junior radiologist, and then compared with intraoperative findings by looking at the operation report, postoperative diagnosis, and intraoperative images and videos by an experienced gynecologist surgeon specialized in endometriosis surgery. All endometriosis lesions were confirmed by pathology. The "cloverleaf sign" was defined as a cloverleaf-like figure in imaging morphology; the "leaves" formed by at least 3 different organs come together in the center of the figure formed by constrictive adhesions including T2-weighted (T2W) hypointense DIE. Operation times, intraoperative blood loss, and the frequency of DIE and bowel resections were analyzed in cloverleaf and noncloverleaf groups. The 2-sample Wilcoxon rank-sum (Mann-Whitney U) test and multivariate analysis of variance were used to calculate the significance of an overall impact of cloverleaf sign on operation time, blood loss, and the amount of the bowel resection rate. P < 0.05 was considered statistically significant. RESULTS The prevalence of DIE in the study population was 79.6%. A total of 11.5% of the patients had no endometriosis, 32.6% had rASRM I and II, and 55.9% had rASRM III and IV. Forty-six patients (45%) had received rectal and vaginal gel opacification before scanning, 57 (55%) did not. A cloverleaf sign on MRI was detected in 34 patients (15 in gel filling and 19 in nonfilling group). The interreader agreement was almost perfect 0.91 (κ). The median operation time in the cloverleaf group was 248 minutes (interquartile range [IQR], 165-330) compared with 145 minutes in the noncloverleaf group (IQR, 90-210), that is, significantly higher (P < 0.001). Intraoperative blood loss was also significantly higher in the conglomerate group (125 vs 50 mL; IQR, 100-300 vs 50-100; P < 0.001). Of the bowel resections in our study population, 41% (14/34) were performed on patients with a cloverleaf sign in the MRI, compared with 13% (9/69) in patients without the cloverleaf sign. CONCLUSIONS The "cloverleaf" MRI sign was associated with significantly longer operation time, increased intraoperative blood loss, and higher rates of bowel resection in DIE patients.
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Stephan S, Reiss S, Lottner T, Özen AC, Bock M. Catheter-based Arterial Input Function Determination for Myocardial Perfusion Measurements. Z Med Phys 2020; 31:65-72. [PMID: 32873440 DOI: 10.1016/j.zemedi.2020.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 07/23/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
The quantification of myocardial perfusion with contrast agent (CA) tracers requires the precise knowledge of the arterial input function (AIF). In this study a method for MR-guided vascular interventions is evaluated that determines the AIF via an active tracking catheter during targeted CA injection. A phantom experiment with a dialysis filter was conducted to measure the AIF using an active catheter and a dynamic image series as reference. To compensate for dilution and coil sensitivity effects, correction methods were developed for the catheter-based AIF determination. From the dynamic MR measurements in the perfusion phantom quantitative perfusion maps were calculated by a deconvolution of the measured CA concentration with the AIF, and additional flow measurements were used to normalize the perfusion map. The signal-time-curves of the measured AIF using the catheter-based and imaging-based methods agree while the absolute values differ by a scaling factor of about 9. After normalization to the surrounding flow, both perfusion techniques are in excellent agreement. Catheter-based AIF measurements are feasible but require an additional normalization which can be determined from a flow measurement. The technique might enable faster perfusion measurements during cardiovascular interventions.
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Affiliation(s)
- Simon Stephan
- Department of Radiology - Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Simon Reiss
- Department of Radiology - Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Thomas Lottner
- Department of Radiology - Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ali Caglar Özen
- Department of Radiology - Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bock
- Department of Radiology - Medical Physics, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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Lunyera J, Mohottige D, Alexopoulos AS, Campbell H, Cameron CB, Sagalla N, Amrhein TJ, Crowley MJ, Dietch JR, Gordon AM, Kosinski AS, Cantrell S, Williams JW, Gierisch JM, Ear B, Goldstein KM. Risk for Nephrogenic Systemic Fibrosis After Exposure to Newer Gadolinium Agents: A Systematic Review. Ann Intern Med 2020; 173:110-119. [PMID: 32568573 PMCID: PMC7847719 DOI: 10.7326/m20-0299] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The risk for nephrogenic systemic fibrosis (NSF) after exposure to newer versus older gadolinium-based contrast agents (GBCAs) remains unclear. PURPOSE To synthesize evidence about NSF risk with newer versus older GBCAs across the spectrum of kidney function. DATA SOURCES MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science for English-language references from inception to 5 March 2020. STUDY SELECTION Randomized controlled trials, cohort studies, and case-control studies that assessed NSF occurrence after GBCA exposure. DATA EXTRACTION Data were abstracted by 1 investigator and verified by a second. Investigator pairs assessed risk of bias by using validated tools. DATA SYNTHESIS Of 32 included studies, 20 allowed for assessment of NSF risk after exposure to newer GBCAs and 12 (11 cohort studies and 1 case-control study) allowed for comparison of NSF risk between newer and older GBCAs. Among 83 291 patients exposed to newer GBCAs, no NSF cases developed (exact 95% CI, 0.0001 to 0.0258 case). Among the 12 studies (n = 118 844) that allowed risk comparison between newer and older GBCAs, 37 NSF cases developed after exposure to older GBCAs (exact CI, 0.0001 to 0.0523 case) and 4 occurred (3 confounded) after exposure to newer GBCAs (exact CI, 0.0018 to 0.0204 case). Data were scant for patients with acute kidney injury or those at risk for chronic kidney disease. LIMITATIONS Study heterogeneity prevented meta-analysis. Risk of bias was high in most studies because of inadequate exposure and outcome ascertainment. CONCLUSION Although NSF occurrence after exposure to newer GBCAs is very rare, the relatively scarce data among patients with acute kidney injury and those with risk factors for chronic kidney disease limit conclusions about safety in these populations. PRIMARY FUNDING SOURCE U.S. Department of Veterans Affairs. (PROSPERO: CRD42019135783).
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Affiliation(s)
- Joseph Lunyera
- Duke University School of Medicine, Durham, North Carolina (J.L., C.B.C.)
| | - Dinushika Mohottige
- Duke University School of Medicine and Duke University Medical Center, Durham, North Carolina (D.M.)
| | - Anastasia-Stefania Alexopoulos
- Duke University Medical Center and Durham Veterans Affairs Health Care System, Durham, North Carolina (A.A., T.J.A., M.J.C.)
| | - Hilary Campbell
- Margolis Center for Health Policy at Duke University, Durham, North Carolina (H.C.)
| | - C Blake Cameron
- Duke University School of Medicine, Durham, North Carolina (J.L., C.B.C.)
| | - Nicole Sagalla
- Durham Veterans Affairs Health Care System and Duke University School of Medicine, Durham, North Carolina (N.S.)
| | - Timothy J Amrhein
- Duke University Medical Center and Durham Veterans Affairs Health Care System, Durham, North Carolina (A.A., T.J.A., M.J.C.)
| | - Matthew J Crowley
- Duke University Medical Center and Durham Veterans Affairs Health Care System, Durham, North Carolina (A.A., T.J.A., M.J.C.)
| | - Jessica R Dietch
- Stanford University and Veterans Affairs Palo Alto Health Care System, Palo Alto, California (J.R.D.)
| | - Adelaide M Gordon
- Durham Veterans Affairs Health Care System, Durham, North Carolina (A.M.G., B.E.)
| | - Andrzej S Kosinski
- Duke University Medical Center and Duke Clinical Research Institute, Durham, North Carolina (A.S.K.)
| | - Sarah Cantrell
- Duke University School of Medicine and Duke University Medical Center Library and Archives, Durham, North Carolina (S.C.)
| | - John W Williams
- Duke University School of Medicine and Durham Veterans Affairs Health Care System, Durham, North Carolina (J.W.W., K.M.G.)
| | - Jennifer M Gierisch
- Duke University School of Medicine, Durham Veterans Affairs Health Care System, and Duke University, Durham, North Carolina (J.M.G.)
| | - Belinda Ear
- Durham Veterans Affairs Health Care System, Durham, North Carolina (A.M.G., B.E.)
| | - Karen M Goldstein
- Duke University School of Medicine and Durham Veterans Affairs Health Care System, Durham, North Carolina (J.W.W., K.M.G.)
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Costelloe CM, Amini B, Madewell JE. Risks and Benefits of Gadolinium-Based Contrast-Enhanced MRI. Semin Ultrasound CT MR 2020; 41:170-182. [DOI: 10.1053/j.sult.2019.12.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Costelloe CM, Amini B, Madewell JE. WITHDRAWN: Risks and Benefits of Gadolinium-Based Contrast Enhanced MRI. Semin Ultrasound CT MR 2020; 41:260-274. [PMID: 32446435 DOI: 10.1053/j.sult.2020.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The Publisher regrets that this article is an accidental duplication of an article that has already been published in [Seminars in Ultrasound, CT, and MRI, 41/2 (2020) 170–182], https://dx.doi.org/10.1053/j.sult.2019.12.005. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal
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Affiliation(s)
- Colleen M Costelloe
- Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Behrang Amini
- Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
| | - John E Madewell
- Division of Diagnostic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX
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Urbanovský P, Kotek J, Císařová I, Hermann P. The solid-state structures and ligand cavity evaluation of lanthanide(iii) complexes of a DOTA analogue with a (dibenzylamino)methylphosphinate pendant arm. Dalton Trans 2020; 49:1555-1569. [PMID: 31932828 DOI: 10.1039/c9dt04056k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A series of lanthanide(iii) complexes of a monophosphinate analogue of H4dota, 1,4,7,10-tetraazacyclododecane-1,4,7-triacetic-10-methyl[(N,N-dibenzylamino)methyl]phosphinic acid (H4do3apDBAm = H4L1), were prepared and their solid-state structures were studied using single-crystal X-ray diffraction. In all structures, the ligand anion was octadentately coordinated to the Ln(iii) or Sc(iii) ions similarly to other DOTA-like ligands, i.e. forming parallel N4- and O4-planes. The lighter lanthanide(iii) complexes (till dysprosium) were nonacoordinated in the twisted square-antiprismatic (TSA) configuration with the apical coordination of water molecules or oxygen atoms from the neighbouring complex unit. The heavier lanthanide(iii) complexes (from terbium) were found as the "anhydrous" octacoordinated twisted square-antiprismatic (TSA') isomer. For the terbium(iii) ion, both forms were structurally characterized. The structural data of the Ln(iii)-H4L1 complexes and complexes of several related DOTA-like ligands were analysed. It clearly showed that the structural parameters for the square-antiprismatic (SA) isomers were clustered in a small range while those for the TSA/TSA' isomers were significantly more spread. The analysis also gave useful information about the influence of various pendant arms on the structure of the complexes of the DOTA-like ligands. The twist angle (torsion) of the chelate ring containing a larger phosphorus atom was similar to those of the remaining three acetate pendants. It led to a larger separation of the N4O4 planes and to smaller trans-O-Ln-O angles than the parameters found in the complexes of H4dota and its tetraamide derivatives dotam(R). It resulted in a relatively long bond between the metal ion and the coordinated water molecule. It led, together with the negative charge of the oxygen atoms forming the O4-plane, to an extremely fast water exchange rate reported for the Gd(iii)-H4L1 complex and, generally, to a fast water exchange of Gd(iii) complexes with the monophosphorus acid analogues of H4dota, H5do3ap/H4do3apR.
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Affiliation(s)
- Peter Urbanovský
- Universita Karlova (Charles University), Department of Inorganic Chemistry, Hlavova 2030, 128 43 Prague 2, Czech Republic.
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Gadolinium Retention in Erythrocytes and Leukocytes From Human and Murine Blood Upon Treatment With Gadolinium-Based Contrast Agents for Magnetic Resonance Imaging. Invest Radiol 2020; 55:30-37. [DOI: 10.1097/rli.0000000000000608] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Robert P, Vives V, Grindel AL, Kremer S, Bierry G, Louin G, Ballet S, Corot C. Contrast-to-Dose Relationship of Gadopiclenol, an MRI Macrocyclic Gadolinium-based Contrast Agent, Compared with Gadoterate, Gadobenate, and Gadobutrol in a Rat Brain Tumor Model. Radiology 2019; 294:117-126. [PMID: 31660804 DOI: 10.1148/radiol.2019182953] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background Detection of cerebral lesions at MRI may benefit from a chemically stable and more sensitively detected gadolinium-based contrast agent (GBCA). Gadopiclenol, a macrocyclic GBCA with at least twofold higher relaxivity, is currently undergoing clinical trials in humans. Purpose To determine the relationship between MRI contrast enhancement and the injected dose of gadopiclenol in a glioma rat model compared with those of conventional GBCA at label dose. Materials and Methods Between April and July 2012, 32 rats implanted with C6 glioma received two intravenous injections at a 24-hour interval. The injections were randomly selected among five doses of gadopiclenol (0.025, 0.05, 0.075, 0.1, and 0.2 mmol/kg) and three reference GBCAs (gadoterate meglumine, gadobutrol, and gadobenate dimeglumine) at 0.1 mmol/kg. MRI tumor enhancement was assessed on T1-weighted images before and up to 30 minutes after injection. Two blinded radiologists visually and qualitatively scored contrast enhancement, border delineation, and visualization of tumor morphology. Quantitatively, variations in contrast-to-noise ratio (ΔCNR) between tumor and contralateral parenchyma were calculated at each time point and were compared for each treatment at 5 minutes by using a mixed model after normality test. Results A total of 24 rats underwent the complete protocol (n = 5-7 per group). A linear dose-dependent ΔCNR relationship was observed between 0.025 and 0.1 mmol/kg for gadopiclenol (R 2 = 0.99). No difference in ΔCNR was observed between the three reference GBCAs (P ≥ .55). Gadopiclenol resulted in twofold higher ΔCNR at 0.1 mmol/kg (P < .001 vs gadobutrol and gadoterate, P = .002 vs gadobenate) and similar ΔCNR at 0.05 mmol/kg (P = .56, P > .99, and P = .44 compared with gadobutrol, gadobenate, and gadoterate, respectively). For both readers, 0.05 mmol/kg of gadopiclenol improved contrast enhancement, border delineation, and visualization of tumor morphology (scores > 3 compared with scores between 2 and 3 for the marketed GBCA). Conclusion Gadopiclenol at 0.05 mmol/kg yielded comparable change in contrast-to-noise ratio and morphologic characterization of brain tumors compared with gadobenate, gadoterate, or gadobutrol at 0.1 mmol/kg. Published under a CC BY 4.0 license. Online supplemental material is available for this article. See also the editorial by Tweedle in this issue.
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Affiliation(s)
- Philippe Robert
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Véronique Vives
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Anne-Laure Grindel
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Stéphane Kremer
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Guillaume Bierry
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Gaelle Louin
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Sébastien Ballet
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
| | - Claire Corot
- From the Department of Research and Innovation, Imaging and Biological Research Division, Guerbet Group, BP57400, 95943 Roissy CDG, France (P.R., V.V., A.L.G., G.L., S.B., C.C.); and Radiologie 2, CHU de Strasbourg, I-Cube, Université de Strasbourg, Strasbourg, France (S.K., G.B.)
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Runge VM. Clinical Safety of Gadoteridol, Representative of the Macrocyclic Class of Gadolinium‐Based Contrast Agents. J Magn Reson Imaging 2019; 51:869-870. [DOI: 10.1002/jmri.26957] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 11/10/2022] Open
Affiliation(s)
- Val Murray Runge
- Department of Diagnostic, Interventional and Pediatric RadiologyUniversity of Bern Bern Switzerland
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Bárta J, Hermann P, Kotek J. Coordination Behavior of 1,4-Disubstituted Cyclen Endowed with Phosphonate, Phosphonate Monoethylester, and H-Phosphinate Pendant Arms. Molecules 2019; 24:E3324. [PMID: 31547345 PMCID: PMC6767212 DOI: 10.3390/molecules24183324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 09/06/2019] [Accepted: 09/08/2019] [Indexed: 11/17/2022] Open
Abstract
Three 1,4,7,10-tetraazacyclododecane-based ligands disubstituted in 1,4-positions with phosphonic acid, phosphonate monoethyl-ester, and H-phosphinic acid pendant arms, 1,4-H4do2p, 1,4-H2do2pOEt, and 1,4-H2Bn2do2pH, were synthesized and their coordination to selected metal ions, Mg(II), Ca(II), Mn(II), Zn(II), Cu(II), Eu(III), Gd(III), and Tb(III), was investigated. The solid-state structure of the phosphonate ligand, 1,4-H4do2p, was determined by single-crystal X-ray diffraction. Protonation constants of the ligands and stability constants of their complexes were obtained by potentiometry, and their values are comparable to those of previously studied analogous 1,7-disubstitued cyclen derivatives. The Gd(III) complex of 1,4-H4do2p is ~1 order of magnitude more stable than the Gd(III) complex of the 1,7-analogue, probably due to the disubstituted ethylenediamine-like structural motif in 1,4-H4do2p enabling more efficient wrapping of the metal ion. Stability of Gd(III)-1,4-H2do2pOEt and Gd(III)-H2Bn2do2pH complexes is low and the constants cannot be determined due to precipitation of the metal hydroxide. Protonations of the Cu(II), Zn(II), and Gd(III) complexes probably takes place on the coordinated phosphonate groups. Complexes of Mn(II) and alkali-earth metal ions are significantly less stable and are not formed in acidic solutions. Potential presence of water molecule(s) in the coordination spheres of the Mn(II) and Ln(III) complexes was studied by variable-temperature NMR experiments. The Mn(II) complexes of the ligands are not hydrated. The Gd(III)-1,4-H4do2p complex undergoes hydration equilibrium between mono- and bis-hydrated species. Presence of two-species equilibrium was confirmed by UV-Vis spectroscopy of the Eu(III)-1,4-H4do2p complex and hydration states were also determined by luminescence measurements of the Eu(III)/Tb(III)-1,4-H4do2p complexes.
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Affiliation(s)
- Jiří Bárta
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43 Prague 2, Czech Republic.
| | - Petr Hermann
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43 Prague 2, Czech Republic.
| | - Jan Kotek
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43 Prague 2, Czech Republic.
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Evaluation of Gadopiclenol and P846, 2 High-Relaxivity Macrocyclic Magnetic Resonance Contrast Agents Without Protein Binding, in a Rodent Model of Hepatic Metastases. Invest Radiol 2019; 54:549-558. [DOI: 10.1097/rli.0000000000000572] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Gadolinium-based contrast agents are used routinely in magnetic resonance imaging (MRI). They can be detected over a long period of time in some tissues (skin, brain, bone). OBJECTIVES What is known on the pharmacokinetics of gadolinium-based contrast agents and on gadolinium deposition in various tissues? MATERIALS AND METHODS Fundamental research and expert recommendations are discussed. RESULTS Gadolinium-based contrast agents are distributed rapidly within the body and are eliminated by the kidneys. A fast initial elimination (half-life approximately 2 h) is followed by a slow elimination phase (half-life approximately 6 days), reflecting slow release from tissues. Deposition in the brain was observed mainly after administration of linear, non-ionic contrast agents. Whether gadolinium deposition in tissues consists of chelated or free gadolinium and whether otherwise healthy subjects are affected to a similar extent, is unclear. Currently, there are no proven risks associated with gadolinium deposition in the brain. CONCLUSIONS Risks and benefits should be considered on an individual basis before MRI with gadolinium-based contrast agents (expected benefit, potentially undetected risks, available alternatives and their risks). Quantification of gadolinium in urine or blood from patients is not meaningful and should not be done outside clinical studies.
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Gadolinium Presence in the Brain After Administration of the Liver-Specific Gadolinium-Based Contrast Agent Gadoxetate. Invest Radiol 2019; 54:468-474. [DOI: 10.1097/rli.0000000000000559] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wu M, Hou P, Dong L, Cai L, Chen Z, Zhao M, Li J. Manganese dioxide nanosheets: from preparation to biomedical applications. Int J Nanomedicine 2019; 14:4781-4800. [PMID: 31308658 PMCID: PMC6613456 DOI: 10.2147/ijn.s207666] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/23/2019] [Indexed: 12/15/2022] Open
Abstract
Advancements in nanotechnology and molecular biology have promoted the development of a diverse range of models to intervene in various disorders (from diagnosis to treatment and even theranostics). Manganese dioxide nanosheets (MnO2 NSs), a typical two-dimensional (2D) transition metal oxide of nanomaterial that possesses unique structure and distinct properties have been employed in multiple disciplines in recent decades, especially in the field of biomedicine, including biocatalysis, fluorescence sensing, magnetic resonance imaging and cargo-loading functionality. A brief overview of the different synthetic methodologies for MnO2 NSs and their state-of-the-art biomedical applications is presented below, as well as the challenges and future perspectives of MnO2 NSs.
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Affiliation(s)
- Muyu Wu
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China.,Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, People's Republic of China
| | - Pingfu Hou
- Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China
| | - Lina Dong
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China
| | - Lulu Cai
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China
| | - Zhudian Chen
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China
| | - Mingming Zhao
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China
| | - Jingjing Li
- School of Medical Imaging, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China.,Department of Radiology, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, People's Republic of China.,Institute of Medical Imaging and Digital Medicine, Xuzhou Medical University, Xuzhou 221004, Jiangsu, People's Republic of China
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Assessment of Pharmacokinetic, Pharmacodynamic Profile, and Tolerance of Gadopiclenol, A New High Relaxivity GBCA, in Healthy Subjects and Patients With Brain Lesions (Phase I/IIa Study). Invest Radiol 2019; 54:396-402. [DOI: 10.1097/rli.0000000000000556] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dechelation (Transmetalation): Consequences and Safety Concerns With the Linear Gadolinium-Based Contrast Agents, In View of Recent Health Care Rulings by the EMA (Europe), FDA (United States), and PMDA (Japan). Invest Radiol 2019; 53:571-578. [PMID: 30130320 DOI: 10.1097/rli.0000000000000507] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The issue of dechelation (transmetallation) in vivo after administration of the linear gadolinium-based contrast agents, and potential safety concerns, is considered on the basis of an extensive, focused literature review. Early indications of potential problems included the high level of excess ligand used in the formulation of 2 agents (indeed the 2 least stable thermodynamically) and interference with laboratory tests when blood was drawn from patients relatively soon after administration of these same agents. The advent of nephrogenic systemic fibrosis in the late 2000s raised additional major concerns.The correlation in 2014 of dentate nucleus hyperintensity on precontrast T1-weighted scans with multiple prior injections of linear gadolinium chelates, in patients with normal renal function, has driven subsequent research concerning dechelation of these agents in vivo. Unexpectedly high levels of gadolinium in the bone, skin, and liver have been found long term after administration, in animal models and in humans, although the latter data are limited. Bone may serve as a long-term reservoir, with a residual excretion phase for gadolinium after intravenous injection of the linear agents due to a subsequent slow release from bone. Many different patient populations could be vulnerable and potentially later develop clinical symptoms, although at this stage there are only limited data and small retrospective uncontrolled studies. Possible vulnerable populations include children, menopausal women, patients with osteoporosis (who are predisposed to fractures and often slow to heal or heal poorly), those receiving multiple doses, those with proinflammatory conditions, moderate renal dysfunction, or an undefined genetic predisposition. Of particular concern would be nephrogenic systemic fibrosis-like symptoms-including particularly pain and skin/joint symptoms, or disease related to the incorporation of gadolinium in hydroxyapatite in bone, in small subgroups of patients with a not yet defined propensity and/or cofactor. These concerns have led to withdrawal of the linear agents from the largest clinical market, Europe, with the exception of the hepatobiliary agents for delayed liver imaging, an indication that cannot be fulfilled by the current macrocyclic gadolinium chelates (for which these concerns do not apply).
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Provenzano DA, Pellis Z, DeRiggi L. Fatal gadolinium-induced encephalopathy following accidental intrathecal administration: a case report and a comprehensive evidence-based review. Reg Anesth Pain Med 2019; 44:rapm-2019-100422. [PMID: 31023932 DOI: 10.1136/rapm-2019-100422] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/04/2019] [Accepted: 03/08/2019] [Indexed: 12/13/2022]
Abstract
Gadolinium-based contrast agents (GBCAs) have been suggested as off-label alternatives to iodine-based contrast agents for fluoroscopic imaging during interventional pain procedures. We report a case of accidental intrathecal administration of a GBCA during a neuraxial interventional pain procedure leading to acute gadolinium neurotoxicity, which resulted in encephalopathy and ultimately death. To our knowledge, it is the first published case of fatal intrathecal gadolinium-induced encephalopathy and the first published case of intrathecal gadoteridol causing serious neurologic complications. In addition, the case presented here is placed in context with an associated comprehensive, evidence-based review of the use of gadolinium in interventional pain procedures, addressing gadolinium chemistry and pharmacologic properties, neurotoxicity and radiology. Physicians must be aware that gadolinium poses a significant risk of acute neurotoxicity even in small doses. Until further safety research is performed, GBCAs should not be considered a safe alternative for use in neuraxial interventional spine procedures when there is a risk of inadvertent intrathecal administration.
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Affiliation(s)
| | - Zachary Pellis
- Pain Diagnostics and Interventional Care, Sewickley, Pennsylvania, USA
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Pujales-Paradela R, Carniato F, Esteban-Gómez D, Botta M, Platas-Iglesias C. Controlling water exchange rates in potential Mn 2+-based MRI agents derived from NO2A 2. Dalton Trans 2019; 48:3962-3972. [PMID: 30834411 DOI: 10.1039/c9dt00211a] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We report a series of pentadentate ligands based on a 1,4,7-triazacyclononane-1,4-diacetic acid (H2NO2A) containing different substituents attached to the third nitrogen atom of the macrocyclic unit. Detailed 1H Nuclear Magnetic Relaxation Dispersion (NMRD) characterisation of the corresponding Mn2+ complexes suggests the formation of six-coordinate species in solution containing an inner-sphere water molecule. This was confirmed by recording the transverse 17O relaxation time and chemical shift measurements. The water exchange rate of the coordinated water molecule was found to be strongly influenced by the nature of the substituent R at position 7 of the triazacyclononane unit (R = Me, k298ex = 62.6 × 107 s-1; R = Bz, k298ex = 4.4 × 107 s-1; R = 1-phenylethyl, k298ex = 2.6 × 107 s-1). The decreasing exchange rates are explained by the increasing bulkiness of the substituent, which hinders the approach of the entering water molecule in an associatively activated water exchange mechanism. This is supported by DFT calculations (M062X/TZVP), which confirm the associative nature of the water exchange reaction. A potentially decadentate ligand containing two NO2A units linked by a xylenyl spacer in the meta position was also synthesised. The corresponding binuclear Mn2+ complex contains two metal ions with different hydration numbers, as evidenced by 1H NMRD and 17O NMR measurements. DFT calculations show that this is related to the presence of a bridging bidentate μ-η1-carboxylate group connecting the two metal centers. The results reported in this work provide a straightforward strategy to control the exchange rate of the coordinated water molecule in this family of MRI contrast agent candidates.
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Affiliation(s)
- Rosa Pujales-Paradela
- Universidade da Coruña, Centro de Investigacións Científicas Avanzadas (CICA) and Departamento de Química, Facultade de Ciencias, 15071, A Coruña, Galicia, Spain.
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