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Gräfe D, Simion SH, Rosolowski M, Merkenschlager A, Frahm J, Voit D, Hirsch FW. Brain deposition of gadobutrol in children-a cross-sectional and longitudinal MRI T1 mapping study. Eur Radiol 2023; 33:4580-4588. [PMID: 36520178 PMCID: PMC10289941 DOI: 10.1007/s00330-022-09297-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/04/2022] [Accepted: 11/13/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Depositions of linear gadolinium-based MRI contrast agents are readily visible in T1-weighted MRIs of certain brain regions in both adults and children. Macrocyclic contrast agents such as gadobutrol have so far escaped detection by qualitative MRI in children. This study aimed to assess whether there is evidence for deposition of gadobutrol in children using quantitative T1 mapping. METHODS This retrospective study included patients, naive to other gadolinium-based contrast agents than gadobutrol, who had received gadobutrol as part of a clinically indicated MRI. For each patient, T1 relaxation times at 3 T were measured using single-shot T1 mapping at two time points. In each of six brain regions, age-adjusted T1 relaxation times were correlated with a number of previous gadobutrol administrations. To combine interindividual, cross-sectional effects with intraindividual, longitudinal effects, both linear mixed model and generalized additive mixed model were applied. RESULTS One hundred four examinations of 52 children (age median 11.4, IQR 6.3-15, 26 female) with a median of 7 doses of gadobutrol in the history of their neurological or neurooncological disease were included. After correction for age and indeterminate disease-related effects to T1 time, a negative correlation of T1 time with the number of gadobutrol doses administered was observed in both mixed models in the putamen (beta - 1.65, p = .03) and globus pallidus (beta - 1.98, p = .012) CONCLUSIONS: The results indicate that in children, gadobutrol is deposited in the globus pallidus and putamen. KEY POINTS • Previous gadobutrol administration correlates with reduced T1 relaxation times in the globus pallidus and putamen in children. • This decreased T1 might be caused by gadobutrol retention within these gray-matter nuclei.
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Affiliation(s)
- Daniel Gräfe
- Department of Pediatric Radiology, University Hospital, Leipzig University, Liebigstraße 20a, 04103, Leipzig, Germany.
| | | | - Maciej Rosolowski
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | | | - Jens Frahm
- Biomedizinische NMR, Max-Planck-Institut für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Dirk Voit
- Biomedizinische NMR, Max-Planck-Institut für Multidisziplinäre Naturwissenschaften, Göttingen, Germany
| | - Franz Wolfgang Hirsch
- Department of Pediatric Radiology, University Hospital, Leipzig University, Liebigstraße 20a, 04103, Leipzig, Germany
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Zhang J, Xie L, Yang X, Xu L, Chen K, Luo Y, Yu C. Higher magnetic susceptibility of globus pallidus in patients after macrocyclic GBCAs: assessment using quantitative susceptibility mapping. Acta Radiol 2022:2841851221147618. [PMID: 36567675 DOI: 10.1177/02841851221147618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND As previous studies reported, gadolinium deposits in globus pallidus (GP) and dentate nucleus (DN) after repeated administrations of gadolinium-based contrast agents (GBCAs) and a signal intensity (SI) increase on T1-weighted images were related to linear GBCAs, not macrocyclic GBCAs. PURPOSE To identify whether quantitative susceptibility mapping (QSM) could measure a subtle increase in magnetic susceptibility in DN and GP in patients after repeated administrations of gadoteric acid meglumine (Gd-DOTA). MATERIAL AND METHODS In this study, 50 patients with cerebral tumors who had received at least three injections of Gd-DOTA (GBCA group) and 50 individuals without a history of GBCA injections (non-GBCA group) were included. The image data for QSM and T1-weighted images were reviewed. Spearman rank correlation was used to estimate the associations between the values (magnetic susceptibility of QSM and SI ratios of T1-weighted images) and the number of Gd-DOTA injections. RESULTS The mean magnetic susceptibility of GP in GBCA group was 0.136 ± 0.031 ppm, which was significantly higher than that in control group (0.114 ± 0.030 ppm) (P = 0.001). In the GBCA group (n = 50), we found a substantial positive correlation between magnetic susceptibility of GP and the number of Gd-DOTA injections according to Spearman rank correlation coefficient (ρ = 0.673, P = 0.0001). There was a modest but significant correlation between magnetic susceptibility of DN and the number of Gd-DOTA injections (ρ = 0.311, P = 0.028). CONCLUSION In comparison to the control group, the magnetic susceptibility of GP in the GBCA group was significantly higher and had a substantial positive association with the number of Gd-DOTA injections.
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Affiliation(s)
- Jing Zhang
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
| | - Lisi Xie
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
| | - Xiaoling Yang
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
| | - Liang Xu
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
| | - Kewei Chen
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
| | - Yuqing Luo
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
| | - Chengxin Yu
- Department of Radiology, 159371Yichang Central People's Hospital, the first Clinical Medical College of Three Gorges University, Yichang, Hubei Province, PR China
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Liachenko SM, Sadovova NV, Tripp A, Ghorai S, Patri AK, Hanig JP, Cohen JE, Krefting I. Optimization of Detection of Gadodiamide Brain Retention in Rats Using Quantitative T 2 Mapping and Intraperitoneal Administration. J Magn Reson Imaging 2022; 56:1499-1504. [PMID: 35278003 DOI: 10.1002/jmri.28149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Currently, the gadolinium retention in the brain after the use of contrast agents is studied by T1 -weighted magnetic resonance imaging (MRI) (T1 w) and T1 mapping. The former does not provide easily quantifiable data and the latter requires prolonged scanning and is sensitive to motion. T2 mapping may provide an alternative approach. Animal studies of gadolinium retention are complicated by repeated intravenous (IV) dosing, whereas intraperitoneal (IP) injections might be sufficient. HYPOTHESIS T2 mapping will detect the changes in the rat brain due to gadolinium retention, and IP administration is equivalent to IV for long-term studies. STUDY TYPE Prospective longitudinal. ANIMAL MODEL A total of 31 Sprague-Dawley rats administered gadodiamide IV (N = 8) or IP (N = 8), or saline IV (N = 6) or IP (N = 9) 4 days per week for 5 weeks. FIELD STRENGTH/SEQUENCES A 7 T, T1 w, and T2 mapping. ASSESSMENT T2 relaxation and image intensities in the deep cerebellar nuclei were measured pre-treatment and weekly for 5 weeks. Then brains were assessed for neuropathology (N = 4) or gadolinium content using inductively coupled plasma mass spectrometry (ICP-MS, N = 12). STATISTICAL TESTS Repeated measures analysis of variance with post hoc Student-Newman-Keuls tests and Hedges' effect size. RESULTS Gadolinium was detected by both approaches; however, T2 mapping was more sensitive (effect size 2.32 for T2 vs. 0.95 for T1 w), and earlier detection (week 3 for T2 vs. week 4 for T1 w). ICP-MS confirmed the presence of gadolinium (3.076 ± 0.909 nmol/g in the IV group and 3.948 ± 0.806 nmol/g in the IP group). There was no significant difference between IP and IV groups (ICP-MS, P = 0.109; MRI, P = 0.696). No histopathological abnormalities were detected in any studied animal. CONCLUSION T2 relaxometry detects gadolinium retention in the rat brain after multiple doses of gadodiamide irrespective of the route of administration. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Serguei M Liachenko
- Division of Neurotoxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Natalya V Sadovova
- Division of Neurotoxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Arnold Tripp
- Division of Neurotoxicology, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Suman Ghorai
- Nanotechnology Core Facility, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Anil K Patri
- Nanotechnology Core Facility, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, Arkansas, USA
| | - Joseph P Hanig
- Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, Maryland, USA
| | - Jonathan E Cohen
- Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, Maryland, USA
| | - Ira Krefting
- Office of New Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, White Oak, Maryland, USA
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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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Springer E, Cardoso PL, Strasser B, Bogner W, Preusser M, Widhalm G, Nittka M, Koerzdoerfer G, Szomolanyi P, Hangel G, Hainfellner JA, Marik W, Trattnig S. MR Fingerprinting-A Radiogenomic Marker for Diffuse Gliomas. Cancers (Basel) 2022; 14:cancers14030723. [PMID: 35158990 PMCID: PMC8833555 DOI: 10.3390/cancers14030723] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Advanced MR imaging (MRI) of brain tumors is mainly based on qualitative contrast images. MR Fingerprinting (MRF) offers a novel approach. The purpose of this study was to use MRF-derived T1 and T2 relaxation maps to differentiate diffuse gliomas according to isocitrate dehydrogenase (IDH) mutation. (2) Methods: Twenty-four patients with histologically verified diffuse gliomas (14 IDH-mutant, four 1p/19q-codeleted, 10 IDH-wildtype) were enrolled. MRF T1 and T2 relaxation times were compared to apparent diffusion coefficient (ADC), relative cerebral blood volume (rCBV) within solid tumor, peritumoral edema, and normal-appearing white matter (NAWM), using contrast-enhanced MRI, diffusion-, perfusion-, and susceptibility-weighted imaging. For perfusion imaging, a T2* weighted perfusion sequence with leakage correction was used. Correlations of MRF T1 and T2 times with two established conventional sequences for T1 and T2 mapping were assessed (a fast double inversion recovery-based MR sequence ('MP2RAGE') for T1 quantification and a multi-contrast spin echo-based sequence for T2 quantification). (3) Results: MRF T1 and T2 relaxation times were significantly higher in the IDH-mutant than in IDH-wildtype gliomas within the solid part of the tumor (p = 0.024 for MRF T1, p = 0.041 for MRF T2). MRF T1 and T2 relaxation times were significantly higher in the IDH-wildtype than in IDH-mutant gliomas within peritumoral edema less than or equal to 1cm adjacent to the tumor (p = 0.038 for MRF T1 mean, p = 0.010 for MRF T2 mean). In the solid part of the tumor, there was a high correlation between MRF and conventionally measured T1 and T2 values (r = 0.913, p < 0.001 for T1, r = 0.775, p < 0.001 for T2), as well as between MRF and ADC values (r = 0.813, p < 0.001 for T2, r = 0.697, p < 0.001 for T1). The correlation was weak between the MRF and rCBV values (r = -0.374, p = 0.005 for T2, r = -0.181, p = 0.181 for T1). (4) Conclusions: MRF enables fast, single-sequence based, multi-parametric, quantitative tissue characterization of diffuse gliomas and may have the potential to differentiate IDH-mutant from IDH-wildtype gliomas.
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Affiliation(s)
- Elisabeth Springer
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Institute of Radiology, Hietzing Hospital, 1130 Vienna, Austria
| | - Pedro Lima Cardoso
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
| | - Bernhard Strasser
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
| | - Wolfgang Bogner
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Correspondence: ; Tel.: +431-40-400-64710
| | - Matthias Preusser
- Division of Oncology, Department of Internal Medicine I, Medical University of Vienna, 1090 Vienna, Austria;
| | - Georg Widhalm
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Mathias Nittka
- Siemens Healthineers, 91052 Erlangen, Germany; (M.N.); (G.K.)
| | | | - Pavol Szomolanyi
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, 84104 Bratislava, Slovakia
| | - Gilbert Hangel
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Johannes A. Hainfellner
- Division of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Wolfgang Marik
- Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria;
| | - Siegfried Trattnig
- High-Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.S.); (P.L.C.); (B.S.); (P.S.); (G.H.); (S.T.)
- Christian Doppler Laboratory for Clinical Molecular MR Imaging, Medical University of Vienna, 1090 Vienna, Austria
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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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Abstract
OBJECTIVES Quantitative T1 relaxometry is the benchmark in imaging potential gadolinium deposition and known to be superior to semiquantitative signal intensity ratio analyses. However, T1 relaxometry studies are rare, commonly limited to a few target structures, and reported results are inconsistent.We systematically investigated quantitative T1 relaxation times (qT1) of a variety of brain nuclei after serial application of gadobutrol. MATERIALS AND METHODS Retrospectively, qT1 measurements were performed in a patient cohort with a mean number of 11 gadobutrol applications (n = 46) and compared with a control group with no prior gadolinium-based contrast agent administration (n = 48). The following target structures were evaluated: dentate nucleus, globus pallidus, thalamus, hippocampus, putamen, caudate, amygdala, and different white matter areas. Subsequently, multivariate regression analysis with adjustment for age, presence of brain metastases and previous cerebral radiotherapy was performed. RESULTS No assessed site revealed a significant correlation between qT1 and number of gadobutrol administrations in multivariate regression analysis. However, a significant negative correlation between qT1 and age was found for the globus pallidus as well as anterior and lateral thalamus (P < 0.05 each). CONCLUSIONS No T1 relaxation time shortening due to gadobutrol injection was found in any of the assessed brain structures after serial administration of 11 doses of gadobutrol.
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Heinen H, Seyler L, Popp V, Hellwig K, Bozec A, Uder M, Ellmann S, Bäuerle T. Morphological, functional, and molecular assessment of breast cancer bone metastases by experimental ultrasound techniques compared with magnetic resonance imaging and histological analysis. Bone 2021; 144:115821. [PMID: 33348127 DOI: 10.1016/j.bone.2020.115821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND The imaging of bone metastases, which is regularly performed by cross-sectional modalities, is clinically vital when characterizing and staging osseous lesions. In this paper, we aimed to establish a novel methodology using experimental ultrasound (US) techniques to assess the morphological, functional, and molecular features of breast cancer bone metastases in an animal model, compared with magnetic resonance imaging (MRI) and histological analysis. MATERIALS AND METHODS Nude rats were implanted intra-arterially with MDA-MB-231 breast cancer cells to induce osteolytic metastasis in their right hind legs. Once tumors had developed, an experimental US technique using automatic 3D scanning and MRI were performed. For assessment of perfusion, functional imaging techniques included contrast-enhanced US (CEUS) and dynamic contrast-enhanced MRI (DCE-MRI). For molecular ultrasound, anti-VEGFR2 conjugated microbubbles were applied and correlated with immunostaining for VEGFR2 expression. RESULTS 3D US enabled the automatic assessment of osteolytic lesions, including the largest tumor diameters along the x-, y- and z-axes as well as the segmented tumor volumes, without significant differences between US and MRI (p > 0.18). The CEUS and DCE-MRI of osseous lesions showed corresponding results for the parameters peak enhancement, wash-in area under the curve (both, r > 0.5) and wash-in perfusion index (r > 0.3) when differentiating between tumor, necrotic tissue and healthy muscle tissue (all, p < 0.01). Finally, molecular US allowed the non-invasive assessment of increased VEGFR2 expression in skeletal lesions compared with surrounding muscle tissue (p = 0.03), while a control antibody could not discriminate between these tissues (p = 0.44)-a factor which was confirmed by histological analysis. CONCLUSION To the best of our knowledge, this is the first report on an imaging protocol for breast cancer bone metastasis using an experimental US scanner. Therefore, we present a novel methodology to characterize these osseous lesions on the morphological, functional, and molecular level in correlation with MRI and histological analysis.
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Affiliation(s)
- Henrik Heinen
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany; Institute of Radiology, University Hospital, Paracelsus University, Prof.-Ernst-Nathan-Str. 1, 90419 Nuremberg, Germany
| | - Lisa Seyler
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Vanessa Popp
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Konstantin Hellwig
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Aline Bozec
- Medical Clinic 3 - Rheumatology and Immunology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Stephan Ellmann
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany
| | - Tobias Bäuerle
- Institute of Radiology, University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Maximiliansplatz 3, 91054 Erlangen, Germany.
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Dogra S, Borja MJ, Lui YW. Impact of Kidney Function on CNS Gadolinium Deposition in Patients Receiving Repeated Doses of Gadobutrol. AJNR Am J Neuroradiol 2021; 42:824-830. [PMID: 33632738 DOI: 10.3174/ajnr.a7031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/24/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Studies associate repeat gadolinium-based contrast agent administration with T1 shortening in the dentate nucleus and globus pallidus, indicating CNS gadolinium deposition, most strongly with linear agents but also reportedly with macrocyclics. Renal impairment effects on long-term CNS gadolinium deposition remain underexplored. We investigated the relationship between signal intensity changes and renal function in patients who received ≥10 administrations of the macrocyclic agent gadobutrol. MATERIALS AND METHODS Patients who underwent ≥10 brain MR imaging examinations with administration of intravenous gadobutrol between February 1, 2014, and January 1, 2018, were included in this retrospective study. Dentate nucleus-to-pons and globus pallidus-to-thalamus signal intensity ratios were calculated, and correlations were calculated between the estimated glomerular filtration rate (minimum and mean) and the percentage change in signal intensity ratios from the first to last scan. Partial correlations were calculated to control for potential confounders. RESULTS One hundred thirty-one patients (73 women; mean age at last scan, 55.9 years) showed a mean percentage change of the dentate nucleus-to-pons of 0.31%, a mean percentage change of the globus pallidus-to-thalamus of 0.15%, a mean minimum estimated glomerular filtration rate of 69.65 (range, 10.16-132.26), and a mean average estimated glomerular filtration rate at 89.48 (range, 38.24-145.93). No significant association was found between the estimated glomerular filtration rate and percentage change of the dentate nucleus-to-pons (minimum estimated glomerular filtration rate, r = -0.09, P = .28; average estimated glomerular filtration rate, r = -0.09, P = .30,) or percentage change of the globus pallidus-to-thalamus (r = 0.07, P = .43; r = 0.07, P = .40). When we controlled for age, sex, number of scans, and total dose, there were no significant associations between the estimated glomerular filtration rate and the percentage change of the dentate nucleus-to-pons (r = 0.16, P = .07; r = 0.15, P = .08) or percentage change of the globus pallidus-to-thalamus (r = -0.14, P = .12; r = -0.15, P = .09). CONCLUSIONS In patients receiving an average of 12 intravenous gadobutrol administrations, no correlation was found between renal function and signal intensity ratio changes, even in those with mild or moderate renal impairment.
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Affiliation(s)
- S Dogra
- From the Department of Radiology, New York University Langone Health, New York, New York
| | - M J Borja
- From the Department of Radiology, New York University Langone Health, New York, New York
| | - Y W Lui
- From the Department of Radiology, New York University Langone Health, New York, New York
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Bäuerle T, Saake M, Uder M. Gadolinium-based contrast agents: What we learned from acute adverse events, nephrogenic systemic fibrosis and brain retention. ROFO-FORTSCHR RONTG 2020; 193:1010-1018. [PMID: 33348385 DOI: 10.1055/a-1328-3177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Radiologists have been administering gadolinium-based contrast agents (GBCA) in magnetic resonance imaging for several decades, so that there is abundant experience with these agents regarding allergic-like reactions, nephrogenic systemic fibrosis (NSF) and gadolinium retention in the brain. METHODS This review is based on a selective literature search and reflects the current state of research on acute adverse effects of GBCA, NSF and brain retention of gadolinium. RESULTS Due to the frequent use of GBCA, data on adverse effects of these compounds are available in large collectives. Allergic-like reactions occurred rarely, whereas severe acute reactions were very rarely observed. Systemic changes in NSF also occur very rarely, although measures to avoid NSF resulted in a significantly reduced incidence of NSF. Due to gadolinium retention in the body after administration of linear MR contrast agents, only macrocyclic preparations are currently used with few exceptions. Clear clinical correlates of gadolinium retention in the brain could not be identified so far. Although the clinical added value of GBCA is undisputed, individual risks associated with the injection of GBCA should be identified and the use of non-contrast enhanced MR techniques should be considered. Alternative contrast agents such as iron oxide nanoparticles are not clinically approved, but are currently undergoing clinical trials. CONCLUSION GBCA have a very good risk profile with a low rate of adverse effects or systemic manifestations such as NSF. Gadolinium retention in the brain can be minimized by the use of macrocyclic GBCA, although clear clinical correlates due to gadolinium retention in the brain following administration of linear GBCA could not be identified yet. KEY POINTS · Acute adverse effects are predominantly mild/moderate, rarely severe reactions occur.. · International guidelines resulted in significant reduction of nephrogenic systemic fibrosis.. · Application of macrocyclic contrast agents minimizes gadolinium retention in the brain.. CITATION FORMAT · Bäuerle T, Saake M, Uder M. Gadolinium-based contrast agents: What we learned from acute adverse events, nephrogenic systemic fibrosis and brain retention. Fortschr Röntgenstr 2021; 193: 1010 - 1018.
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Affiliation(s)
- Tobias Bäuerle
- Institute of Radiology, University Medical Center, Erlangen, Germany
| | - Marc Saake
- Institute of Radiology, University Medical Center, Erlangen, Germany
| | - Michael Uder
- Institute of Radiology, University Medical Center, Erlangen, Germany
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Choi Y, Jang J, Kim J, Nam Y, Shin NY, Ahn KJ, Jeon SS, Kim BS. MRI and Quantitative Magnetic Susceptibility Maps of the Brain after Serial Administration of Gadobutrol: A Longitudinal Follow-up Study. Radiology 2020; 297:143-150. [PMID: 32692298 DOI: 10.1148/radiol.2020192579] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Background The relationship between administration of macrocyclic gadolinium-based contrast agents and T1-weighted signal intensity (SI) change of the globus pallidus (GP) and dentate nucleus (DN) is, to the knowledge of the authors, not known. Purpose To determine if quantitative susceptibility mapping (QSM) can detect changes in magnetic susceptibility of the GP and DN after serial administration of macrocyclic gadobutrol in patients with primary brain tumors. Materials and Methods Patients diagnosed with primary brain tumors from August 2014 to February 2019 were eligible for this single-center retrospective study. Among 501 consecutive adult patients who were given at least one administration of gadobutrol, those who were previously administered an unknown or linear gadolinium-based contrast agent were excluded. Brain MRI scans with three-dimensional gradient-recalled-echo image phase data for QSM processing were reviewed. Regions of interest were drawn on the GP and DN on the basis of semiautomatic thresholding. Univariable generalized estimation equations were used to determine the associations between MRI measures (SI on T1-weighted images and magnetic susceptibility on QSM) and number of gadobutrol doses. Potential confounding factors were adjusted for in multivariable generalized estimating equation. Results Ninety patients (mean age, 51 years ± 17 [standard deviation]; 51 men) with 199 MRI scans were analyzed. In models adjusted for repeated observations between injections, the number of injections of gadobutrol was associated with the magnetic susceptibility of the GP (1.4 × 10-3 ppm/number of gadobutrol injections; P = .01) and DN (8.1 × 10-4 ppm/number of gadobutrol injections; P = .03). After adjustment for confounders, the number of gadobutrol injections remained an independent predictor of increased magnetic susceptibility in the GP (1.3 × 10-3 ppm/number of gadobutrol injections; 95% confidence interval: 0.39 × 10-3, -2.4 × 10-3; P = .006). There were no associations between number of gadobutrol injections and SI or magnetic susceptibility in the DN. Conclusion The magnetic susceptibility of the globus pallidus increased after serial administration of gadobutrol. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Wang and Prince in this issue.
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Affiliation(s)
- Yangsean Choi
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Jinhee Jang
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Jiwoong Kim
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Yoonho Nam
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Na-Young Shin
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Kook-Jin Ahn
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Sin-Soo Jeon
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
| | - Bum-Soo Kim
- From the Departments of Radiology (Y.C., J.J., J.K., Y.N., N.Y.S., K.J.A., B.S.K.) and Neurosurgery (S.S.J.), Seoul Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea; and Department of Radiology, Eunpyeong Saint Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (Y.N.)
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Palm T, Wenkel E, Ohlmeyer S, Janka R, Uder M, Weiland E, Bickelhaupt S, Ladd ME, Zaitsev M, Hensel B, Laun FB. Diffusion kurtosis imaging does not improve differentiation performance of breast lesions in a short clinical protocol. Magn Reson Imaging 2019; 63:205-216. [DOI: 10.1016/j.mri.2019.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/26/2019] [Accepted: 08/15/2019] [Indexed: 01/08/2023]
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Benlala I, Hocke F, Macey J, Bui S, Berger P, Laurent F, Dournes G. Quantification of MRI T2-weighted High Signal Volume in Cystic Fibrosis: A Pilot Study. Radiology 2019; 294:186-196. [PMID: 31660805 DOI: 10.1148/radiol.2019190797] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background In patients with cystic fibrosis (CF), pulmonary structures with high MRI T2 signal intensity relate to inflammatory changes in the lung and bronchi. These areas of pathologic abnormalities can serve as imaging biomarkers. The feasibility of automated quantification is unknown. Purpose To quantify the MRI T2 high-signal-intensity lung volume and T2-weighted volume-intensity product (VIP) by using a black-blood T2-weighted radial fast spin-echo sequence in participants with CF. Materials and Methods Healthy individuals and study participants with CF were prospectively enrolled between January 2017 and November 2017. All participants underwent a lung MRI protocol including T2-weighted radial fast spin-echo sequence. Participants with CF also underwent pulmonary function tests the same day. Participants with CF exacerbation underwent repeat MRI after their treatment with antibiotics. Two observers supervised automated quantification of T2-weighted high-signal-intensity volume (HSV) and T2-weighted VIP independently, and the average score was chosen as consensus. Statistical analysis used the Mann-Whitney test for comparison of medians, correlations used the Spearman test, comparison of paired medians used the Wilcoxon signed rank test, and reproducibility was evaluated by using intraclass correlation coefficient. Results In 10 healthy study participants (median age, 21 years [age range, 18-27 years]; six men) and 12 participants with CF (median age, 18 years [age range, 9-40 years]; eight men), T2-weighted HSV was equal to 0% and 4.1% (range, 0.1%-17%), respectively, and T2-weighted VIP was equal to 0 msec and 303 msec (range, 39-1012 msec), respectively (P < .001). In participants with CF, T2-weighted HSV or T2-weighted VIP were associated with forced expiratory volume in 1 second percentage predicted (ρ = -0.88 and ρ = -0.94, respectively; P < .001). In six participants with CF exacerbation and follow-up after treatment, a decrease in both T2-weighted HSV and T2-weighted VIP was observed (P = .03). The intra- and interobserver reproducibility of MRI were good (intraclass correlation coefficients, >0.99 and >0.99, respectively). Conclusion In patients with cystic fibrosis (CF), automated quantification of lung MRI high-signal-intensity volume was reproducible and correlated with pulmonary function testing severity, and it improved after treatment for CF exacerbation. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Revel and Chassagnon in this issue.
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Affiliation(s)
- Ilyes Benlala
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - François Hocke
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Julie Macey
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Stéphanie Bui
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Patrick Berger
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - François Laurent
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
| | - Gaël Dournes
- From the Univ. Bordeaux, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); Inserm, Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, CIC 1401, F-33000 Bordeaux, France (I.B., P.B., F.L., G.D.); and CHU de Bordeaux, Service d'Imagerie Thoracique et Cardiovasculaire, Service des Maladies Respiratoires, Service d'Exploration Fonctionnelle Respiratoire, Unité de Pneumologie Pédiatrique, CIC 1401, F-33600 Pessac, France (I.B., F.H., J.M., S.B., P.B., F.L., G.D.)
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