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Hugon G, Adriaensen H, Wintrebert M, Arnould L, Serfaty JM, Robert P. Evaluation of the Contrast Enhancement Performance of Gadopiclenol for Magnetic Resonance Angiography in Healthy Rabbits and Pigs. Invest Radiol 2024; 59:614-621. [PMID: 38709660 DOI: 10.1097/rli.0000000000001083] [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: 05/08/2024]
Abstract
OBJECTIVES Unexpected accumulations of gadolinium in various organs were reported after the administration of gadolinium-based contrast agents, making desirable to reduce the dose while maintaining equivalent diagnostic performance. The aim of this study was to evaluate the contrast enhancement performance of high relaxivity gadopiclenol compared with gadoterate meglumine in abdominal contrast-enhanced magnetic resonance angiography (CE-MRA). MATERIALS AND METHODS In a first study in healthy rabbits, axial 3D gradient echo sequences were applied at 4.7 T to study arterial enhancement as a function of gadopiclenol dose (0.025, 0.05, 0.075, and 0.1 mmol Gd/kg) or gadoterate meglumine at 0.1 mmol Gd/kg (n = 5-6/group). The increase in signal-to-noise ratio (ΔSNR) in the aorta at the first pass was measured and compared. In a second, crossover study in 6 healthy pigs, abdominal CE-MRA sequences were acquired at 3 T with gadopiclenol at 0.05 mmol Gd/kg or gadoterate meglumine at 0.1 mmol Gd/kg at a 1-week interval. Quantitatively on the maximum intensity projection (MIP) images, the mean MIP SNR within the aorta of both groups was compared. Qualitatively, a blinded comparison of the angiograms was performed by an experienced radiologist to determine the preferred contrast agent. RESULTS In the rabbit, ∆SNR is linearly correlated with the gadopiclenol dose ( P = 0.0010). Compared with gadoterate meglumine 0.1 mmol Gd/kg, an increase in the ∆SNR is observed after 0.05, 0.075, and 0.1 mmol Gd/kg of gadopiclenol (+63% P = 0.0731, +78% P = 0.0081, and +72% P = 0.0773, respectively), whereas at 0.025 mmol Gd/kg, ∆SNR is in the same range as with gadoterate meglumine 0.1 mmol Gd/kg (+15% P > 0.9999). In pigs, contrast enhancement after gadopiclenol at 0.05 mmol/kg is +22% superior to MIP SNR after gadoterate meglumine at 0.1 mmol Gd/kg ( P = 0.3095). Qualitatively, a preference was shown for gadopiclenol images (3/6) over the gadoterate meglumine examinations (1/6), with no preference being shown for the remainder (2/6). CONCLUSIONS First-pass CE-MRA is feasible with gadopiclenol at 0.05 mmol Gd/kg with at least the same arterial signal enhancement and image quality as gadoterate meglumine at 0.1 mmol Gd/kg.
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Affiliation(s)
- Gaëlle Hugon
- From the Guerbet Research and Innovation, Guerbet, Roissy CdG, France (G.H., M.W., P.R.); INRAE, CNRS, Université de Tours, PRC, 37380, Nouzilly, France (H.A.); INRAE, Université de Tours, CHU de Tours, PIXANIM, 37380, Nouzilly, France (H.A.); Siemens Healthineers, Courbevoie-La Défense, France (L.A.); and Hôpital Guillaume et René Laennec, Department of Cardiovascular Radiology, Unité d'Imagerie Cardiaque et Vasculaire Diagnostique, Institut du Thorax-Clinique Cardiologique, Nantes, France (J.-M.S.)
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Versolatto S, Boccalon M, Guidolin N, Travagin F, Alessio E, Aime S, Balducci G, Giovenzana GB, Baranyai Z. [Gd(HB-DO3A)]: Equilibrium, Dissociation Kinetic and Structural Differences in a Simple Homolog of [Gd(HP-DO3A)] (Prohance ®). Chemistry 2024; 30:e202400344. [PMID: 38469901 DOI: 10.1002/chem.202400344] [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: 01/26/2024] [Revised: 03/10/2024] [Accepted: 03/11/2024] [Indexed: 03/13/2024]
Abstract
[Gd(HP-DO3A)] (gadoteridol) as an active compound of ProHance® is a widely employed contrast agent in clinical MRI scans in the last 30 years. Recent concerns about the long-term retention of gadolinium-based contrast agents (GBCAs) led to a deeper investigation of the structural features underlying the integrity of the paramagnetic metal complex. Several human and nonclinical studies have noted marked differences among the macrocyclic GBCAs, with the least retention of Gd traces and most rapid elimination consistently being reported for [Gd(HP-DO3A)]. It was deemed of interest to assess how minor structural/electronic changes associated to the ligand structure may affect basic properties of the metal complex with several [Gd(HP-DO3A)] analogues synthesized and characterized in the last years. We recently reported that the closest homolog of [Gd(HP-DO3A)], i. e.: [Gd(HB-DO3A)], in which a (±)-2-hydroxy-1-propyl pendant arm is replaced by a (±)-2-hydroxy-1-butyl moiety, showed a significantly different retention behaviour in the model interaction with collagen, despite the apparently very minor structural difference. In this paper we report a comprehensive study of the structural, thermodynamic, kinetic and relaxation properties of [Gd(HB-DO3A)], compared to the parent [Gd(HP-DO3A)] and to other closely related macrocyclic GBCAs to assess whether very minor structural changes can modulate the physico-chemical properties of Gd3+ complexes.
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Affiliation(s)
- Silvia Versolatto
- Dipartimento di Scienze Chimiche e Farmaceutiche Università di Trieste, Piazzale Europa 1, 34127, Trieste, TS, Italy
| | - Mariangela Boccalon
- Bracco Imaging Spa, CRB Trieste, AREA Science Park, 34149, Basovizza, TS, Italy
| | - Nicol Guidolin
- Bracco Imaging Spa, CRB Trieste, AREA Science Park, 34149, Basovizza, TS, Italy
| | - Fabio Travagin
- Dipartimento di Scienze del Farmaco, Università del Piemonte Orientale, Largo Donegani 2/3, Novara, NO, 28100, Italy
| | - Enzo Alessio
- Dipartimento di Scienze Chimiche e Farmaceutiche Università di Trieste, Piazzale Europa 1, 34127, Trieste, TS, Italy
| | - Silvio Aime
- IRCCS SDN Research Institute Diagnostics and Nuclear SynLab, Via Emanuele Gianturco, 113, 80143, Napoli, NA, Italy
| | - Gabriele Balducci
- Dipartimento di Scienze Chimiche e Farmaceutiche Università di Trieste, Piazzale Europa 1, 34127, Trieste, TS, Italy
| | - Giovanni B Giovenzana
- Dipartimento di Scienze del Farmaco, Università del Piemonte Orientale, Largo Donegani 2/3, Novara, NO, 28100, Italy
| | - Zsolt Baranyai
- Bracco Imaging Spa, CRB Trieste, AREA Science Park, 34149, Basovizza, TS, Italy
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Wang W, Huang XX, Jiang RH, Zhou J, Shi HB, Xu XQ, Wu FY. Gadolinium Retention and Nephrotoxicity in a Mouse Model of Acute Ischemic Stroke: Linear Versus Macrocyclic Agents. J Magn Reson Imaging 2024; 59:1852-1861. [PMID: 37548106 DOI: 10.1002/jmri.28931] [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: 04/29/2023] [Revised: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Gadolinium (Gd)-based contrast agents (GBCAs) have been widely used for acute ischemic stroke (AIS) patients. GBCAs or AIS alone may cause the adverse effects on kidney tissue, respectively. However, whether GBCAs and AIS would generate a synergistic negative effect remains undefined. PURPOSE To evaluate synergistic negative effects of AIS and GBCAs on renal tissues in a mouse model of AIS, and to compare the differences of these negative effects between linear and macrocyclic GBCAs. STUDY TYPE Animal study. ANIMAL MODEL Seventy-two healthy mice underwent transient middle cerebral artery occlusion (tMCAO) and sham operation to establish AIS and sham model (N = 36/model). 5.0 mmol/kg GBCAs (gadopentetate or gadobutrol) or 250 μL saline were performed at 4.5 hours and 1 day after model establishing (N = 12/group). ASSESSMENT Inductively coupled plasma mass spectrometry (ICP-MS) was performed to detect Gd concentrations. Serum biochemical analyzer was performed to measure the serum creatinine (Scr), uric acid (UA), and blood urea nitrogen (BUN). Pathological staining was performed to observe tubular injury, cell apoptosis, mesangial hyperplasia, and interstitial fibrosis. STATISTICAL TESTS Two-way analysis of variances with post hoc Sidak's tests and independent-samples t-tests were performed. A P-value <0.05 was considered statistically significant. RESULTS AIS groups showed higher Gd concentration than sham group on day 1 p.i. regardless of gadopentetate or gadobutrol used. Increased total Gd concentration was also found in AIS + gadopentetate group compared with the sham group on day 28 p.i. Significantly higher rates for renal dysfunction, higher tubular injury scores, and higher numbers of apoptotic cells on days 1 or 28 p.i. were found for AIS mice injected with GBCA. AIS + gadopentetate group displayed more severe renal damage than the AIS + gadobutrol group. DATA CONCLUSION AIS and GBCAs may cause increased total Gd accumulation and nephrotoxicity in a mouse, especially linear GBCAs were used. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Wei Wang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xin-Xin Huang
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Run-Hao Jiang
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hai-Bin Shi
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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4
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Ouyang M, Bao L. Gadolinium Contrast Agent Deposition in Children. J Magn Reson Imaging 2024. [PMID: 38597340 DOI: 10.1002/jmri.29389] [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: 01/20/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Over the past few years, a large number of studies have evidenced increased signal intensity in the deep brain nuclei on unenhanced T1-MRI images achieved by the application of gadolinium-based contrast agents (GBCAs). The deposition of gadolinium in the brain, bone, and other tissues following administration of GBCAs has also been confirmed in histological studies in rodents and in necropsy studies in adults and children. Given the distinct physiological characteristics of children, this review focuses on examining the current research on gadolinium deposition in children, particularly studies utilizing novel methods and technologies. Furthermore, the article compares safety research findings of linear GBCAs and macrocyclic GBCAs in children, with the aim of offering clinicians practical guidance based on the most recent research outcomes. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Minglei Ouyang
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Bao
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Coimbra S, Rocha S, Sousa NR, Catarino C, Belo L, Bronze-da-Rocha E, Valente MJ, Santos-Silva A. Toxicity Mechanisms of Gadolinium and Gadolinium-Based Contrast Agents-A Review. Int J Mol Sci 2024; 25:4071. [PMID: 38612881 PMCID: PMC11012457 DOI: 10.3390/ijms25074071] [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: 03/04/2024] [Revised: 03/28/2024] [Accepted: 03/30/2024] [Indexed: 04/14/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) have been used for more than 30 years to improve magnetic resonance imaging, a crucial tool for medical diagnosis and treatment monitoring across multiple clinical settings. Studies have shown that exposure to GBCAs is associated with gadolinium release and tissue deposition that may cause short- and long-term toxicity in several organs, including the kidney, the main excretion organ of most GBCAs. Considering the increasing prevalence of chronic kidney disease worldwide and that most of the complications following GBCA exposure are associated with renal dysfunction, the mechanisms underlying GBCA toxicity, especially renal toxicity, are particularly important. A better understanding of the gadolinium mechanisms of toxicity may contribute to clarify the safety and/or potential risks associated with the use of GBCAs. In this work, a review of the recent literature concerning gadolinium and GBCA mechanisms of toxicity was performed.
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Affiliation(s)
- Susana Coimbra
- 1H-TOXRUN—1H-Toxicology Research Unit, University Institute of Health Sciences, Cooperativa de Ensino Superior Politécnico e Universitário (CESPU), Advanced Polytechnic and University Cooperative, CRL, 4585-116 Gandra, Portugal
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Susana Rocha
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Nícia Reis Sousa
- Departamento de Ciências e Tecnologia da Saúde, Instituto Superior Politécnico de Benguela, Benguela, Angola
| | - Cristina Catarino
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Luís Belo
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Elsa Bronze-da-Rocha
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
| | - Maria João Valente
- National Food Institute, Technical University of Denmark, Kongens Lyngby, 2800 Copenhagen, Denmark
| | - Alice Santos-Silva
- Associate Laboratory i4HB—Institute for Health and Bioeconomy, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
- UCIBIO—Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, 4050-313 Porto, Portugal
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van der Molen AJ, Quattrocchi CC, Mallio CA, Dekkers IA. Ten years of gadolinium retention and deposition: ESMRMB-GREC looks backward and forward. Eur Radiol 2024; 34:600-611. [PMID: 37804341 PMCID: PMC10791848 DOI: 10.1007/s00330-023-10281-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/30/2023] [Accepted: 08/09/2023] [Indexed: 10/09/2023]
Abstract
In 2014, for the first time, visible hyperintensities on unenhanced T1-weighted images in the nucleus dentatus and globus pallidus of the brain were associated with previous Gadolinium-based contrast agent (GBCA) injections and gadolinium deposition in patients with normal renal function. This led to a frenzy of retrospective studies with varying methodologies that the European Society of Magnetic Resonance in Medicine and Biology Gadolinium Research and Educational Committee (ESMRMB-GREC) summarised in 2019. Now, after 10 years, the members of the ESMRMB-GREC look backward and forward and review the current state of knowledge of gadolinium retention and deposition. CLINICAL RELEVANCE STATEMENT: Gadolinium deposition is associated with the use of linear GBCA but no clinical symptoms have been associated with gadolinium deposition. KEY POINTS : • Traces of Gadolinium-based contrast agent-derived gadolinium can be retained in multiple organs for a prolonged time. • Gadolinium deposition is associated with the use of linear Gadolinium-based contrast agents. • No clinical symptoms have been associated with gadolinium deposition.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, C-2S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands.
| | - Carlo C Quattrocchi
- Centre for Medical Sciences CISMed, University of Trento, 38122, Trento, Italy
| | - Carlo A Mallio
- Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Roma, Italy
- Operative Research Unit of Diagnostic Imaging, Fondazione Policlinico Universitario Campus Bio-Medico, Roma, Italy
| | - Ilona A Dekkers
- Department of Radiology, C-2S, Leiden University Medical Center, Albinusdreef 2, NL-2333 ZA, Leiden, The Netherlands
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Le Fur M, Moon BF, Zhou IY, Zygmont S, Boice A, Rotile NJ, Ay I, Pantazopoulos P, Feldman AS, Rosales IA, How IDAL, Izquierdo-Garcia D, Hariri LP, Astashkin AV, Jackson BP, Caravan P. Gadolinium-based Contrast Agent Biodistribution and Speciation in Rats. Radiology 2023; 309:e230984. [PMID: 37874235 PMCID: PMC10623187 DOI: 10.1148/radiol.230984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/07/2023] [Accepted: 09/08/2023] [Indexed: 10/25/2023]
Abstract
Background Gadolinium retention has been observed in organs of patients with normal renal function; however, the biodistribution and speciation of residual gadolinium is not well understood. Purpose To compare the pharmacokinetics, distribution, and speciation of four gadolinium-based contrast agents (GBCAs) in healthy rats using MRI, mass spectrometry, elemental imaging, and electron paramagnetic resonance (EPR) spectroscopy. Materials and Methods In this prospective animal study performed between November 2021 and September 2022, 32 rats received a dose of gadoterate, gadoteridol, gadobutrol, or gadobenate (2.0 mmol/kg) for 10 consecutive days. GBCA-naive rats were used as controls. Three-dimensional T1-weighted ultrashort echo time images and R2* maps of the kidneys were acquired at 3, 17, 34, and 52 days after injection. At 17 and 52 days after injection, gadolinium concentrations in 23 organ, tissue, and fluid specimens were measured with mass spectrometry; gadolinium distribution in the kidneys was evaluated using elemental imaging; and gadolinium speciation in the kidney cortex was assessed using EPR spectroscopy. Data were assessed with analysis of variance, Kruskal-Wallis test, analysis of response profiles, and Pearson correlation analysis. Results For all GBCAs, the kidney cortex exhibited higher gadolinium retention at 17 days after injection than all other specimens tested (mean range, 350-1720 nmol/g vs 0.40-401 nmol/g; P value range, .001-.70), with gadoteridol showing the lowest level of retention. Renal cortex R2* values correlated with gadolinium concentrations measured ex vivo (r = 0.95; P < .001), whereas no associations were found between T1-weighted signal intensity and ex vivo gadolinium concentration (r = 0.38; P = .10). EPR spectroscopy analysis of rat kidney cortex samples showed that all GBCAs were primarily intact at 52 days after injection. Conclusion Compared with other macrocyclic GBCAs, gadoteridol administration led to the lowest level of retention. The highest concentration of gadolinium was retained in the kidney cortex, but T1-weighted MRI was not sensitive for detecting residual gadolinium in this tissue. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Tweedle in this issue.
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Affiliation(s)
- Mariane Le Fur
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Brianna F. Moon
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Iris Y. Zhou
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Samantha Zygmont
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Avery Boice
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Nicholas J. Rotile
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Ilknur Ay
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Pamela Pantazopoulos
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Adam S. Feldman
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Ivy A. Rosales
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Ira Doressa Anne L. How
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - David Izquierdo-Garcia
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Lida P. Hariri
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Andrei V. Astashkin
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Brian P. Jackson
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
| | - Peter Caravan
- From the Athinoula A. Martinos Center for Biomedical Imaging,
Department of Radiology (M.L.F., B.F.M., I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P.,
D.I.G., P.C.), Department of Urology (A.S.F.), and Department of Pathology
(I.A.R., I.D.A.L.H., L.P.H.), Massachusetts General Hospital and Harvard Medical
School, 149 13th St, Charlestown, MA 02129; Institute for Innovation in
Imaging, Massachusetts General Hospital, Charlestown, Mass (M.L.F., B.F.M.,
I.Y.Z., S.Z., A.B., N.J.R., I.A., P.P., P.C.); Harvard-MIT Health Sciences and
Technology, Cambridge, Mass (D.I.G.); Bioengineering Department, Universidad
Carlos III de Madrid, Madrid, Spain (D.I.G.); Department of Chemistry and
Biochemistry, University of Arizona, Tucson, Ariz (A.V.A.); and Trace Element
Analysis Laboratory, Dartmouth College, Hanover, NH (B.P.J.)
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8
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Parillo M, Mallio CA, Van der Molen AJ, Rovira À, Ramalho J, Ramalho M, Gianolio E, Karst U, Radbruch A, Stroomberg G, Clement O, Dekkers IA, Nederveen AJ, Quattrocchi CC. Skin Toxicity After Exposure to Gadolinium-Based Contrast Agents in Normal Renal Function, Using Clinical Approved Doses: Current Status of Preclinical and Clinical Studies. Invest Radiol 2023; 58:530-538. [PMID: 37185158 DOI: 10.1097/rli.0000000000000973] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES The aim of this study was to summarize the current preclinical and clinical evidence on the association between exposure to gadolinium (Gd) compounds and skin toxicity in a setting similar to clinical practice. MATERIALS AND METHODS A search of MEDLINE and PubMed references from January 2000 to December 2022 was performed using keywords related to gadolinium deposition and its effects on the skin, such as "gadolinium," "gadolinium-based contrast agents," "skin," "deposition," and "toxicity." In addition, cross-referencing was added when appropriate. For preclinical in vitro studies, we included all the studies that analyzed the response of human dermal fibroblasts to exposure to various gadolinium compounds. For preclinical animal studies and clinical studies, we included only those that analyzed animals or patients with preserved renal function (estimated glomerular filtration rate >30 mL/min/1.73 m 2 ), using a dosage of gadolinium-based contrast agents (GBCAs) similar to that commonly applied (0.1 mmol/kg). RESULTS Forty studies were selected. Preclinical findings suggest that Gd compounds can produce profibrotic responses in the skin in vitro, through the activation and proliferation of dermal fibroblasts and promoting their myofibroblast differentiation. Gadolinium influences the process of collagen production and the collagen content of skin, by increasing the levels of matrix metalloproteinase-1 and tissue inhibitor of metalloproteinase-1. Preclinical animal studies show that Gd can deposit in the skin with higher concentrations when linear GBCAs are applied. However, these deposits decrease over time and are not associated with obvious macroscopic or histological modifications. The clinical relevance of GBCAs in inducing small fiber neuropathy remains to be determined. Clinical studies show that Gd is detectable in the skin and hair of subjects with normal renal function in higher concentrations after intravenous administration of linear compared with macrocyclic GBCA. However, these deposits decrease over time and are not associated with cutaneous or histological modifications. Also, subclinical dermal involvement related to linear GBCA exposure may be detectable on brain MRI. There is no conclusive evidence to support a causal relationship between GBCA administration at the clinical dose and cutaneous manifestations in patients with normal renal function. CONCLUSIONS Gadolinium can produce profibrotic responses in the skin, especially acting on fibroblasts, as shown by preclinical in vitro studies. Gadolinium deposits are detectable in the skin even in subjects with normal renal function with higher concentrations when linear GBCAs are used, as confirmed by both preclinical animal and human studies. There is no proof to date of a cause-effect relationship between GBCA administration at clinical doses and cutaneous consequences in patients with normal renal function. Multiple factors, yet to be determined, should be considered for sporadic patients with normal renal function who develop clinical skin manifestations temporally related to GBCA administration.
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Affiliation(s)
- Marco Parillo
- From the Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Carlo A Mallio
- From the Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - Aart J Van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Àlex Rovira
- Section of Neuroradiology, Department of Radiology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joana Ramalho
- Department of Neuroradiology, Centro Hospitalar Universitário de Lisboa Central, Lisbon
| | - Miguel Ramalho
- Department of Radiology, Hospital Garcia de Orta, EPE, Almada, Portugal
| | - Eliana Gianolio
- Department of Molecular Biotechnologies and Health Science, University of Turin, Turin, Italy
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Münster
| | - Alexander Radbruch
- Department of Neuroradiology, University Hospital Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Gerard Stroomberg
- RIWA-Rijn-Association of River Water Works, Nieuwegein, the Netherlands
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Paris, France
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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9
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Takanezawa Y, Nakamura R, Ohshiro Y, Uraguchi S, Kiyono M. Gadolinium-based contrast agents suppress adipocyte differentiation in 3T3-L1 cells. Toxicol Lett 2023; 383:S0378-4274(23)00218-7. [PMID: 37437671 DOI: 10.1016/j.toxlet.2023.07.003] [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: 02/28/2023] [Revised: 06/28/2023] [Accepted: 07/09/2023] [Indexed: 07/14/2023]
Abstract
Gadolinium-based contrast agents (GBCAs) are widely used in magnetic resonance imaging (MRI) to improve the sensitivity and enhance diagnostic performance. GBCAs are mostly eliminated from the body through the kidney after administration; however small amounts of gadolinium are retained in the brain and other tissues. Although there is increasing concern about the adverse health effects of gadolinium, the cellular effects of GBCAs remains poorly understood. Here, we elucidated the potential cytotoxicity of the GBCAs Omniscan and Gadovist in 12 different cell lines, especially 3T3-L1 adipocyte cell line. Omniscan and Gadovist treatments significantly increased intracellular gadolinium levels in 3T3-L1 cells in a time- and dose-dependent manner. Additionally, Omniscan and Gadovist treatments downregulated the expression of adipocyte differentiation markers, including peroxisome proliferator-activated receptor γ (PPARG), adiponectin (ADIPOQ), and fatty acid-binding protein (FABP4), in 3T3-L1 cells, especially during early differentiation (day 0-2). Moreover, histological analysis using Oil red O staining showed that gadolinium chloride (GdCl3) treatment suppressed lipid droplet accumulation and the expression of adipocyte differentiation markers. Overall, the results showed that Omniscan and Gadovist treatment suppressed adipocyte differentiation in 3T3-L1 cells, contributing to the understanding of the potential toxic effects of GBCA exposure.
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Affiliation(s)
- Yasukazu Takanezawa
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Ryosuke Nakamura
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Yuka Ohshiro
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Shimpei Uraguchi
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan
| | - Masako Kiyono
- Department of Public Health, School of Pharmacy, Kitasato University, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8641, Japan.
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10
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Longo DL, Carella A, Corrado A, Pirotta E, Mohanta Z, Singh A, Stabinska J, Liu G, McMahon MT. A snapshot of the vast array of diamagnetic CEST MRI contrast agents. NMR IN BIOMEDICINE 2023; 36:e4715. [PMID: 35187749 PMCID: PMC9724179 DOI: 10.1002/nbm.4715] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 05/11/2023]
Abstract
Since the inception of CEST MRI in the 1990s, a number of compounds have been identified as suitable for generating contrast, including paramagnetic lanthanide complexes, hyperpolarized atom cages and, most interesting, diamagnetic compounds. In the past two decades, there has been a major emphasis in this field on the identification and application of diamagnetic compounds that have suitable biosafety profiles for usage in medical applications. Even in the past five years there has been a tremendous growth in their numbers, with more and more emphasis being placed on finding those that can be ultimately used for patient studies on clinical 3 T scanners. At this point, a number of endogenous compounds present in tissue have been identified, and also natural and synthetic organic compounds that can be administered to highlight pathology via CEST imaging. Here we will provide a very extensive snapshot of the types of diamagnetic compound that can generate CEST MRI contrast, together with guidance on their utility on typical preclinical and clinical scanners and a review of the applications that might benefit the most from this new technology.
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Affiliation(s)
- Dario Livio Longo
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), Turin, Italy
| | - Antonella Carella
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), Turin, Italy
| | - Alessia Corrado
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), Turin, Italy
| | - Elisa Pirotta
- Institute of Biostructures and Bioimaging (IBB), National Research Council of Italy (CNR), Turin, Italy
| | - Zinia Mohanta
- F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Aruna Singh
- F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Julia Stabinska
- F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Guanshu Liu
- F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael T. McMahon
- F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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11
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Bonafè R, Coppo A, Queliti R, Bussi S, Maisano F, Kirchin MA, Tedoldi F. Gadolinium retention in a rat model of subtotal renal failure: are there differences among macrocyclic GBCAs? Eur Radiol Exp 2023; 7:7. [PMID: 36855001 PMCID: PMC9975137 DOI: 10.1186/s41747-023-00324-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 01/11/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Gd levels are higher in tissues of animals with compromised renal function, but studies to compare levels after exposure to different macrocyclic gadolinium-based contrast agents (GBCAs) are lacking. We compared Gd levels in tissues of subtotally nephrectomised (SN) rats after repeated exposure to macrocyclic GBCAs. METHODS Sprague-Dawley SN male rats (19 per group) received 16 injections of gadoteridol, gadobutrol, or gadoterate meglumine at 0.6 mmol Gd/kg 4 times/weeks over 4 weeks. A control group of healthy male rats (n = 10) received gadoteridol at the same dosage. Plasma urea and creatinine levels were monitored. Blood, cerebrum, cerebellum, liver, femur, kidney(s), skin and peripheral nerves were harvested for Gd determination by inductively coupled plasma-mass spectrometry at 28 and 56 days after the end of treatment. RESULTS Plasma urea and creatinine levels were roughly twofold higher in SN rats than in healthy rats at all timepoints. At day 28, Gd levels in the peripheral nerves of gadobutrol- or gadoterate-treated SN animals were 5.4 or 7.2 times higher than in gadoteridol-treated animals (p < 0.001). Higher Gd levels after administration of gadobutrol or gadoterate versus gadoteridol were also determined in kidneys (p ≤ 0.002), cerebrum (p ≤ 0.001), cerebellum (p ≤ 0.003), skin (p ≥ 0.244), liver (p ≥ 0.053), and femur (p ≥ 0.271). At day 56, lower Gd levels were determined both in SN and healthy rats for all GBCAs and tissues, except the femur. CONCLUSIONS Gd tissue levels were lower following gadoteridol exposure than following gadobutrol or gadoterate exposure.
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Affiliation(s)
- Roberta Bonafè
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010, Colleretto Giacosa, TO Italy
| | - Alessandra Coppo
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010, Colleretto Giacosa, TO Italy
| | - Roberta Queliti
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010, Colleretto Giacosa, TO Italy
| | - Simona Bussi
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010, Colleretto Giacosa, TO Italy
| | - Federico Maisano
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010, Colleretto Giacosa, TO Italy
| | - Miles A. Kirchin
- grid.476177.40000 0004 1755 9978Bracco Imaging SpA, Global Medical & Regulatory Affairs, Milan, Italy
| | - Fabio Tedoldi
- Bracco Imaging SpA, Bracco Research Centre, Via Ribes 5, 10010, Colleretto Giacosa, TO Italy
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12
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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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13
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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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14
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Huang X, Jiang R, Xu X, Wang W, Sun Y, Li L, Shi H, Liu S. Gadolinium retention in the ischemic cerebrum: Implications for pain, neuron loss, and neurological deficits. Magn Reson Med 2022; 89:384-395. [DOI: 10.1002/mrm.29443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Xin‐Xin Huang
- Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Run‐Hao Jiang
- Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Xiao‐Quan Xu
- Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Wei Wang
- Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Yu‐Qin Sun
- Neuroprotective Drug Discovery Key Laboratory, Jiangsu Key Laboratory of Neurodegeneration Nanjing Medical University Nanjing China
| | - Lei Li
- Neuroprotective Drug Discovery Key Laboratory, Jiangsu Key Laboratory of Neurodegeneration Nanjing Medical University Nanjing China
| | - Hai‐Bin Shi
- Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Sheng Liu
- Department of Interventional Radiology The First Affiliated Hospital of Nanjing Medical University Nanjing China
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15
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Gallo-Bernal S, Patino-Jaramillo N, Calixto CA, Higuera SA, Forero JF, Lara Fernandes J, Góngora C, Gee MS, Ghoshhajra B, Medina HM. Nephrogenic Systemic Fibrosis in Patients with Chronic Kidney Disease after the Use of Gadolinium-Based Contrast Agents: A Review for the Cardiovascular Imager. Diagnostics (Basel) 2022; 12:diagnostics12081816. [PMID: 36010167 PMCID: PMC9406537 DOI: 10.3390/diagnostics12081816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/11/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Gadolinium-enhanced cardiac magnetic resonance has revolutionized cardiac imaging in the last two decades and has emerged as an essential and powerful tool for the characterization and treatment guidance of a wide range of cardiovascular diseases. However, due to the high prevalence of chronic renal dysfunction in patients with cardiovascular conditions, the risk of nephrogenic systemic fibrosis (NSF) after gadolinium exposure has been a permanent concern. Even though the newer macrocyclic agents have proven to be much safer in patients with chronic kidney disease and end-stage renal failure, clinicians must fully understand the clinical characteristics and risk factors of this devastating pathology and maintain a high degree of suspicion to prevent and recognize it. This review aimed to summarize the existing evidence regarding the physiopathology, clinical manifestations, diagnosis, and prevention of NSF related to the use of gadolinium-based contrast agents.
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Affiliation(s)
- Sebastian Gallo-Bernal
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Correspondence:
| | - Nasly Patino-Jaramillo
- Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia; (N.P.-J.); (S.A.H.); (H.M.M.)
| | - Camilo A. Calixto
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Department of Radiology Boston Children’s Hospital, Boston, MA 02115, USA
| | - Sergio A. Higuera
- Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia; (N.P.-J.); (S.A.H.); (H.M.M.)
| | - Julian F. Forero
- Division of Radiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia;
| | - Juliano Lara Fernandes
- Jose Michel Kalaf Research Institute, Radiologia Clinica de Campinas, São Paulo 13092-123, Brazil;
| | - Carlos Góngora
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Cardiovascular Imaging Research Center (CIRC), Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, USA; (C.G.); (B.G.)
| | - Michael S. Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
| | - Brian Ghoshhajra
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Cardiovascular Imaging Research Center (CIRC), Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, USA; (C.G.); (B.G.)
| | - Hector M. Medina
- Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia; (N.P.-J.); (S.A.H.); (H.M.M.)
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16
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Funke SKI, Factor C, Rasschaert M, Lezius L, Sperling M, Karst U, Robert P. Long-term Gadolinium Retention in the Healthy Rat Brain: Comparison between Gadopiclenol, Gadobutrol, and Gadodiamide. Radiology 2022; 305:179-189. [PMID: 35727155 DOI: 10.1148/radiol.212600] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Safety concerns caused by gadolinium retention call for the development of high-relaxivity gadolinium-based contrast agents (GBCAs) allowing minimal dosing. Purpose To investigate brain gadolinium retention in healthy rats after exposure to gadopiclenol (Elucirem, Guerbet; macrocyclic GBCA) compared with gadobutrol (Gadovist or Gadavist, Bayer; macrocyclic GBCA) and gadodiamide (Omniscan, GE Healthcare; linear GBCA) over 1 year. Materials and Methods In this study conducted between May 2018 and April 2020, 9-week-old healthy Sprague Dawley rats received five injections of either gadopiclenol, gadobutrol, or gadodiamide (2.4 mmol of gadolinium per kilogram of body weight for each), or saline (control animals) over a period of 5 weeks. Rats were randomly assigned to different groups (six female and six male rats per group). MRI examinations were performed before euthanasia at 1, 3, 5, or 12 months after the last injection. Brains were sampled to determine the total gadolinium content via inductively coupled plasma mass spectrometry (ICP-MS), to characterize gadolinium species with size exclusion chromatography (SEC)-ICP-MS, and to perform elemental mapping with laser ablation (LA)-ICP-MS. Mann-Whitney tests were performed on pairwise comparisons of the same time points. Results For both macrocyclic agents, no T1 signal hyperintensities were observed in the cerebellum, and approximately 80% of gadolinium washout was found between 1 month (gadobutrol, 0.30 nmol/g; gadopiclenol, 0.37 nmol/g) and 12 months (gadobutrol, 0.062 nmol/g; gadopiclenol, 0.078 nmol/g). After 12 months, only low-molecular-weight gadolinium species were detected in the soluble fraction. Gadodiamide led to significantly higher gadolinium concentrations after 1 month in the cerebellum (gadodiamide, 2.65 nmol/g; P < .001 vs both macrocyclics) combined with only 15% washout after 12 months (gadodiamide, 2.25 nmol/g) and with gadolinium detected bound to macromolecules. Elemental bioimaging enabled visualization of gadolinium deposition patterns colocalized with iron. Conclusion Gadopiclenol and gadobutrol demonstrated similar in vivo distribution and washout of gadolinium in the healthy rat brain, markedly differing from gadodiamide up to 12 months after the last injection. © 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, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
| | - Cécile Factor
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
| | - Marlène Rasschaert
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
| | - Lena Lezius
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
| | - Michael Sperling
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
| | - Uwe Karst
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
| | - Philippe Robert
- From the Institute of Inorganic and Analytical Chemistry, University of Münster, Münster, Germany (S.K.I.F., L.L., M.S., U.K.); and Department of Research and Innovation, Guerbet Group, BP57400, Roissy 95943, France (C.F., M.R., P.R.)
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17
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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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18
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Davies J, Siebenhandl-Wolff P, Tranquart F, Jones P, Evans P. Gadolinium: pharmacokinetics and toxicity in humans and laboratory animals following contrast agent administration. Arch Toxicol 2022; 96:403-429. [PMID: 34997254 PMCID: PMC8837552 DOI: 10.1007/s00204-021-03189-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/02/2021] [Indexed: 12/12/2022]
Abstract
Gadolinium-based contrast agents (GBCAs) have transformed magnetic resonance imaging (MRI) by facilitating the use of contrast-enhanced MRI to allow vital clinical diagnosis in a plethora of disease that would otherwise remain undetected. Although over 500 million doses have been administered worldwide, scientific research has documented the retention of gadolinium in tissues, long after exposure, and the discovery of a GBCA-associated disease termed nephrogenic systemic fibrosis, found in patients with impaired renal function. An understanding of the pharmacokinetics in humans and animals alike are pivotal to the understanding of the distribution and excretion of gadolinium and GBCAs, and ultimately their potential retention. This has been well studied in humans and more so in animals, and recently there has been a particular focus on potential toxicities associated with multiple GBCA administration. The purpose of this review is to highlight what is currently known in the literature regarding the pharmacokinetics of gadolinium in humans and animals, and any toxicity associated with GBCA use.
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Affiliation(s)
- Julie Davies
- GE Healthcare, Pollards Wood, Nightingales Lane, Chalfont St. Giles, UK.
| | | | | | - Paul Jones
- GE Healthcare, Pollards Wood, Nightingales Lane, Chalfont St. Giles, UK
| | - Paul Evans
- GE Healthcare, Pollards Wood, Nightingales Lane, Chalfont St. Giles, UK
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Pavuluri K, Yang E, Ayyappan V, Sonkar K, Tan Z, Tressler CM, Bo S, Bibic A, Glunde K, McMahon MT. Unlabeled aspirin as an activatable theranostic MRI agent for breast cancer. Theranostics 2022; 12:1937-1951. [PMID: 35198081 PMCID: PMC8825591 DOI: 10.7150/thno.53147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 11/17/2021] [Indexed: 01/11/2023] Open
Abstract
Rationale: Chemical exchange saturation transfer (CEST) magnetic resonance imaging (MRI) is emerging as an alternative to gadolinium-based contrast MRI. We have evaluated the possibility of CEST MRI of orthotopic breast tumor xenografts with unlabeled aspirin's conversion to salicylic acid (SA) through various enzymatic activities, most notably inhibition of cyclooxygenase (COX)-1/-2 enzymes. Methods: We measured the COX-1/-2 expression in four breast cancer cell lines by Western Blot analysis and selected the highest and lowest expressing cell lines. We then performed CEST MRI following aspirin treatment to detect SA levels and ELISA to measure levels of downstream prostaglandin E2 (PGE2). We also injected aspirin into the tail vein of mice growing orthotopic tumor xenografts which expressed high and low COX-1/-2 and acquired SA CEST MR images of these tumor xenografts for up to 70 minutes. Tumors were then harvested to perform Western Blot and ELISA experiments to measure COX-1/-2 expression and PGE2 levels, respectively. Results: Western Blots determined that SUM159 cells contained significantly higher COX-1/-2 expression levels than MDA-MB-231 cells, in line with higher levels of downstream PGE2. SA CEST MRI yielded similar contrast at approximately 3% for both cell lines, independent of COX-1/-2 expression level. PGE2 levels decreased by about 50% following aspirin treatment. Results from our mouse study aligned with cultured cells, the overall SA CEST MRI contrast in both MDA-MB-231 and SUM159 tumor xenograft models was 5~8% at one hour post injection. PGE2 levels were ten times higher in SUM159 than MDA-MB-231 and decreased by 50%. The CEST contrast directly depended on the injected dose, with ~6%, ~3% and ~1.5% contrast observed following injection of 100 µL of 300 mM, 200 mM and 150 mM aspirin, respectively. Conclusions: Our data demonstrate the feasibility of using aspirin as a noninvasive activatable CEST MRI contrast agent for breast tumor detection.
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Affiliation(s)
- KowsalyaDevi Pavuluri
- Division of MR Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ethan Yang
- Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vinay Ayyappan
- Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Kanchan Sonkar
- Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Zheqiong Tan
- Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Caitlin M. Tressler
- Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shaowei Bo
- Division of MR Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Adnan Bibic
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD
| | - Kristine Glunde
- Division of Cancer Imaging Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD.,The Department of Biological Chemistry, The Johns Hopkins University School of Medicine, Baltimore, MD.,Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine, Baltimore, MD.,✉ Corresponding authors: ,
| | - Michael T McMahon
- Division of MR Research, The Russell H. Morgan Department of Radiology and Radiological Science; The Johns Hopkins University School of Medicine, Baltimore, MD.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD.,✉ Corresponding authors: ,
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20
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Do QN, Lenkinski RE, Tircso G, Kovacs Z. How the Chemical Properties of GBCAs Influence Their Safety Profiles In Vivo. Molecules 2021; 27:58. [PMID: 35011290 PMCID: PMC8746842 DOI: 10.3390/molecules27010058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 01/21/2023] Open
Abstract
The extracellular class of gadolinium-based contrast agents (GBCAs) is an essential tool for clinical diagnosis and disease management. In order to better understand the issues associated with GBCA administration and gadolinium retention and deposition in the human brain, the chemical properties of GBCAs such as relative thermodynamic and kinetic stabilities and their likelihood of forming gadolinium deposits in vivo will be reviewed. The chemical form of gadolinium causing the hyperintensity is an open question. On the basis of estimates of total gadolinium concentration present, it is highly unlikely that the intact chelate is causing the T1 hyperintensities observed in the human brain. Although it is possible that there is a water-soluble form of gadolinium that has high relaxitvity present, our experience indicates that the insoluble gadolinium-based agents/salts could have high relaxivities on the surface of the solid due to higher water access. This review assesses the safety of GBCAs from a chemical point of view based on their thermodynamic and kinetic properties, discusses how these properties influence in vivo behavior, and highlights some clinical implications regarding the development of future imaging agents.
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Affiliation(s)
- Quyen N. Do
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; (Q.N.D.); (R.E.L.)
| | - Robert E. Lenkinski
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA; (Q.N.D.); (R.E.L.)
| | - Gyula Tircso
- Department of Physical Chemistry Debrecen, University of Debrecen, Egyetem tér 1, H-4032 Debrecen, Hungary;
| | - Zoltan Kovacs
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
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21
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Sousa NR, Rocha S, Santos-Silva A, Coimbra S, Valente MJ. Cellular and molecular pathways underlying the nephrotoxicity of gadolinium. Toxicol Sci 2021; 186:134-148. [PMID: 34878122 DOI: 10.1093/toxsci/kfab148] [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] [Indexed: 01/13/2023] Open
Abstract
Mounting evidence on the short- and long-term adverse effects associated with gadolinium [Gd (III)]-based contrast agents used in magnetic resonance imaging have emerged in the past three decades. Safety issues arise from the release of Gd (III) from chelates and its deposition in tissues, which is exacerbated in patients with renal disease, since the kidney is the major excretion organ of most of these agents. This study aimed at unveiling the cellular and molecular mechanisms of nephrotoxicity of Gd (III), using an in vitro model of human proximal tubular cells (HK-2 cell line). Cell viability declined in a concentration- and time-dependent manner after exposure to GdCl3·6H2O. The estimated inhibitory concentrations (ICs) eliciting 1 to 50% of cell death, after 24 h of exposure, ranged from 3.4 to 340.5 µM. At toxic concentrations, exposure to Gd (III) led to disruption of the oxidative status, mitochondrial dysfunction, cell death by apoptosis, switching to necrosis at higher levels, and autophagic activation. Disturbance of the lipid metabolism was already observed at low-toxicity ICs, with accumulation of lipid droplets, and upregulation of genes related to both lipogenesis and lipolysis. Gd (III)-exposure, even at the subtoxic IC01, increased the expression of modulators of various signaling pathways involved in the development and progression of renal disease, including inflammation, hypoxia and fibrosis. Our results give new insights into the mechanisms underlying the nephrotoxic potential of Gd (III) and highlight the need to further clarify the risks versus benefits of the Gd (III)-based contrast agents currently in use.
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Affiliation(s)
- Nícia Reis Sousa
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal.,Departamento de Ciências e Tecnologia da Saúde, Instituto Superior Politécnico de Benguela, Benguela, Angola
| | - Susana Rocha
- LAQV, REQUIMTE, Laboratório de Química Aplicada, Departamento de Ciências Químicas, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Alice Santos-Silva
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Susana Coimbra
- TOXRUN-Toxicology Research Unit, University Institute of Health Sciences, CESPU, CRL, Gandra, Portugal.,Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
| | - Maria João Valente
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculdade de Farmácia da, Universidade do Porto, Porto, Portugal.,UCIBIO-Applied Molecular Biosciences Unit, Department of Biological Sciences, Faculdade de Farmácia da Universidade do Porto, Porto, Portugal
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22
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Kuhn MJ, Patriarche JW, Patriarche D, Kirchin MA, Bona M, Pirovano G. The TRUTH confirmed: validation of an intraindividual comparison of gadobutrol and gadoteridol for imaging of glioblastoma using quantitative enhancement analysis. Eur Radiol Exp 2021; 5:46. [PMID: 34635965 PMCID: PMC8505590 DOI: 10.1186/s41747-021-00240-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 08/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous intraindividual comparative studies evaluating gadobutrol and gadoteridol for contrast-enhanced magnetic resonance imaging (MRI) of brain tumours have relied on subjective image assessment, potentially leading to misleading conclusions. We used artificial intelligence algorithms to objectively compare the enhancement achieved with these contrast agents in glioblastoma patients. METHODS Twenty-seven patients from a prior study who received identical doses of 0.1 mmol/kg gadobutrol and gadoteridol (with appropriate washout in between) were evaluated. Quantitative enhancement (QE) maps of the normalised enhancement of voxels, derived from computations based on the comparison of contrast-enhanced T1-weighted images relative to the harmonised intensity on unenhanced T1-weighted images, were compared. Bland-Altman analysis, linear regression analysis and Pearson correlation coefficient (r) determination were performed to compare net QE and per-region of interest (per-ROI) average QE (net QE divided by the number of voxels). RESULTS No significant differences were observed for comparisons performed on net QE (mean difference -24.37 ± 620.8, p = 0.840, r = 0.989) or per-ROI average QE (0.0043 ± 0.0218, p = 0.313, r = 0.958). Bland-Altman analysis revealed better per-ROI average QE for gadoteridol-enhanced MRI in 19/27 (70.4%) patients although the mean difference (0.0043) was close to zero indicating high concordance and the absence of fixed bias. CONCLUSIONS The enhancement of glioblastoma achieved with gadoteridol and gadobutrol at 0.1 mmol/kg bodyweight is similar indicating that these agents have similar contrast efficacy and can be used interchangeably, confirming the results of a prior double-blind, randomised, intraindividual, crossover study.
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Affiliation(s)
- Matthew J Kuhn
- University of Illinois College of Medicine at Peoria, 221 NE Glen Oak Ave, Peoria, IL, 61636, USA. .,A.I. Analysis, Inc., 1425 Broadway #20-2656, Seattle, WA, 98122, USA.
| | | | | | - Miles A Kirchin
- Global Medical & Regulatory Affairs, Bracco Imaging SpA, Via Caduti di Marcinelle, 13, 20134, Milan, Italy
| | - Massimo Bona
- Global Medical & Regulatory Affairs, Bracco Imaging SpA, Via Caduti di Marcinelle, 13, 20134, Milan, Italy
| | - Gianpaolo Pirovano
- Global Medical & Regulatory Affairs, Bracco Diagnostics, Inc., 259 Prospect Plains Rd. Building H, Monroe Township, NJ, 08831, USA
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23
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Schlatt L, Köhrer A, Factor C, Robert P, Rasschaert M, Sperling M, Karst U. Mild Dissolution/Recomplexation Strategy for Speciation Analysis of Gadolinium from MR Contrast Agents in Bone Tissues by Means of HPLC-ICP-MS. Anal Chem 2021; 93:11398-11405. [PMID: 34387072 DOI: 10.1021/acs.analchem.1c01100] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A species-dependent and total gadolinium quantification strategy for the analysis of bone and bone marrow samples was developed and applied to femurs of rats previously treated with different gadolinium-based contrast agents (GBCAs). A combined mild dissolution/recomplexation strategy allows the quantification of total Gd as well as the quantification of intact GBCA in bones within one analysis for the first time. Samples of rat bones and bone marrow were dissolved in low concentrations of hydrochloric acid and diethylenetriamine pentaacetate (DTPA). This is followed by the addition of excess In(III) to recomplex all free ligands, previously added DTPA as well as the ligands of GBCAs that were not stable during the dissolution step. Separation and quantification were carried out by means of high-performance liquid chromatography (HPLC) on a hydrophilic interaction liquid chromatography (HILIC) column with subsequent inductively coupled plasma-mass spectrometry (ICP-MS). The results show that the investigated GBCA with a macrocyclic ligand shows a higher tendency to stay intact in the bone tissues over time, while a GBCA with a linear ligand is decomplexed more rapidly four weeks after GBCA administration. Additionally, for all macrocyclic GBCAs, a similar limited gadolinium accumulation was observed in the bone and bone marrow. Whereas linear GBCAs showed a higher gadolinium accumulation, a difference was observed between bone and bone marrow, indicating a different biodistribution behavior.
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Affiliation(s)
- Lukas Schlatt
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 28/30, 49149 Münster, Germany
| | - Alexander Köhrer
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 28/30, 49149 Münster, Germany
| | - Cécile Factor
- Department of Research and Innovation, Guerbet Group, BP57400, 95943 Roissy CDG, France
| | - Philippe Robert
- Department of Research and Innovation, Guerbet Group, BP57400, 95943 Roissy CDG, France
| | - Marlène Rasschaert
- Department of Research and Innovation, Guerbet Group, BP57400, 95943 Roissy CDG, France
| | - Michael Sperling
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 28/30, 49149 Münster, Germany.,European Virtual Institute for Speciation Analysis (EVISA), c/o IAAC, Corrensstraße 28/30, 48149 Münster, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 28/30, 49149 Münster, Germany
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24
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Guidolin N, Travagin F, Giovenzana GB, Vágner A, Lotti S, Chianale F, Brücher E, Maisano F, Kirchin MA, Tedoldi F, Giorgini A, Colombo Serra S, Baranyai Z. Interaction of macrocyclic gadolinium-based MR contrast agents with Type I collagen. Equilibrium and kinetic studies. Dalton Trans 2021; 49:14863-14870. [PMID: 33073806 DOI: 10.1039/d0dt03314f] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The interactions of gadoterate meglumine, gadobutrol, gadoteridol and Gd(HB-DO3A) with bovine Type I collagen were investigated by ultrafiltration and dialysis. The affinity of the four agents to collagen is similar. However, the maximum adsorbed amount of GdIII-complexes decreases in the following order: gadoterate meglumine > gadobutrol > gadoteridol > Gd(HB-DO3A). Calculations with the open three-compartment model reveal that the structural homologs gadoteridol and Gd(HB-DO3A) have a lower adsorption onto collagen, which may explain the less prolonged in vivo retention of gadoteridol observed in soft tissues of rats.
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Affiliation(s)
- Nicol Guidolin
- Bracco Imaging Spa, Bracco Research Centre, Via Ribes 5, 10010 Colleretto Giacosa (TO), Italy.
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25
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Davies J, Marino M, Smith APL, Crowder JM, Larsen M, Lowery L, Castle J, Hibberd MG, Evans PM. Repeat and single dose administration of gadodiamide to rats to investigate concentration and location of gadolinium and the cell ultrastructure. Sci Rep 2021; 11:13950. [PMID: 34230532 PMCID: PMC8260729 DOI: 10.1038/s41598-021-93147-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/21/2021] [Indexed: 01/20/2023] Open
Abstract
Gadolinium based contrast agents (GBCA) are used to image patients using magnetic resonance (MR) imaging. In recent years, there has been controversy around gadolinium retention after GBCA administration. We sought to evaluate the potential toxicity of gadolinium in the rat brain up to 1-year after repeated gadodiamide dosing and tissue retention kinetics after a single administration. Histopathological and ultrastructural transmission electron microscopy (TEM) analysis revealed no findings in rats administered a cumulative dose of 12 mmol/kg. TEM-energy dispersive X-ray spectroscopy (TEM-EDS) localization of gadolinium in the deep cerebellar nuclei showed ~ 100 nm electron-dense foci in the basal lamina of the vasculature. Laser ablation-ICP-MS (LA-ICP-MS) showed diffuse gadolinium throughout the brain but concentrated in perivascular foci of the DCN and globus pallidus with no observable tissue injury or ultrastructural changes. A single dose of gadodiamide (0.6 mmol/kg) resulted in rapid cerebrospinal fluid (CSF) and blood clearance. Twenty-weeks post administration gadolinium concentrations in brain regions was reduced by 16-72-fold and in the kidney (210-fold), testes (194-fold) skin (44-fold), liver (42-fold), femur (6-fold) and lung (64-fold). Our findings suggest that gadolinium does not lead to histopathological or ultrastructural changes in the brain and demonstrate in detail the kinetics of a human equivalent dose over time in a pre-clinical model.
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Affiliation(s)
- Julie Davies
- GE Healthcare, Pollards Wood, Nightingales lane, Chalfont St. Giles, UK.
| | - Michael Marino
- GE Global Research Centre, 1 Research Circle, Niskayuna, NY, USA
| | - Adrian P L Smith
- GE Healthcare, Pollards Wood, Nightingales lane, Chalfont St. Giles, UK
| | - Janell M Crowder
- GE Global Research Centre, 1 Research Circle, Niskayuna, NY, USA
| | - Michael Larsen
- GE Global Research Centre, 1 Research Circle, Niskayuna, NY, USA
| | - Lisa Lowery
- GE Global Research Centre, 1 Research Circle, Niskayuna, NY, USA
| | - Jason Castle
- GE Global Research Centre, 1 Research Circle, Niskayuna, NY, USA
| | | | - Paul M Evans
- GE Healthcare, Pollards Wood, Nightingales lane, Chalfont St. Giles, UK
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26
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Frenzel T, Ulbrich HF, Pietsch H. The Macrocyclic Gadolinium-Based Contrast Agents Gadobutrol and Gadoteridol Show Similar Elimination Kinetics From the Brain After Repeated Intravenous Injections in Rabbits. Invest Radiol 2021; 56:341-347. [PMID: 33259443 DOI: 10.1097/rli.0000000000000749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
MATERIALS AND METHODS Male white New Zealand rabbits (2.4-3.1 kg) in 2 study groups (n = 21 each) received 3 injections of either gadobutrol or gadoteridol at 0.9 mmol Gd/kg within 5 days (total dose, 2.7 mmol Gd/kg). Animals in one control group (n = 9) received 3 injections of saline (1.8 mL/kg). After 2, 6, and 12 weeks, 7 animals from each study group and 3 from the control group were killed and the Gd concentrations in the cerebellum, cerebrum, in blood and in urine were determined by inductively coupled plasma mass spectrometry. The chemical species of excreted Gd in urine were determined by high pressure liquid chromatography. RESULTS No significant (P > 0.05) differences in the Gd concentrations in the brain of rabbits were observed between the 2 macrocyclic GBCAs gadoteridol and gadobutrol at all time points. In the gadobutrol group, the mean Gd concentrations in the cerebellum and cerebrum decreased from 0.26 and 0.21 nmol Gd/g after 2 weeks, to 0.040 and 0.027 nmol Gd/g after 12 weeks, respectively, and in the gadoteridol group, from 0.25 and 0.21, to 0.037 and 0.023 nmol Gd/g, respectively. The plasma levels decreased from 0.11 and 0.13 nmol Gd/mL at 2 weeks for gadobutrol and gadoteridol to below the limit of quantification (<0.005 nmol Gd/mL) at 12 weeks. The urine concentration dropped in a biphasic course from 2 to 6 and from 6 to 12 weeks for both agents. The Gd excreted after 12 weeks was still present in the urine in the chemical form of the intact Gd complex for both agents. CONCLUSIONS Contrary to what had been reported in rats, no significant differences in the elimination kinetics from brain tissue in rabbits were observed after intravenous injection of multiple doses of the macrocyclic GBCAs gadobutrol and gadoteridol.
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27
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Bussi S, Coppo A, Bonafè R, Rossi S, Colombo Serra S, Penard L, Kirchin MA, Maisano F, Tedoldi F. Gadolinium Clearance in the First 5 Weeks After Repeated Intravenous Administration of Gadoteridol, Gadoterate Meglumine, and Gadobutrol to rats. J Magn Reson Imaging 2021; 54:1636-1644. [PMID: 33973290 PMCID: PMC8597020 DOI: 10.1002/jmri.27693] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background Studies of gadolinium (Gd) clearance from animals in the first weeks after administration of gadolinium‐based contrast agents (GBCAs) have previously looked at solitary timepoints only. However, this does not give information on differences between GBCAs and between organs in terms of Gd elimination kinetics. Purpose To compare Gd levels in rat cerebellum, cerebrum, skin, and blood at 1, 2, 3, and 5 weeks after repeated administration of macrocyclic GBCAs. Study Type Prospective. Animal Model One hundred eighty male Sprague–Dawley rats randomized to three groups (n = 60/group), received intravenous administrations of gadoteridol, gadoterate meglumine, or gadobutrol (0.6 mmol/kg for each) four times/week for 5 consecutive weeks. Rats were sacrificed after washout periods of 1, 2, 3, or 5 weeks. Field Strength/Sequence Not applicable. Assessment Cerebellum, cerebrum, skin, and blood were harvested for Gd determination by inductively coupled plasma‐mass spectrometry (15 animals/group/all timepoints). Statistical Tests Anova and Dunnett's test (data with homogeneous variances and normal distribution). Kruskal–Wallis and Wilcoxon's rank sum tests (data showing nonhomogeneous variances or a non‐normal distribution, significance levels: P < 0.05, P < 0.01, and P < 0.001). Results Gd levels in cerebellum, cerebrum, and skin were significantly lower after gadoteridol than after gadoterate and gadobutrol at all timepoints. Mean cerebellum Gd concentrations after gadoteridol, gadoterate, and gadobutrol decreased from 0.693, 0.878, and 1.011 nmol Gd/g at 1 week to 0.144, 0.282, and 0.297 nmol Gd/g at 5 weeks after injection. Similar findings were noted for cerebrum and skin. Conversely, significantly higher Gd levels were noted in blood after gadoteridol compared to gadobutrol at 1, 2, and 3 weeks and compared to gadoterate at all timepoints. Data Conclusion Gadoteridol is eliminated more rapidly from rat cerebellum, cerebrum, and skin compared to gadoterate and gadobutrol in the first 5 weeks after administration, resulting in lower levels of retained Gd in these tissues. Evidence Level 1 Technical Efficacy Stage 5
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Affiliation(s)
- Simona Bussi
- Bracco Imaging SpA, Bracco Research Centre, Colleretto Giacosa, TO, Italy
| | - Alessandra Coppo
- Bracco Imaging SpA, Bracco Research Centre, Colleretto Giacosa, TO, Italy
| | - Roberta Bonafè
- Bracco Imaging SpA, Bracco Research Centre, Colleretto Giacosa, TO, Italy
| | - Silvia Rossi
- Bracco Imaging SpA, Bracco Research Centre, Colleretto Giacosa, TO, Italy
| | | | - Laure Penard
- Charles River Saint Germain-Nuelles, Lyon, France
| | - Miles A Kirchin
- Bracco Imaging SpA, Global Medical & Regulatory Affairs, Milan, Italy
| | - Federico Maisano
- Bracco Imaging SpA, Bracco Research Centre, Colleretto Giacosa, TO, Italy
| | - Fabio Tedoldi
- Bracco Imaging SpA, Bracco Research Centre, Colleretto Giacosa, TO, Italy
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28
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Safety and diagnostic efficacy of gadoteridol for magnetic resonance imaging of the brain and spine in children 2 years of age and younger. Pediatr Radiol 2021; 51:1895-1906. [PMID: 33950270 PMCID: PMC8426253 DOI: 10.1007/s00247-021-05069-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/11/2021] [Accepted: 03/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Neonates and young children require efficacious magnetic resonance imaging (MRI) examinations but are potentially more susceptible to the short- and long-term adverse effects of gadolinium-based contrast agents due to the immaturity of their body functions. OBJECTIVE To evaluate the acute safety and diagnostic efficacy of gadoteridol (ProHance) for contrast-enhanced MRI of the central nervous system (CNS) in children ≤2 years of age. MATERIALS AND METHODS One hundred twenty-five children ≤2 years old (including 57 children <6 months old) who underwent contrast-enhanced MRI of the CNS with gadoteridol at 0.1 mmol/kg body weight were retrospectively enrolled at five imaging centers. Safety data were assessed for acute/subacute adverse events in the 48 h following gadoteridol administration and, when available, vital signs, electrocardiogram (ECG) and clinical laboratory values obtained from blood samples taken from 48 h before until 48 h following the MRI exam. The efficacy of gadoteridol-enhanced MRI compared to unenhanced MRI for disease diagnosis was evaluated prospectively by three blinded, unaffiliated readers. RESULTS Thirteen changes of laboratory values (11 mild, 1 moderate, 1 unspecified) were reported as adverse events in 7 (5.6%) patients. A relationship to gadoteridol was deemed possible though doubtful for two of these adverse events in two patients (1.6%). There were no clinical adverse events, no serious adverse events and no clinically meaningful changes in vital signs or ECG recordings. Accurate differentiation of tumor from non-neoplastic disease, and exact matching of specific MRI-determined diagnoses with on-site final diagnoses, was achieved in significantly more patients by each reader following the evaluation of combined pre- and post-contrast images compared to pre-contrast images alone (84.6-88.0% vs. 70.9-76.9%; P≤0.006 and 67.5-79.5% vs. 47.0-66.7%; P≤0.011, respectively). CONCLUSION Gadoteridol at 0.1 mmol/kg body weight is safe, well tolerated and effective for contrast-enhanced MRI of the CNS in children ≤2 years of age.
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29
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Kanal E, Weinreb JC, Frischman C. Gadolinium Retention and Legal Risk Management: A Second Opinion. J Am Coll Radiol 2020; 17:1515-1519. [PMID: 32628900 DOI: 10.1016/j.jacr.2020.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Emanuel Kanal
- Chief, Division of Emergency Radiology; Director, Magnetic Resonance Services; Professor of Radiology and Neuroradiology, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
| | - Jeffrey C Weinreb
- Chief, MRI services, Yale-New Haven Hospital; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
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30
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Rogg J. “Gadolinium Deposition Disease: A New Risk Management Threat” Adds Controversy to a Controversial Topic. J Am Coll Radiol 2020; 17:1077. [DOI: 10.1016/j.jacr.2020.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022]
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31
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Liu CY, Schöckel L, Habib P, Balzer T, Pietsch H. Re: "Gadolinium Deposition Disease: A New Risk Management Threat". J Am Coll Radiol 2020; 17:1077-1078. [PMID: 32663450 DOI: 10.1016/j.jacr.2020.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Chia-Ying Liu
- US Medical Affairs, Bayer HealthCare, Whippany, New Jersey
| | - Laura Schöckel
- US Medical Affairs, Bayer HealthCare, Whippany, New Jersey
| | - Pamela Habib
- US Medical Affairs Bayer HealthCare 100 Bayer Boulevard Whippany, NJ 07981-0915.
| | - Thomas Balzer
- US Medical Affairs, Bayer HealthCare, Whippany, New Jersey
| | - Hubertus Pietsch
- Head of the Department of MR and CT Contrast Media Research, Bayer, Berlin, Germany
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32
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Harvey HB, Gowda V, Cheng G. Authors' Reply. J Am Coll Radiol 2020; 17:1078-1079. [PMID: 32653272 DOI: 10.1016/j.jacr.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 11/18/2022]
Affiliation(s)
- H Benjamin Harvey
- Department of Radiology, Massachusetts General Hospital, 175 Cambridge Street, Suite 200, Boston, MA 02114.
| | | | - Glen Cheng
- Harvard Medical School, Boston, Massachusetts; Environmental and Occupational Medicine and Epidemiology, T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
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33
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McDonald RJ, Kallmes DF. Signal Intensity Changes at MRI Following GBCA Exposure: Incidental Finding or Cause for Concern? Radiology 2020; 296:131-133. [DOI: 10.1148/radiol.2020201256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Robert J. McDonald
- From the Departments of Radiology (R.J.M., D.F.K.) and Neurosurgery (D.F.K.), College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905
| | - David F. Kallmes
- From the Departments of Radiology (R.J.M., D.F.K.) and Neurosurgery (D.F.K.), College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905
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34
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Gadolinium Deposition Disease: A New Risk Management Threat. J Am Coll Radiol 2020; 17:546-550. [DOI: 10.1016/j.jacr.2019.11.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 01/06/2023]
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