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Norris EC, Schneider G, Clark TJ, Kirchin MA, Wilson GJ, Maki JH. Efficacy of Whole-Blood Model of Gadolinium-Based Contrast Agent Relaxivity in Predicting Vascular MR Signal Intensity In Vivo. J Magn Reson Imaging 2024; 60:615-627. [PMID: 37916957 DOI: 10.1002/jmri.29089] [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: 05/11/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Previous in vitro studies have described sub-linear longitudinal and heightened transverse H2O relaxivities of gadolinium-based contrast agents (GBCAs) in blood due to their extracellular nature. However, in vivo validation is lacking. PURPOSE Validate theory describing blood behavior of R1 and R2* in an animal model. STUDY TYPE Prospective, animal. ANIMAL MODEL Seven swine (54-65 kg). FIELD STRENGTH/SEQUENCE 1.5 T; time-resolved 3D spoiled gradient-recalled echo (SPGR) and quantitative Look-Locker and multi-echo fast field echo sequences. ASSESSMENT Seven swine were each injected three times with 0.1 mmol/kg intravenous doses of one of three GBCAs: gadoteridol, gadobutrol, and gadobenate dimeglumine. Injections were randomized for rate (1, 2, and 3 mL/s) and order, during which time-resolved aortic 3D SPGR imaging was performed concurrently with aortic blood sampling via an indwelling catheter. Time-varying [GBCA] was measured by mass spectrometry of sampled blood. Predicted signal intensity (SI) was determined from a model incorporating sub-linear R1 and R2* effects (whole-blood model) and simpler models incorporating linear R1, with and without R2* effects. Predicted SIs were compared to measured aortic SI. STATISTICAL TESTS Linear correlation (coefficient of determination, R2) and mean errors were compared across the SI prediction models. RESULTS There was an excellent correlation between predicted and measured SI across all injections and swine when accounting for the non-linear dependence of R1 and high blood R2* (regression slopes 0.91-1.04, R2 ≥ 0.91). Simplified models (linear R1 with and without R2* effects) showed poorer correlation (slopes 0.67-0.85 and 0.54-0.64 respectively, both R2 ≥ 0.89) and higher averaged mean absolute and mean square errors (128.4 and 177.4 vs. 42.0, respectively, and 5506 and 11,419 vs. 699, respectively). DATA CONCLUSION Incorporating sub-linear R1 and high first-pass R2* effects in arterial blood models allows accurate SPGR SI prediction in an in vivo animal model, and might be utilized when modeling MR blood SI. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Evan C Norris
- Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Guenther Schneider
- Department of Diagnostic and Interventional Radiology, Saarland University Medical Center, Homburg, Germany
| | - Toshimasa J Clark
- Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Miles A Kirchin
- Global Medical & Regulatory Affairs, Bracco Imaging SpA, Milan, Italy
| | - Gregory J Wilson
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Jeffrey H Maki
- Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
- Department of Radiology, University of Washington, Seattle, Washington, USA
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Kanal E, Maki JH, Schramm P, Marti-Bonmati L. Evolving Characteristics of Gadolinium-Based Contrast Agents for MR Imaging: A Systematic Review of the Importance of Relaxivity. J Magn Reson Imaging 2024. [PMID: 38699938 DOI: 10.1002/jmri.29367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/15/2024] [Accepted: 03/15/2024] [Indexed: 05/05/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are widely and routinely used to enhance the diagnostic performance of magnetic resonance imaging and magnetic resonance angiography examinations. T1 relaxivity (r1) is the measure of their ability to increase signal intensity in tissues and blood on T1-weighted images at a given dose. Pharmaceutical companies have invested in the design and development of GBCAs with higher and higher T1 relaxivity values, and "high relaxivity" is a claim frequently used to promote GBCAs, with no clear definition of what "high relaxivity" means, or general concurrence about its clinical benefit. To understand whether higher relaxivity values translate into a material clinical benefit, well-designed, and properly powered clinical studies are necessary, while mere in vitro measurements may be misleading. This systematic review of relevant peer-reviewed literature provides high-quality clinical evidence showing that a difference in relaxivity of at least 40% between two GBCAs results in superior diagnostic efficacy for the higher-relaxivity agent when this is used at the same equimolar gadolinium dose as the lower-relaxivity agent, or similar imaging performance when used at a lower dose. Either outcome clearly implies a relevant clinical benefit. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Emanuel Kanal
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
- Division of Emergency Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jeffrey H Maki
- Department of Radiology, University of Colorado Anschutz Medical Center, Aurora, Colorado, USA
| | - Peter Schramm
- Department of Neuroradiology, University Luebeck and Universitaetsklinikum Schleswig-Holstein Campus Luebeck, Luebeck, Germany
| | - Luis Marti-Bonmati
- Department of Radiology and GIBI230 Research Group on Biomedical Imaging, Hospital Universitario y Politécnico de La Fe and Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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Luzzi S, Agosti A. Radiomics Multifactorial in Silico Model for Spatial Prediction of Glioblastoma Progression and Recurrence: A Proof-of-Concept. World Neurosurg 2024; 183:e677-e686. [PMID: 38184226 DOI: 10.1016/j.wneu.2024.01.002] [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: 10/02/2023] [Revised: 12/30/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024]
Abstract
BACKGROUND Radiomics-based prediction of glioblastoma spatial progression and recurrence may improve personalized strategies. However, most prototypes are based on limited monofactorial Gompertzian models of tumor growth. The present study consists of a proof of concept on the accuracy of a radiomics multifactorial in silico model in predicting short-term spatial growth and recurrence of glioblastoma. METHODS A radiomics-based biomathematical multifactorial in silico model was developed using magnetic resonance imaging (MRI) data from a 53-year-old patient with newly diagnosed glioblastoma of the right supramarginal gyrus. Raw and optimized models were derived from the MRI at diagnosis and matched to the preoperative MRI obtained 28 days after diagnosis to test the accuracy in predicting the short-term spatial growth of the tumor. An additional optimized model was derived from the early postoperative MRI and matched to the MRI documenting tumor recurrence to test spatial accuracy in predicting the location of recurrence. The spatial prediction accuracy of the model was reported as an average Jaccard index. RESULTS Optimized models yielded an average Jaccard index of 0.69 and 0.26 for short-term tumor growth and long-term recurrence site, respectively. CONCLUSIONS The present radiomics-based multifactorial in silico model was feasible, reliable, and accurate for short-term spatial prediction of glioblastoma progression. The predictive value for the spatial location of recurrence was still low, and refinements in the description of tissue reorganization in the peritumoral and resected areas may be critical to optimize accuracy further.
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Affiliation(s)
- Sabino Luzzi
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy; Neurosurgery Unit, Department of Surgical Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
| | - Abramo Agosti
- Department of Mathematics, University of Pavia, Pavia, Italy
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Božić‐Iven M, Rapacchi S, Tao Q, Pierce I, Thornton G, Nitsche C, Treibel TA, Schad LR, Weingärtner S. Improved reproducibility for myocardial ASL: Impact of physiological and acquisition parameters. Magn Reson Med 2024; 91:118-132. [PMID: 37667643 PMCID: PMC10962577 DOI: 10.1002/mrm.29834] [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: 08/07/2022] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE To investigate and mitigate the influence of physiological and acquisition-related parameters on myocardial blood flow (MBF) measurements obtained with myocardial Arterial Spin Labeling (myoASL). METHODS A Flow-sensitive Alternating Inversion Recovery (FAIR) myoASL sequence with bSSFP and spoiled GRE (spGRE) readout is investigated for MBF quantification. Bloch-equation simulations and phantom experiments were performed to evaluate how variations in acquisition flip angle (FA), acquisition matrix size (AMS), heart rate (HR) and bloodT 1 $$ {\mathrm{T}}_1 $$ relaxation time (T 1 , B $$ {\mathrm{T}}_{1,B} $$ ) affect quantification of myoASL-MBF. In vivo myoASL-images were acquired in nine healthy subjects. A corrected MBF quantification approach was proposed based on subject-specificT 1 , B $$ {\mathrm{T}}_{1,B} $$ values and, for spGRE imaging, subtracting an additional saturation-prepared baseline from the original baseline signal. RESULTS Simulated and phantom experiments showed a strong dependence on AMS and FA (R 2 $$ {R}^2 $$ >0.73), which was eliminated in simulations and alleviated in phantom experiments using the proposed saturation-baseline correction in spGRE. Only a very mild HR dependence (R 2 $$ {R}^2 $$ >0.59) was observed which was reduced when calculating MBF with individualT 1 , B $$ {\mathrm{T}}_{1,B} $$ . For corrected spGRE, in vivo mean global spGRE-MBF ranged from 0.54 to 2.59 mL/g/min and was in agreement with previously reported values. Compared to uncorrected spGRE, the intra-subject variability within a measurement (0.60 mL/g/min), between measurements (0.45 mL/g/min), as well as the inter-subject variability (1.29 mL/g/min) were improved by up to 40% and were comparable with conventional bSSFP. CONCLUSION Our results show that physiological and acquisition-related factors can lead to spurious changes in myoASL-MBF if not accounted for. Using individualT 1 , B $$ {\mathrm{T}}_{1,B} $$ and a saturation-baseline can reduce these variations in spGRE and improve reproducibility of FAIR-myoASL against acquisition parameters.
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Affiliation(s)
- Maša Božić‐Iven
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | | | - Qian Tao
- Department of Imaging PhysicsDelft University of TechnologyDelftThe Netherlands
| | - Iain Pierce
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
| | - George Thornton
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Christian Nitsche
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
- Division of CardiologyMedical University of ViennaViennaAustria
| | - Thomas A. Treibel
- Barts Heart CentreSt Bartholomew's HospitalLondonUK
- Institute of Cardiovascular ScienceUniversity College LondonLondonUK
| | - Lothar R. Schad
- Medical Faculty MannheimHeidelberg UniversityMannheimGermany
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Tsui B, Calabrese E, Zaharchuk G, Rauschecker AM. Reducing Gadolinium Contrast With Artificial Intelligence. J Magn Reson Imaging 2023. [PMID: 37905681 DOI: 10.1002/jmri.29095] [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: 08/03/2023] [Revised: 10/11/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023] Open
Abstract
Gadolinium contrast is an important agent in magnetic resonance imaging (MRI), particularly in neuroimaging where it can help identify blood-brain barrier breakdown from an inflammatory, infectious, or neoplastic process. However, gadolinium contrast has several drawbacks, including nephrogenic systemic fibrosis, gadolinium deposition in the brain and bones, and allergic-like reactions. As computer hardware and technology continues to evolve, machine learning has become a possible solution for eliminating or reducing the dose of gadolinium contrast. This review summarizes the clinical uses of gadolinium contrast, the risks of gadolinium contrast, and state-of-the-art machine learning methods that have been applied to reduce or eliminate gadolinium contrast administration, as well as their current limitations, with a focus on neuroimaging applications. EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Brian Tsui
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Evan Calabrese
- Department of Radiology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Andreas M Rauschecker
- Center for Intelligent Imaging, Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
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Foster D, Larsen J. Polymeric Metal Contrast Agents for T 1-Weighted Magnetic Resonance Imaging of the Brain. ACS Biomater Sci Eng 2023; 9:1224-1242. [PMID: 36753685 DOI: 10.1021/acsbiomaterials.2c01386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Imaging plays an integral role in diagnostics and treatment monitoring for conditions affecting the brain; enhanced brain imaging capabilities will improve upon both while increasing the general understanding of how the brain works. T1-weighted magnetic resonance imaging is the preferred modality for brain imaging. Commercially available contrast agents, which are often required to render readable brain images, have considerable toxicity concerns. In recent years, much progress has been made in developing new contrast agents based on the magnetic features of gadolinium, iron, or magnesium. Nanotechnological approaches for these systems allow for the protected integration of potentially harmful metals with added benefits like reduced dosage and improved transport. Polymeric enhancement of each design further improves biocompatibility while allowing for specific brain targeting. This review outlines research on polymeric nanomedicine designs for T1-weighted contrast agents that have been evaluated for performance in the brain.
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Boldrini L, Alongi F, Romano A, Charles Davies D, Bassetti M, Chiloiro G, Corradini S, Gambacorta MA, Placidi L, Tree AC, Westley R, Nicosia L. Current practices and perspectives on the integration of contrast agents in MRI-guided radiation therapy clinical practice: a worldwide survey. Clin Transl Radiat Oncol 2023; 40:100615. [PMID: 36968577 PMCID: PMC10034422 DOI: 10.1016/j.ctro.2023.100615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023] Open
Abstract
Aims The introduction of on-line magnetic resonance image-guided radiotherapy (MRIgRT) has led to an improvement in the therapeutic workflow of radiotherapy treatments thanks to the better visualization of therapy volumes assured by the higher soft tissue contrast. Magnetic Resonance contrast agents (MRCA) could improve the target delineation in on-line MRIgRT planning as well as reduce inter-observer variability and enable innovative treatment optimization protocols. The aim of this survey is to investigate the utilization of MRCA among centres that clinically implemented on-line MRIgRT technology. Methods In September 2021, we conducted an online survey consisting of a sixteen-question questionnaire that was distributed to the all the hospitals around the world equipped with MR Linacs. The questionnaire was developed by two Italian 0.35 T and 1.5 T MR-Linac centres and was validated by four other collaborating centres, using a Delphi consensus methodology. Results The survey was distributed to 52 centres and 43 centres completed it (82.7%). Among these centres, 23 institutions (53.5%) used the 0.35T MR-Linac system, while the remaining 20 (46.5%) used the 1.5T MR-Linac system.According to results obtained, 25 (58%) of the centres implemented the use of MRCA for on-line MRIgRT. Gadoxetate (Eovist®; Primovist®) was reported to be the most used MRCA (80%) and liver the most common site of application (58%). Over 70% of responders agreed/strongly agreed to the need for international guidelines. Conclusions The use of MRCA in clinical practice presents several pitfalls and future research will be necessary to understand the actual advantage derived from the use of MRCA in clinical practice, their toxicity profiles and better define the need of formulating guidelines for standardising the use of MRCA in MRIgRT workflow.
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Affiliation(s)
- Luca Boldrini
- Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Filippo Alongi
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
- University of Brescia, Brescia, Italy
| | - Angela Romano
- Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
- Corresponding author.
| | - Diepriye Charles Davies
- Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Michael Bassetti
- Department of Human Oncology, University of Wisconsin-Madison, Madison, WI, USA
| | - Giuditta Chiloiro
- Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Stefanie Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - Maria Antonietta Gambacorta
- Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Lorenzo Placidi
- Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Rome, Italy
| | - Alison C. Tree
- The Royal Marsden NHS Foundation Trust, Sutton, UK
- The Institute of Cancer Research, London, UK
| | - Rosalyne Westley
- The Royal Marsden NHS Foundation Trust, Sutton, UK
- The Institute of Cancer Research, London, UK
| | - Luca Nicosia
- Advanced Radiation Oncology Department, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
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Doan-Nguyen TP, Crespy D. Advanced density-based methods for the characterization of materials, binding events, and kinetics. Chem Soc Rev 2022; 51:8612-8651. [PMID: 36172819 DOI: 10.1039/d1cs00232e] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Investigations of the densities of chemicals and materials bring valuable insights into the fundamental understanding of matter and processes. Recently, advanced density-based methods have been developed with wide measurement ranges (i.e. 0-23 g cm-3), high resolutions (i.e. 10-6 g cm-3), compatibility with different types of samples and the requirement of extremely low volumes of sample (as low as a single cell). Certain methods, such as magnetic levitation, are inexpensive, portable and user-friendly. Advanced density-based methods are, therefore, beneficially used to obtain absolute density values, composition of mixtures, characteristics of binding events, and kinetics of chemical and biological processes. Herein, the principles and applications of magnetic levitation, acoustic levitation, electrodynamic balance, aqueous multiphase systems, and suspended microchannel resonators for materials science are discussed.
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Affiliation(s)
- Thao P Doan-Nguyen
- Max Planck-VISTEC Partner Laboratory for Sustainable Materials, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand. .,Department of Materials Science and Engineering, School of Molecular Science and Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand
| | - Daniel Crespy
- Max Planck-VISTEC Partner Laboratory for Sustainable Materials, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand. .,Department of Materials Science and Engineering, School of Molecular Science and Engineering, Vidyasirimedhi Institute of Science and Technology (VISTEC), Rayong 21210, Thailand
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Heshmatzadeh Behzadi A, McDonald J. Gadolinium-based contrast agents for imaging of the central nervous system: A multicenter European prospective study. Medicine (Baltimore) 2022; 101:e30163. [PMID: 36042629 PMCID: PMC9410688 DOI: 10.1097/md.0000000000030163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Contrast-enhanced MR (CE-MR) imaging is required to improve lesion detection and characterization and to increase diagnostic confidence. This study aims to evaluate the safety, effectiveness, and usage patterns of recently introduced ClariscanTM (gadoterate meglumine) and other macrocyclic gadolinium-based contrast agents (GBCAs) used for magnetic resonance imaging (MRI) of the central nervous system (CNS). Data was obtained from a European multicenter, prospective, observational postmarketing study that included pediatric and adult patients undergoing contrast-enhanced MRI with a GBCA used in routine clinical practice. Safety data was collected by spontaneous patient adverse event (AE) reporting. Effectiveness was assessed via changes in radiological diagnosis, diagnostic confidence, and image quality. 766 patients with CNS-related indications were included from 8 centers across 5 European countries between December 2018 and November 2019. Clariscan (gadoterate meglumine) was used in 66% (503) of exams, Dotarem® (gadoterate meglumine) in 20% (160), Gadovist® (gadobutrol) in 13% (97), and ProHance® (gadoteridol) in 1%. GBCA use increased the diagnostic confidence in 95% (724/766) of patients and a change in radiological diagnosis in 65% (501/766) of patients. The Clariscan-specific data revealed an increase in diagnostic confidence in 94% (472/503) of patients and resulted in a change in radiological diagnosis in 58% (293/503) of patients. Image quality was considered excellent or good in 95% of patients across all GBCAs and in 94% of patients who received Clariscan. No AEs were reported in this cohort including Clariscan. This data demonstrates the excellent safety and efficacy profile of Clariscan and other GBCAs used in MRI examination of the CNS.
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Affiliation(s)
- Ashkan Heshmatzadeh Behzadi
- Department of Radiology, Yale Newhaven Health System, Bridgeport Hospital, CT
- *Correspondence: Ashkan Heshmatzadeh Behzadi, Department of Radiology, Yale Newhaven Health, Bridgeport hospital, CT, USA (e-mail: )
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Ozturk K, Nascene D. Diffusion Tensor Imaging of the Dentate Nucleus After Repeated Administration of Gadobutrol in Children. CEREBELLUM (LONDON, ENGLAND) 2022; 21:657-664. [PMID: 34453283 DOI: 10.1007/s12311-021-01324-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to investigate possible signal changes in the dentate nucleus (DN) on diffusion tensor imaging (DTI) after administration of gadobutrol in a pediatric cohort. Total of 50 pediatric patients (mean age: 6.2 ± 4.3 years) with normal renal function exposed exclusively to the macrocyclic GBCA (mcGBCA) gadobutrol and 50 age- and sex-matched control patients with nonpathological neuroimaging findings (and no GBCA administration). Mean diffusivity (MD) and fractional anisotropy (FA) values were determined in the DN. A paired t test was performed to compare FA, MD values, and DN-to-middle cerebral peduncle (MCP) T1WI SI ratios between children exposed to gadobutrol and controls. Pearson correlation analysis was conducted to determine any correlation between FA and MD values as well as T1WI SI ratios and confounding parameters. The mean FA values of DN was significantly lower in children with mcGBCA than in the control group (p < 0.001; non-GBCA group, 0.299 ± 0.03; mcGBCA group, 0.254 ± 0.05), but no significant difference of the T1WI SI ratio was noted between the mcGBCA group (0.946 ± 0.06) and the control group (0.963 ± 0.05; p = 0.336). There was also a significant MD value difference between mcGBCA group and control group (p < 0.001; non-GBCA group, 0.152 ± 0.02 × 10-3 mm2/s; mcGBCA group, 0.173 ± 0.03 × 10-3 mm2/s). A significant correlation was identified between FA/MD values and the number of mcGBCA administration (FA; correlation coefficient = - 0.355, p = 0.011 and MD; correlation coefficient = 0.334, p = 0.018). The administration of the gadobutrol was associated with higher MD and lower FA values in DN suggesting a difference in cerebellar tissue integrity between children exposed to mcGBCAs and control group.
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Affiliation(s)
- Kerem Ozturk
- Division of Neuroradiology, Department of Radiology, University of Minnesota, B-226 Mayo Memorial Building, MMC 292, 420 Delaware Street S.E, Minneapolis, MN, 55455, USA.
| | - David Nascene
- Division of Neuroradiology, Department of Radiology, University of Minnesota, B-226 Mayo Memorial Building, MMC 292, 420 Delaware Street S.E, Minneapolis, MN, 55455, USA
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Ozturk K, Nascene D. Dentate nucleus signal intensity changes on T1-weighted MRI after repeated administrations of linear and macrocyclic gadolinium-based contrast agents: a pediatric intraindividual case-control study. Acta Radiol 2022; 63:914-922. [PMID: 34018821 DOI: 10.1177/02841851211018809] [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: 11/17/2022]
Abstract
BACKGROUND An association between consecutive administrations of macrocyclic gadolinium-based contrast agent (mcGBCA) gadobutrol and linear (L)-GBCA gadopentetate dimeglumine and gadolinium retention in the pediatric brain remains incompletely understood. PURPOSE To compare signal intensity (SI) changes in the dentate nucleus (DN) on unenhanced T1-weighted imaging (T1WI) in children who obtained mcGBCA gadobutrol with those who had previously received L-GBCA gadopentetate dimeglumine. MATERIAL AND METHODS This retrospective study included 27 children who received L-GBCA gadopentetate dimeglumine followed by mcGBCA gadobutrol and two different control groups matched for age and sex for both periods, each involving 27 individuals with no GBCA administration from January 2010 to January 2020. DN-to-middle cerebellar peduncle (MCP) SI ratios on T1WI were determined. A repeated-measures ANOVA was performed to compare the T1WI SI ratio between children exposed to GBCA in each of the two periods and controls. Pearson correlation analysis was conducted to determine any correlation between SI ratios and confounding parameters. RESULTS T1WI SI ratio was significantly higher in those who had only L-GBCA (1.005±0.087) or subsequent mcGBCA gadobutrol (1.002±0.104) than in control groups 1 (0.927±0.041; P<0.001) and 2 (0.930±0.041; P=0.002), respectively, but no significant difference of the T1WI SI ratio was noted between L-GBCA period and subsequent mcGBCA gadobutrol period (P=0.917). T1WI SI ratios and the L-GBCA administration number revealed a modest but significant correlation (correlation coefficient=0.034; P=0.016). CONCLUSION Previous administration of gadopentetate dimeglumine is associated with increased T1WI SI in the DN, while subsequent administration of gadobutrol does not demonstrate any additional SI increase in the pediatric brain.
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Affiliation(s)
- Kerem Ozturk
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - David Nascene
- Department of Radiology, University of Minnesota, Minneapolis, MN, USA
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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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13
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DeLano MC, Spampinato MV, Chang EY, Barr RG, Lichtenstein RJ, Colosimo C, Vymazal J, Wen Z, Lin DDM, Kirchin MA, Pirovano G. Dose-Lowering in Contrast-Enhanced MRI of the Central Nervous System: A Retrospective, Parallel-Group Comparison Using Gadobenate Dimeglumine. J Magn Reson Imaging 2021; 54:1660-1675. [PMID: 34018290 PMCID: PMC9290706 DOI: 10.1002/jmri.27731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 11/16/2022] Open
Abstract
Background Concerns over gadolinium (Gd) retention encourage the use of lower Gd doses. However, lower Gd doses may compromise imaging performance. Higher relaxivity gadobenate may be suited to reduced dose protocols. Purpose To compare 0.05 mmol/kg and 0.1 mmol/kg gadobenate in patients undergoing enhanced MRI of the central nervous system (CNS). Study Type Retrospective, multicenter. Population Three hundred and fifty‐two patients receiving 0.05 (n = 181) or 0.1 (n = 171) mmol/kg gadobenate. Field Strength/Sequences 1.5 T and 3.0 T/precontrast and postcontrast T1‐weighted spin echo/fast spin echo (SE/FSE) and/or gradient echo/fast field echo (GRE/FFE); precontrast T2‐weighted FSE and T2‐FLAIR. Assessment Images of patients with extra‐axial lesions at 1.5 T or any CNS lesion at 3.0 T were reviewed by three blinded, independent neuroradiologists for qualitative (lesion border delineation, internal morphology visualization, contrast enhancement; scores from 1 = poor to 4 = excellent) and quantitative (lesion‐to‐brain ratio [LBR], contrast‐to‐noise ratio [CNR]; SI measurements at regions‐of‐interest on lesion and normal parenchyma) enhancement measures. Noninferiority of 0.05 mmol/kg gadobenate was determined for each qualitative endpoint if the lower limit of the 95% confidence interval (CI) for the difference in precontrast + postcontrast means was above a noninferiority margin of −0.4. Statistical Tests Student's t‐test for comparison of mean qualitative endpoint scores, Wilcoxon signed rank test for comparison of LBR and CNR values; Wilcoxon rank sum test for comparison of SI changes. Tests were significant for P < 0.05. Results The mean change from precontrast to precontrast + postcontrast was significant for all endpoints. Readers 1, 2, and 3 evaluated 304, 225, and 249 lesions for 0.05 mmol/kg gadobenate, and 382, 309, and 298 lesions for 0.1 mmol/kg gadobenate. The lower limit of the 95% CI was above −0.4 for all comparisons. Significantly, higher LBR and CNR was observed with the higher dose. Data Conclusion 0.05 mmol/kg gadobenate was noninferior to 0.1 mmol/kg gadobenate for lesion visualization. Evidence Level 2 Technical Efficacy Stage 3
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Affiliation(s)
- Mark C DeLano
- Spectrum Health System, Advanced Radiology Services PC, Division of Radiology and Biomedical Imaging, College of Human Medicine, Michigan State University, Michigan, USA
| | - Maria Vittoria Spampinato
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Eric Y Chang
- Radiology Service, VA San Diego Healthcare System, San Diego, California, USA
| | - Richard G Barr
- Department of Radiology, Rootstown, Northeastern Ohio Medical University, Rootstown, Ohio, USA
| | | | - Cesare Colosimo
- Institute of Radiology, Radiodiagnostica e Neuroradiologia, Fondazione Policlinico Universitario "A. Gemelli", Università Cattolica del Sacro Cuore, Rome, Italy
| | - Josef Vymazal
- Department of Radiology, Na Homolce Hospital, Prague, Czech Republic
| | - Zhibo Wen
- Department of Radiology, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Doris D M Lin
- Division of Neuroradiology, Russell H. Morgan Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Miles A Kirchin
- Global Medical & Regulatory Affairs, Bracco Imaging SpA, Milan, Italy
| | - Gianpaolo Pirovano
- Global Medical & Regulatory Affairs, Bracco Diagnostics Inc., Monroe, New Jersey, USA
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14
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Wang J, Yang Y, Weller DS, Zhou R, Van Houten M, Sun C, Epstein FH, Meyer CH, Kramer CM, Salerno M. High spatial resolution spiral first-pass myocardial perfusion imaging with whole-heart coverage at 3 T. Magn Reson Med 2021; 86:648-662. [PMID: 33709415 DOI: 10.1002/mrm.28701] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/16/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE To develop and evaluate a high spatial resolution (1.25 × 1.25 mm2 ) spiral first-pass myocardial perfusion imaging technique with whole-heart coverage at 3T, to better assess transmural differences in perfusion between the endocardium and epicardium, to quantify the myocardial ischemic burden, and to improve the detection of obstructive coronary artery disease. METHODS Whole-heart high-resolution spiral perfusion pulse sequences and corresponding motion-compensated reconstruction techniques for both interleaved single-slice (SS) and simultaneous multi-slice (SMS) acquisition with or without outer-volume suppression (OVS) were developed. The proposed techniques were evaluated in 34 healthy volunteers and 8 patients (55 data sets). SS and SMS images were reconstructed using motion-compensated L1-SPIRiT and SMS-Slice-L1-SPIRiT, respectively. Images were blindly graded by 2 experienced cardiologists on a 5-point scale (5, excellent; 1, poor). RESULTS High-quality perfusion imaging was achieved for both SS and SMS acquisitions with or without OVS. The SS technique without OVS had the highest scores (4.5 [4, 5]), which were greater than scores for SS with OVS (3.5 [3.25, 3.75], P < .05), MB = 2 without OVS (3.75 [3.25, 4], P < .05), and MB = 2 with OVS (3.75 [2.75, 4], P < .05), but significantly higher than those for MB = 3 without OVS (4 [4, 4], P = .95). SMS image quality was improved using SMS-Slice-L1-SPIRiT as compared to SMS-L1-SPIRiT (P < .05 for both reviewers). CONCLUSION We demonstrated the successful implementation of whole-heart spiral perfusion imaging with high resolution at 3T. Good image quality was achieved, and the SS without OVS showed the best image quality. Evaluation in patients with expected ischemic heart disease is warranted.
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Affiliation(s)
- Junyu Wang
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Yang Yang
- Biomedical Engineering and Imaging Institute and Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.,Department of Medicine, Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Daniel S Weller
- Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Ruixi Zhou
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Matthew Van Houten
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Changyu Sun
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA
| | - Frederick H Epstein
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA.,Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Craig H Meyer
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA.,Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Christopher M Kramer
- Department of Medicine, Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia, USA.,Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Michael Salerno
- Department of Biomedical Engineering, University of Virginia, Charlottesville, Virginia, USA.,Department of Medicine, Cardiovascular Division, University of Virginia Health System, Charlottesville, Virginia, USA.,Radiology and Medical Imaging, University of Virginia Health System, Charlottesville, Virginia, USA
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15
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Hannoun S, Kocevar G, Codjia P, Maucort-Boulch D, Cotton F, Vukusic S, Durand-Dubief F, Sappey-Marinier D. Signal Intensity Evaluation in the Dentate Nucleus and Subcortical Gray Matter : Effect of Several Administrations of Gadoterate Meglumine in Multiple Sclerosis. Clin Neuroradiol 2021; 32:677-685. [PMID: 33630120 DOI: 10.1007/s00062-021-00995-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/15/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Several studies reported gadolinium deposition in the dentate nuclei (DN) and the globus pallidus (GP) that was associated to linear GBCA administrations rather than macrocyclic. It is therefore imperative to evaluate and assess the safety of cumulative administration of gadoterate meglumine (macrocyclic). Thus, T1-weighted images (T1WI) of multiple sclerosis (MS) patients longitudinally followed for 4 years were retrospectively analyzed. METHODS In this study 44 patients, 10 with clinically isolated syndrome (CIS), 24 relapsing-remitting MS (RRMS) and 10 primary-progressive MS (PPMS) were examined every 6 months (first four scans) and then with a 1-year interval (last two scans). Image processing consisted in reorienting unenhanced T1WI to standard space, followed by B1 inhomogeneity correction. A patient-specific template was then generated to normalize T1WI signal intensity (SI) and segment the DN and subcortical GM structures. All structures were then transformed to each patient space in order to measure the SI in each region. The cerebellar peduncles (CP) and semi-oval (SO) white matter were then manually delineated and used as reference to calculate SI ratios in the DN and subcortical GM structures. A linear mixed-effect model was finally applied to longitudinally analyze SI variations. RESULTS The SI measurements performed in all structures showed no significant increases with the cumulative GBCA administration. CONCLUSION This study showed no significant SI increases within the DN and subcortical GM structures of longitudinally followed MS patients even with the cumulative administration of the macrocyclic GBCA gadoterate meglumine.
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Affiliation(s)
- Salem Hannoun
- Medical Imaging Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Gabriel Kocevar
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Datascience pole, Seenovate, Lyon, France
| | - Pekes Codjia
- Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
| | | | - François Cotton
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Sandra Vukusic
- Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
| | - Françoise Durand-Dubief
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.,Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France
| | - Dominique Sappey-Marinier
- CREATIS-CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France. .,CERMEP-Imagerie du Vivant, Université de Lyon, Bron, France.
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16
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MacKay JW, Nezhad FS, Rifai T, Kaggie JD, Naish JH, Roberts C, Graves MJ, Waterton JC, Janiczek RL, Roberts AR, McCaskie A, Gilbert FJ, Parker GJM. Dynamic contrast-enhanced MRI of synovitis in knee osteoarthritis: repeatability, discrimination and sensitivity to change in a prospective experimental study. Eur Radiol 2021; 31:5746-5758. [PMID: 33591383 PMCID: PMC8270862 DOI: 10.1007/s00330-021-07698-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/07/2020] [Accepted: 01/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Evaluate test-retest repeatability, ability to discriminate between osteoarthritic and healthy participants, and sensitivity to change over 6 months, of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) biomarkers in knee OA. METHODS Fourteen individuals aged 40-60 with mild-moderate knee OA and 6 age-matched healthy volunteers (HV) underwent DCE-MRI at 3 T at baseline, 1 month and 6 months. Voxelwise pharmacokinetic modelling of dynamic data was used to calculate DCE-MRI biomarkers including Ktrans and IAUC60. Median DCE-MRI biomarker values were extracted for each participant at each study visit. Synovial segmentation was performed using both manual and semiautomatic methods with calculation of an additional biomarker, the volume of enhancing pannus (VEP). Test-retest repeatability was assessed using intraclass correlation coefficients (ICC). Smallest detectable differences (SDDs) were calculated from test-retest data. Discrimination between OA and HV was assessed via calculation of between-group standardised mean differences (SMD). Responsiveness was assessed via the number of OA participants with changes greater than the SDD at 6 months. RESULTS Ktrans demonstrated the best test-retest repeatability (Ktrans/IAUC60/VEP ICCs 0.90/0.84/0.40, SDDs as % of OA mean 33/71/76%), discrimination between OA and HV (SMDs 0.94/0.54/0.50) and responsiveness (5/1/1 out of 12 OA participants with 6-month change > SDD) when compared to IAUC60 and VEP. Biomarkers derived from semiautomatic segmentation outperformed those derived from manual segmentation across all domains. CONCLUSIONS Ktrans demonstrated the best repeatability, discrimination and sensitivity to change suggesting that it is the optimal DCE-MRI biomarker for use in experimental medicine studies. KEY POINTS • Dynamic contrast-enhanced MRI (DCE-MRI) provides quantitative measures of synovitis in knee osteoarthritis which may permit early assessment of efficacy in experimental medicine studies. • This prospective observational study compared DCE-MRI biomarkers across domains relevant to experimental medicine: test-retest repeatability, discriminative validity and sensitivity to change. • The DCE-MRI biomarker Ktrans demonstrated the best performance across all three domains, suggesting that it is the optimal biomarker for use in future interventional studies.
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Affiliation(s)
- James W MacKay
- Department of Radiology, University of Cambridge, Cambridge, UK. .,Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, NR4 7UY, UK.
| | | | - Tamam Rifai
- Department of Radiology, Norfolk & Norwich University Hospital, Norwich, UK
| | - Joshua D Kaggie
- Department of Radiology, University of Cambridge, Cambridge, UK
| | | | | | - Martin J Graves
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - John C Waterton
- Bioxydyn Limited, Manchester, UK.,Centre for Imaging Sciences, Division of Informatics Imaging & Data Sciences, School of Health Sciences, Faculty of Biology Medicine & Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | | | - Alexandra R Roberts
- Clinical Imaging, GlaxoSmithKline, London, UK.,Antaros Medical, Uppsala, Sweden
| | - Andrew McCaskie
- Division of Trauma & Orthopaedics, Department of Surgery, University of Cambridge, Cambridge, UK
| | - Fiona J Gilbert
- Department of Radiology, University of Cambridge, Cambridge, UK
| | - Geoff J M Parker
- Bioxydyn Limited, Manchester, UK.,Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK
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17
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Wang N, Xie Y, Fan Z, Ma S, Saouaf R, Guo Y, Shiao SL, Christodoulou AG, Li D. Five-dimensional quantitative low-dose Multitasking dynamic contrast- enhanced MRI: Preliminary study on breast cancer. Magn Reson Med 2021; 85:3096-3111. [PMID: 33427334 DOI: 10.1002/mrm.28633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/17/2020] [Accepted: 11/13/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To develop a low-dose Multitasking DCE technique (LD-MT-DCE) for breast imaging, enabling dynamic T1 mapping-based quantitative characterization of tumor blood flow and vascular properties with whole-breast coverage, a spatial resolution of 0.9 × 0.9 × 1.1 mm3 , and a temporal resolution of 1.4 seconds using a 20% gadolinium dose (0.02 mmol/kg). METHODS Magnetic resonance Multitasking was used to reconstruct 5D images with three spatial dimensions, one T1 recovery dimension for dynamic T1 quantification, and one DCE dimension for contrast kinetics. Kinetic parameters F p , v p , K trans , and v e were estimated from dynamic T1 maps using the two-compartment exchange model. The LD-MT-DCE repeatability and agreement against standard-dose MT-DCE were evaluated in 20 healthy subjects. In 7 patients with triple-negative breast cancer, LD-MT-DCE image quality and diagnostic results were compared with that of standard-dose clinical DCE in the same imaging session. One-way unbalanced analysis of variance with Tukey test was performed to evaluate the statistical significance of the kinetic parameters between control and patient groups. RESULTS The LD-MT-DCE technique was repeatable, agreed with standard-dose MT-DCE, and showed excellent image quality. The diagnosis using LD-MT-DCE matched well with clinical results. The values of F p , v p , and K trans were significantly different between malignant tumors and normal breast tissue (P < .001, < .001, and < .001, respectively), and between malignant and benign tumors (P = .020, .003, and < .001, respectively). CONCLUSION The LD-MT-DCE technique was repeatable and showed excellent image quality and equivalent diagnosis compared with standard-dose clinical DCE. The estimated kinetic parameters were capable of differentiating between normal breast tissue and benign and malignant tumors.
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Affiliation(s)
- Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Sen Ma
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Rola Saouaf
- Department of Imaging, Cedars Sinai Medical Center, Los Angeles, California, USA
| | - Yu Guo
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Stephen L Shiao
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Biomedical Sciences, Division of Immunology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Anthony G Christodoulou
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
| | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.,Department of Bioengineering, University of California, Los Angeles, California, USA
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18
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Valkovič L, Lau JYC, Abdesselam I, Rider OJ, Frollo I, Tyler DJ, Rodgers CT, Miller JJJ. Effects of contrast agents on relaxation properties of 31P metabolites. Magn Reson Med 2020; 85:1805-1813. [PMID: 33090502 DOI: 10.1002/mrm.28541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 08/22/2020] [Accepted: 09/14/2020] [Indexed: 11/10/2022]
Abstract
PURPOSE Phosphorous MR spectroscopy (31P-MRS) forms a powerful, non-invasive research tool to quantify the energetics of the heart in diverse patient populations. 31P-MRS is frequently applied alongside other radiological examinations, many of which use various contrast agents that shorten relaxation times of water in conventional proton MR, for a better characterisation of cardiac function, or following prior computed tomography (CT). It is, however, unknown whether these agents confound 31P-MRS signals, for example, 2,3-diphosphoglycerate (2,3-DPG). METHODS In this work, we quantitatively assess the impact of non-ionic, low osmolar iodinated CT contrast agent (iopamidol/Niopam), gadolinium chelates (linear gadopentetic acid dimeglumine/Magnevist and macrocyclic gadoterate meglumine/Dotarem) and superparamagnetic iron oxide nanoparticles (ferumoxytol/Feraheme) on the nuclear T1 and T2 of 31P metabolites (ie, 2,3-DPG), and 1H in water in live human blood and saline phantoms at 11.7 T. RESULTS Addition of all contrast agents led to significant shortening of all relaxation times in both 1H and 31P saline phantoms. On the contrary, the T1 relaxation time of 2,3-DPG in blood was significantly shortened only by Magnevist (P = .03). Similarly, the only contrast agent that influenced the T2 relaxation times of 2,3-DPG in blood samples was ferumoxytol (P = .02). CONCLUSION Our results show that, unlike conventional proton MR, phosphorus MRS is unconfounded in patients who have had prior CT with contrast, not all gadolinium-based contrast agents influence 31P-MRS data in vivo, and that ferumoxytol is a promising contrast agent for the reduction in 31P-MRS blood-pool signal.
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Affiliation(s)
- Ladislav Valkovič
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Justin Y C Lau
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Ines Abdesselam
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Oliver J Rider
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
| | - Ivan Frollo
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Damian J Tyler
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Christopher T Rodgers
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
- The Wolfson Brain Imaging Centre, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Jack J J Miller
- Oxford Centre for Clinical MR Research (OCMR), RDM Cardiovascular Medicine, University of Oxford, Oxford, UK
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
- Department of Physics, Clarendon Laboratory, University of Oxford, Oxford, UK
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19
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Edelman R, Leloudas N, Pang J, Bailes J, Merrell R, Koktzoglou I. Twofold improved tumor-to-brain contrast using a novel T1 relaxation-enhanced steady-state (T 1RESS) MRI technique. SCIENCE ADVANCES 2020; 6:6/44/eabd1635. [PMID: 33115747 PMCID: PMC7608787 DOI: 10.1126/sciadv.abd1635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
A technique that provides more accurate cancer detection would be of great value. Toward this end, we developed T1 relaxation-enhanced steady-state (T1RESS), a novel magnetic resonance imaging (MRI) pulse sequence that enables the flexible modulation of T1 weighting and provides the unique feature that intravascular signals can be toggled on and off in contrast-enhanced scans. T1RESS makes it possible to effectively use an MRI technique with improved signal-to-noise ratio efficiency for cancer imaging. In a proof-of-concept study, "dark blood" unbalanced T1RESS provided a twofold improvement in tumor-to-brain contrast compared with standard techniques, whereas balanced T1RESS greatly enhanced vascular detail. In conclusion, T1RESS represents a new MRI technique with substantial potential value for cancer imaging, along with a broad range of other clinical applications.
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Affiliation(s)
- R Edelman
- Radiology, NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201, USA.
- Northwestern Medicine, 251 E. Huron St., Chicago, IL 60611, USA
| | - N Leloudas
- Radiology, NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201, USA
| | - J Pang
- Siemens Medical Solutions USA Inc., 737 N. Michigan Ave., Chicago, IL 60611, USA
| | - J Bailes
- University of Chicago Pritzker School of Medicine, 924 E. 57th St., Chicago, IL 60637, USA
- Neurosurgery, NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201, USA
| | - R Merrell
- University of Chicago Pritzker School of Medicine, 924 E. 57th St., Chicago, IL 60637, USA
- Neurology, NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201, USA
| | - I Koktzoglou
- Radiology, NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL 60201, USA
- University of Chicago Pritzker School of Medicine, 924 E. 57th St., Chicago, IL 60637, USA
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20
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State of the Art Imaging in Menière’s Disease. Tips and Tricks for Protocol and Interpretation. CURRENT RADIOLOGY REPORTS 2020. [DOI: 10.1007/s40134-020-00365-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Abstract
Purpose of Review
Menière’s disease (MD) is a burdensome and not well understood inner ear disorder that has received increasing attention of scientists over the past decade. Until 2007, a certain diagnosis of endolymphatic hydrops (EH) required post-mortem histology. Today, dedicated high-resolution magnetic resonance imaging (MRI) protocols enable detection of disease-related changes in the membranous labyrinth in vivo. In this review, we summarize the current status of MR imaging for MD.
Recent Findings
The mainstays of hydrops imaging are inversion recovery sequences using delayed acquisition after intravenous or intratympanic contrast administration. Based on these techniques, several methods have been developed to detect and classify EH. In addition, novel imaging features of MD, such as blood-labyrinth barrier impairment, have recently been observed.
Summary
Delayed contrast enhanced MRI has emerged as a reliable technique to demonstrate EH in vivo, with promising application in the diagnosis and follow-up of MD patients. Therefore, familiarity with current techniques and diagnostic imaging criteria is increasingly important.
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Lersy F, Diepenbroek AL, Lamy J, Willaume T, Bierry G, Cotton F, Kremer S. Signal changes in enhanced T1-weighted images related to gadolinium retention: A three-time-point imaging study. J Neuroradiol 2020; 48:82-87. [PMID: 32615207 DOI: 10.1016/j.neurad.2020.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/03/2020] [Accepted: 06/17/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Concern has grown about the finding of gadolinium deposits in the brain after administering gadolinium-based contrast agents (GBCAs). The mechanism is unclear, and related questions remain unanswered, including the stability over time. Therefore, we conducted a three-time-point study to explore T1-weighted (W) signal changes in the dentate nucleus (DN) and globus pallidus (GP), after the first, fifth, and tenth injections of either a macrocyclic agent (gadoterate meglumine) or a linear agent (gadobenate dimeglumine). MATERIALS AND METHODS For this retrospective, multicenter, longitudinal study, two groups of 18 (gadoterate meglumine) and 19 (gadobenate dimeglumine) patients were identified. The evolution of the signal over time was analyzed using DN/pons (DN/P) and GP/thalamus (GP/T) ratios. RESULTS DN/P and GP/T ratios tended to increase after the fifth administration of gadobenate dimeglumine, following by a downward trend. A trend in a decrease in DN/P and GP/T ratios were found after the fifth and tenth administrations of gadoterate meglumine. CONCLUSION After exposure to gadobenate dimeglumine, the signal intensity (SI) tended to increase after the fifth injection owing to gadolinium accumulation, however, a SI increase was not found after the tenth administration supporting the hypothesis of a slow elimination of the previously retained gadolinium (wash-out effect) from the brain or of a change in form (by dechelation), causing the signal to fade. No increasing SI was found in the DN and GP after exclusive exposure to gadoterate meglumine, thus confirming its stability. We found, instead, a trend for a significative gadolinium elimination over time.
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Affiliation(s)
- François Lersy
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
| | - Anne-Lise Diepenbroek
- Faculté de médecine de Strasbourg, Université de Strasbourg, 67000 Strasbourg, France.
| | - Julien Lamy
- ICube, Université de Strasbourg-CNRS, ICube - Institut de physique biologique, 4, rue Kirschleger, 67000 Strasbourg, France.
| | - Thibault Willaume
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
| | - Guillaume Bierry
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
| | - François Cotton
- Service de Radiologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69310 Pierre Bénite, France.
| | - Stéphane Kremer
- Service de Radiologie, Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, 67200 Strasbourg Cedex, France.
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Chronaiou I, Giskeødegård GF, Goa PE, Teruel J, Hedayati R, Lundgren S, Huuse EM, Pickles MD, Gibbs P, Sitter B, Bathen TF. Feasibility of contrast-enhanced MRI derived textural features to predict overall survival in locally advanced breast cancer. Acta Radiol 2020; 61:875-884. [PMID: 31744303 DOI: 10.1177/0284185119885116] [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: 11/15/2022]
Abstract
BACKGROUND The prognosis for women with locally advanced breast cancer (LABC) is poor and there is a need for better treatment stratification. Gray-level co-occurrence matrix (GLCM) texture analysis of magnetic resonance (MR) images has been shown to predict pathological response and could become useful in stratifying patients to more targeted treatments. PURPOSE To evaluate the ability of GLCM textural features obtained before neoadjuvant chemotherapy to predict overall survival (OS) seven years after diagnosis of patients with LABC. MATERIAL AND METHODS This retrospective study includes data from 55 patients with LABC. GLCM textural features were extracted from segmented tumors in pre-treatment dynamic contrast-enhanced 3-T MR images. Prediction of OS by GLCM textural features was assessed and compared to predictions using traditional clinical variables. RESULTS Linear mixed-effect models showed significant differences in five GLCM features (f1, f2, f5, f10, f11) between survivors and non-survivors. Using discriminant analysis for prediction of survival, GLCM features from 2 min post-contrast images achieved a classification accuracy of 73% (P < 0.001), whereas traditional prognostic factors resulted in a classification accuracy of 67% (P = 0.005). Using a combination of both yielded the highest classification accuracy (78%, P < 0.001). Median values for features f1, f2, f10, and f11 provided significantly different survival curves in Kaplan-Meier analysis. CONCLUSION This study shows a clear association between textural features from post-contrast images obtained before neoadjuvant chemotherapy and OS seven years after diagnosis. Further studies in larger cohorts should be undertaken to investigate how this prognostic information can be used to benefit treatment stratification.
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Affiliation(s)
- Ioanna Chronaiou
- Department of Circulation and Medical Imaging, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro Fanneløb Giskeødegård
- Department of Circulation and Medical Imaging, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Pål Erik Goa
- Department of Physics, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Jose Teruel
- Department of Radiation Oncology, NYU Langone Health, New York, NY, USA
| | - Roja Hedayati
- Cancer clinic, St. Olavs University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Steinar Lundgren
- Cancer clinic, St. Olavs University Hospital, Trondheim, Norway
- Department of Clinical and Molecular Medicine, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Else Marie Huuse
- Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
| | - Martin D Pickles
- Radiology Department, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Peter Gibbs
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Beathe Sitter
- Department of Circulation and Medical Imaging, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
| | - Tone Frost Bathen
- Department of Circulation and Medical Imaging, NTNU – Norwegian University of Science and Technology, Trondheim, Norway
- Clinic of Radiology and Nuclear Medicine, St. Olavs University Hospital, Trondheim, Norway
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Funck-Brentano C, Felices M, Le Fur N, Dubourdieu C, Desché P, Vanhoutte F, Voiriot P. Randomized study of the effect of gadopiclenol, a new gadolinium-based contrast agent, on the QTc interval in healthy subjects. Br J Clin Pharmacol 2020; 86:2174-2181. [PMID: 32302009 DOI: 10.1111/bcp.14309] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 02/25/2020] [Accepted: 04/06/2020] [Indexed: 01/07/2023] Open
Abstract
AIMS We investigated the effect of gadopiclenol, a new gadolinium-based contrast agent, on the QTc interval at clinical and supraclinical dose, considering the relative hyperosmolarity of this product. METHODS This was a single centre, randomized, double-blind, placebo- and positive-controlled, 4-way crossover study. Forty-eight healthy male and female subjects were included to receive single intravenous (i.v.) administrations of gadopiclenol at the clinical dose of 0.1 mmol kg-1 , standard for current gadolinium-based contrast agents, the supraclinical dose of 0.3 mmol kg-1 , placebo and a single oral dose of 400 mg moxifloxacin. RESULTS The largest time-matched placebo-corrected, mean change from-baseline in QTcF (ΔΔQTcF) was observed 3 hours after administration of 0.1 mmol kg-1 gadopiclenol (2.39 ms, 90% confidence interval [CI]: 0.35, 4.43 ms) and 5 minutes after administration of 0.3 mmol kg-1 (4.81 ms, 90%CI: 2.84, 6.78 ms). The upper limit of the 90% CI was under the threshold of 10 ms, demonstrating no significant effect of gadopiclenol on QTc interval. From 1.5 to 4 hours postdose moxifloxacin, the lower limit of the 90% CI of ΔΔQTcF exceeded 5 ms demonstrating assay sensitivity. Although there was a positive slope, the concentration-response analysis estimated that the values of ΔΔQTcF at the maximal concentration of gadopiclenol at 0.1 and 0.3 mmol kg-1 were 0.41 and 2.23 ms, respectively, with the upper limit of the 90% CI not exceeding 10 ms. No serious or severe adverse events or treatment discontinuations due to adverse events were reported. CONCLUSION This thorough QT/QTc study demonstrated that gadopiclenol did not prolong the QT interval at clinical and supraclinical doses and was well tolerated in healthy volunteers. The positive slope of the QTc prolongation vs concentration relationship suggests that hyperosmolarity could be associated with QTc prolongation. However, the amplitude of this effects is unlikely to be associated with proarrhythmia.
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Affiliation(s)
- Christian Funck-Brentano
- INSERM, CIC-1901 and UMRS 1166, Paris, France; AP-HP, Pitié-Salpêtrière Hospital, Department of Pharmacology and CIC-1901, Paris, France; Sorbonne Université Médecine, Paris, France; Institute of Cardiometabolism and Nutrition (ICAN), Paris, France
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Physicochemical and Pharmacokinetic Profiles of Gadopiclenol: A New Macrocyclic Gadolinium Chelate With High T1 Relaxivity. Invest Radiol 2020; 54:475-484. [PMID: 30973459 PMCID: PMC6661244 DOI: 10.1097/rli.0000000000000563] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Objectives We aimed to evaluate gadopiclenol, a newly developed extracellular nonspecific macrocyclic gadolinium-based contrast agent (GBCA) having high relaxivity properties, which was designed to increase lesion detection and characterization by magnetic resonance imaging. Methods We described the molecular structure of gadopiclenol and measured the r1 and r2 relaxivity properties at fields of 0.47 and 1.41 T in water and human serum. Nuclear magnetic relaxation dispersion profile measurements were performed from 0.24 mT to 7 T. Protonation and complexation constants were determined using pH-metric measurements, and we investigated the acid-assisted dissociation of gadopiclenol, gadodiamide, gadobutrol, and gadoterate at 37°C and pH 1.2. Applying the relaxometry technique (37°C, 0.47 T), we investigated the risk of dechelation of gadopiclenol, gadoterate, and gadodiamide in the presence of ZnCl2 (2.5 mM) and a phosphate buffer (335 mM). Pharmacokinetics studies of radiolabeled 153Gd-gadopiclenol were performed in Beagle dogs, and protein binding was measured in rats, dogs, and humans plasma and red blood cells. Results Gadopiclenol [gadolinium chelate of 2,2′,2″-(3,6,9-triaza-1(2,6)-pyridinacyclodecaphane-3,6,9-triyl)tris(5-((2,3-dihydroxypropyl)amino)-5-oxopentanoic acid); registry number 933983-75-6] is based on a pyclen macrocyclic structure. Gadopiclenol exhibited a very high relaxivity in water (r1 = 12.2 mM−1·s−1 at 1.41 T), and the r1 value in human serum at 37°C did not markedly change with increasing field (r1 = 12.8 mM−1·s−1 at 1.41 T and 11.6 mM−1·s−1 at 3 T). The relaxivity data in human serum did not indicate protein binding. The nuclear magnetic relaxation dispersion profile of gadopiclenol exhibited a high and stable relaxivity in a strong magnetic field. Gadopiclenol showed high kinetic inertness under acidic conditions, with a dissociation half-life of 20 ± 3 days compared with 4 ± 0.5 days for gadoterate, 18 hours for gadobutrol, and less than 5 seconds for gadodiamide and gadopentetate. The pharmacokinetic profile in dogs was typical of extracellular nonspecific GBCAs, showing distribution in the extracellular compartment and no metabolism. No protein binding was found in rats, dogs, and humans. Conclusions Gadopiclenol is a new extracellular and macrocyclic Gd chelate that exhibited high relaxivity, no protein binding, and high kinetic inertness. Its pharmacokinetic profile in dogs was similar to that of other extracellular nonspecific GBCAs.
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Nguyen TDT, Marasini R, Rayamajhi S, Aparicio C, Biller D, Aryal S. Erythrocyte membrane concealed paramagnetic polymeric nanoparticle for contrast-enhanced magnetic resonance imaging. NANOSCALE 2020; 12:4137-4149. [PMID: 32022084 DOI: 10.1039/d0nr00039f] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Recent progress in bioimaging nanotechnology has a great impact on the diagnosis, treatment, and prevention of diseases by enabling early intervention. Among different types of bioimaging modalities, contrast-enhanced magnetic resonance imaging using paramagnetic gadolinium-based molecular contrast agents (GBCAs) are most commonly used in clinic. However, molecular GBCAs distribute rapidly between plasma and interstitial spaces with short half-lives limiting its clinical impacts. To improve the properties of GBCAs, herein an effort has been put forth by incorporating GBCA into nanoscale system mimicking the property of red blood cell (RBC) that could facilitate contrast enhancement and prolong intraluminal retention in the body. The proposed nanoconstruct is made up of polymeric-core labeled with lipid conjugated GBCA followed by the imprint of the RBC membrane concealment layer to enhance stability and biocompatibility. Meanwhile, the confinement strategy of GBCA was implemented to accelerate magnetic properties of nanoconstruct providing longitudinal-relaxivity (r1) to 12.78 ± 0.29 (mM s)-1. Such improvement in r1 was further confirmed by enhanced contrast in the vascular angiography of the murine model. Given higher colloidal stability and tunable magnetic properties, nanoconstruct proposed herein is a promising platform technology for the applications where enhanced plasma residence time and magnetic properties are necessary for diagnosis and therapy.
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Affiliation(s)
- Tuyen Duong Thanh Nguyen
- Department of Chemistry, Kansas State University, Manhattan, KS 66506, USA. and Nanotechnology Innovation Center of Kansas States (NICKS), Kansas State University, Manhattan, KS 66506, USA
| | - Ramesh Marasini
- Department of Chemistry, Kansas State University, Manhattan, KS 66506, USA. and Nanotechnology Innovation Center of Kansas States (NICKS), Kansas State University, Manhattan, KS 66506, USA
| | - Sagar Rayamajhi
- Department of Chemistry, Kansas State University, Manhattan, KS 66506, USA. and Nanotechnology Innovation Center of Kansas States (NICKS), Kansas State University, Manhattan, KS 66506, USA
| | - Cesar Aparicio
- Department of Chemistry, Kansas State University, Manhattan, KS 66506, USA. and Nanotechnology Innovation Center of Kansas States (NICKS), Kansas State University, Manhattan, KS 66506, USA
| | - David Biller
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
| | - Santosh Aryal
- Department of Chemistry, Kansas State University, Manhattan, KS 66506, USA. and Nanotechnology Innovation Center of Kansas States (NICKS), Kansas State University, Manhattan, KS 66506, USA
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Wang N, Gaddam S, Wang L, Xie Y, Fan Z, Yang W, Tuli R, Lo S, Hendifar A, Pandol S, Christodoulou AG, Li D. Six-dimensional quantitative DCE MR Multitasking of the entire abdomen: Method and application to pancreatic ductal adenocarcinoma. Magn Reson Med 2020; 84:928-948. [PMID: 31961967 DOI: 10.1002/mrm.28167] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/09/2019] [Accepted: 12/18/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE To develop a quantitative DCE MRI technique enabling entire-abdomen coverage, free-breathing acquisition, 1-second temporal resolution, and T1 -based quantification of contrast agent concentration and kinetic modeling for the characterization of pancreatic ductal adenocarcinoma (PDAC). METHODS Segmented FLASH readouts following saturation-recovery preparation with randomized 3D Cartesian undersampling was used for incoherent data acquisition. MR Multitasking was used to reconstruct 6-dimensional images with 3 spatial dimensions, 1 T1 recovery dimension for dynamic T1 quantification, 1 respiratory dimension to resolve respiratory motion, and 1 DCE time dimension to capture the contrast kinetics. Sixteen healthy subjects and 14 patients with pathologically confirmed PDAC were recruited for the in vivo studies, and kinetic parameters vp , Ktrans , ve , and Kep were evaluated for each subject. Intersession repeatability of Multitasking DCE was assessed in 8 repeat healthy subjects. One-way unbalanced analysis of variance was performed between control and patient groups. RESULTS In vivo studies demonstrated that vp , Ktrans , and Kep of PDAC were significantly lower compared with nontumoral regions in the patient group (P = .002, .003, .004, respectively) and normal pancreas in the control group (P = .011, <.001, <.001, respectively), while ve was significantly higher than nontumoral regions (P < .001) and healthy pancreas (P < .001). The kinetic parameters showed good in vivo repeatability (interclass correlation coefficient: vp , 0.95; Ktrans , 0.98; ve , 0.96; Kep , 0.99). CONCLUSION The proposed Multitasking DCE is promising for the quantification of vascular properties of PDAC. Quantitative DCE parameters were repeatable in vivo and showed significant differences between normal pancreas and both tumor and nontumoral regions in patients with PDAC.
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Affiliation(s)
- Nan Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
| | - Srinivas Gaddam
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California
| | - Lixia Wang
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Yibin Xie
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Zhaoyang Fan
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
| | - Wensha Yang
- Department of Clinical Radiation Oncology, University of Southern California, Los Angeles, California
| | - Richard Tuli
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Simon Lo
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California
| | - Andrew Hendifar
- Department of Gastrointestinal Malignancies, Cedars-Sinai Medical Center, Los Angeles, California
| | - Stephen Pandol
- Division of Digestive and Liver Diseases, Cedars-Sinai Medical Center, Los Angeles, California
| | | | - Debiao Li
- Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, California.,Department of Bioengineering, University of California, Los Angeles, California
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Enterline DS, Martin KW, Parmar HA, Triulzi FM, Colosimo C. Safety and Diagnostic Efficacy of Gadobenate Dimeglumine in MRI of the Brain and Spine of Neonates and Infants. AJNR Am J Neuroradiol 2019; 40:2001-2009. [PMID: 31727753 DOI: 10.3174/ajnr.a6319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 09/18/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE Contrast-enhanced MR imaging provides essential information for pediatric imaging applications. We evaluated gadobenate dimeglumine for contrast-enhanced MR imaging of infants younger than 2 years of age. MATERIALS AND METHODS Ninety children younger than 2 years of age (including 55 children younger than 1 year) who underwent enhanced MR imaging of the CNS with gadobenate dimeglumine at 0.1 mmol/kg body weight ± 25% by volume were retrospectively enrolled at 2 imaging centers. Safety data were assessed for adverse events and, when available, vital signs and electrocardiogram and clinical laboratory values obtained from 48 hours before until 48 hours after the MR imaging examination. The efficacy of gadobenate dimeglumine-enhanced MR imaging was evaluated prospectively by 3 blinded, unaffiliated readers in terms of the accuracy of combined pre- and postcontrast images relative to precontrast images alone for differentiation of tumor from non-neoplastic disease and the correct diagnosis of specific disease. Differences were tested using the McNemar test. A possible effect of dose on diagnostic accuracy was assessed using the Fisher exact test. RESULTS Nine nonserious adverse events were reported for 8 (8.8%) patients. Five adverse events occurred in patients 12 months of age or older. All events occurred at least 24 hours after gadobenate dimeglumine administration, and in each case, the investigating radiologist considered that there was no reasonable possibility of a relationship to gadobenate dimeglumine. No clinically meaningful changes in vital signs, electrocardiogram results, or laboratory parameters were reported. Accurate differentiation of tumor from non-neoplastic disease and exact matching of each specific MR imaging-determined diagnosis with the on-site final diagnosis were achieved in significantly more patients by each reader following evaluation of combined pre- and postcontrast images relative to precontrast images alone (91.0%-94.4% versus 75.3%-87.6%, P < .04, and 66.3%-73.0% versus 52.8%-58.4%, P < .02, respectively). No significant differences (P > .133) in diagnostic accuracy were noted between patients receiving ≤0.08 mmol/kg of gadobenate dimeglumine and patients receiving >0.08 mmol/kg of gadobenate dimeglumine. CONCLUSIONS Gadobenate dimeglumine is safe and effective for pediatric MR imaging.
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Affiliation(s)
- D S Enterline
- From the Department of Radiology (D.S.E.), Duke University, Durham, North Carolina
| | - K W Martin
- Department of Diagnostic Imaging (K.W.M.), University of California, San Francisco, Benioff Children's Hospital, Oakland, California
| | - H A Parmar
- Department of Radiology (H.A.P.), University of Michigan, C.S. Mott Children's Hospital, Ann Arbor, Michigan
| | - F M Triulzi
- Department of Neuroradiology (F.M.T.), Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Cà Granda Ospedale Maggiore Policlinic, Milan, Italy
| | - C Colosimo
- Radiodiagnostica e Neuroradiologia (C.C.), Institute of Radiology, Fondazione Policlinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Rome, Italy
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Abstract
Gadolinium (Gd)-based contrast agents have been routinely used worldwide in diagnostic MRI since 1988. All routinely applied contrast agents for clinical use were considered extremely safe with regard to tolerance, adverse effects and diagnostic efficacy and when used at Food and Drug Administration-approved doses. With the identification of Gd-associated disorders, namely nephrogenic systemic fibrosis and adverse reactions, and in the longer term Gd-retention in the brain, this view changed and led to the withdrawal or restriction of approval of linear Gd chelates in Europe. Even though Gd deposition in different human body areas was described very early, recently published literature of intracerebral accumulation of contrast agents as well as deposition in bone have created surprising attention. Not only was the fact of Gd deposition in the body well known for many years, but there is currently no clinical evidence of patient symptoms and no resulting health issues of patients have been observed yet. The expression "gadolinium deposition disease" has been termed by active patient advocacy groups with an online presence with reports of individual members stating a broad spectrum of disorders yielding a large symptom complex after administration of Gd-based contrast agents without evidence of any pre-existing or otherwise underlying disease process which could explain the mentioned disorder.
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Takahashi EA, Kallmes DF, Mara KC, Harmsen WS, Misra S. Nephrotoxicity of gadolinium-based contrast in the setting of renal artery intervention: retrospective analysis with 10-year follow-up. ACTA ACUST UNITED AC 2019; 24:378-384. [PMID: 30406762 DOI: 10.5152/dir.2018.18172] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE We aimed to determine the incidence rate and potential risk factors for postcontrast acute kidney injury (PC-AKI) as well as the long-term clinical implications on dialysis and mortality in patients with chronic kidney disease (CKD) who underwent renal artery stent placement exclusively with gadolinium-based contrast agents. METHODS This retrospective study reviewed 412 patients with CKD who underwent renal artery stent placement. Sixty-eight patients underwent intervention exclusively with gadolinium-based contrast agents and were analyzed. Criteria for PC-AKI included either an absolute serum creatinine increase >0.3 mg/dL or percentage increase in serum creatinine >50% within 48 hours of intervention. Logistic regression analysis was performed to identify risk factors for PC-AKI. The cumulative proportion of patients who died or went on to hemodialysis was determined using Kaplan-Meier survival analysis. RESULTS The incidence of PC-AKI was 14.7%. The rate of AKI decreased for every 1 unit increase in glomerular filtration rate ( GFR, odds ratio [OR]=0.91, P = 0.047). Prehydration was associated with a lower PC-AKI rate (OR=0.17; P = 0.015). Acute kidney injury after intervention was associated with an increased rate of dialysis (Hazard ratio [HR]=4.51, P = 0.002) and mortality (HR=2.52; P = 0.027). CONCLUSION Gadolinium-based contrast agents are potentially nephrotoxic when used for endovascular intervention in patients with CKD. The risk of PC-AKI increased with lower GFR and decreased with prehydration. Dialysis and mortality risk were increased in patients who developed PC-AKI.
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Affiliation(s)
| | | | - Kristin C Mara
- Department of Clinical Statistics, Mayo Clinic, Minnesota, USA
| | - William S Harmsen
- Department of Radiology, Mayo Clinic, Department of Clinical Statistics, Mayo Clinic, Minnesota, USA
| | - Sanjay Misra
- Department of Radiology, Division of Vascular and Interventional Radiology, Mayo Clinic, Minnesota, USA
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MRI features suggestive of gadolinium retention do not correlate with Expanded Disability Status Scale worsening in Multiple Sclerosis. Neuroradiology 2019; 61:155-162. [DOI: 10.1007/s00234-018-02150-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 12/19/2018] [Indexed: 12/11/2022]
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Clauser P, Helbich TH, Kapetas P, Pinker K, Bernathova M, Woitek R, Kaneider A, Baltzer PAT. Breast lesion detection and characterization with contrast-enhanced magnetic resonance imaging: Prospective randomized intraindividual comparison of gadoterate meglumine (0.15 mmol/kg) and gadobenate dimeglumine (0.075 mmol/kg) at 3T. J Magn Reson Imaging 2018; 49:1157-1165. [PMID: 30552829 PMCID: PMC6620600 DOI: 10.1002/jmri.26335] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/24/2018] [Accepted: 08/24/2018] [Indexed: 12/17/2022] Open
Abstract
Background Contrast‐enhanced magnetic resonance imaging (CE‐MRI) of the breast is highly sensitive for breast cancer detection. Multichannel coils and 3T scanners can increase signal, spatial, and temporal resolution. In addition, the T1‐reduction effect of a gadolinium‐based contrast agent (GBCA) is higher at 3T. Thus, it might be possible to reduce the dose of GBCA at 3T without losing diagnostic information. Purpose To compare a three‐quarter (0.075 mmol/kg) dose of the high‐relaxivity GBCA gadobenate dimeglumine, with a 1.5‐fold higher than on‐label dose (0.15 mmol/kg) of gadoterate meglumine for breast lesion detection and characterization at 3T CE‐MRI. Study Type Prospective, randomized, intraindividual comparative study. Population Eligible were patients with imaging abnormalities (BI‐RADS 0, 4, 5) on conventional imaging. Each patient underwent two examinations, 24–72 hours apart, one with 0.075 mmol/kg gadobenate and the other with 0.15 mmol/kg gadoterate administered in a randomized order. In all, 109 patients were prospectively recruited. Field Strength/Sequence 3T MRI with a standard breast protocol (dynamic‐CE, T2w‐TSE, STIR‐T2w, DWI). Assessment Histopathology was the standard of reference. Three blinded, off‐site breast radiologists evaluated the examinations using the BI‐RADS lexicon. Statistical Tests Lesion detection, sensitivity, specificity, and diagnostic accuracy were calculated per‐lesion and per‐region, and compared by univariate and multivariate analysis (Generalized Estimating Equations, GEE). Results Five patients were excluded, leaving 104 women with 142 histologically verified breast lesions (109 malignant, 33 benign) available for evaluation. Lesion detection with gadobenate (84.5‐88.7%) was not inferior to gadoterate (84.5–90.8%) (P ≥ 0.165). At per‐region analysis, gadobenate demonstrated higher specificity (96.4–98.7% vs. 92.6–97.3%, P ≤ 0.007) and accuracy (96.3–97.8% vs. 93.6–96.1%, P ≤ 0.001) compared with gadoterate. Multivariate analysis demonstrated superior, reader‐independent diagnostic accuracy with gadobenate (odds ratio = 1.7, P < 0.001 using GEE). Data Conclusion A 0.075 mmol/kg dose of the high‐relaxivity contrast agent gadobenate was not inferior to a 0.15 mmol/kg dose of gadoterate for breast lesion detection. Gadobenate allowed increased specificity and accuracy. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1157–1165.
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Affiliation(s)
- Paola Clauser
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Thomas H Helbich
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Panagiotis Kapetas
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Katja Pinker
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.,Department of Radiology, Breast Imaging Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Maria Bernathova
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | - Ramona Woitek
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
| | | | - Pascal A T Baltzer
- Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria
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Arena F, Bardini P, Blasi F, Gianolio E, Marini GM, La Cava F, Valbusa G, Aime S. Gadolinium presence, MRI hyperintensities, and glucose uptake in the hypoperfused rat brain after repeated administrations of gadodiamide. Neuroradiology 2018; 61:163-173. [DOI: 10.1007/s00234-018-2120-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 10/19/2018] [Indexed: 12/30/2022]
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Eliezer M, Poillon G, Gillibert A, Horion J, Cruypeninck Y, Gerardin E, Magne N, Attyé A. Comparison of enhancement of the vestibular perilymph between gadoterate meglumine and gadobutrol at 3-Tesla in Meniere's disease. Diagn Interv Imaging 2018; 99:271-277. [DOI: 10.1016/j.diii.2018.01.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 12/28/2017] [Accepted: 01/11/2018] [Indexed: 10/18/2022]
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Beyazal Celiker F, Tumkaya L, Mercantepe T, Turan G, Yılmaz A, Beyazal M, Turan A, Inecikli MF, Kösem M. The effect of gadolinium-based contrast agents on rat testis. Andrologia 2018; 50:e13031. [PMID: 29700836 DOI: 10.1111/and.13031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2018] [Indexed: 11/29/2022] Open
Abstract
Previous studies have reported that repeated administrations of linear gadolinium-based contrast agents lead to their accumulation in the brain and other tissues in individuals with normal renal functions. The purpose of this prospective animal study was to investigate the effect of multiple administrations of macrocyclic ionic (gadoteric acid) and linear nonionic (gadodiamide) gadolinium-based contrast agents (GBCAs) on rat testis tissue and to compare these molecules in terms of tissue damage. Thirty-two male Sprague-Dawley rats were kept without drugs for 5 weeks after administration of 0.1 mmol mg-1 kg-1 (0.2 ml/kg) gadodiamide and gadoteric acid for 4 days over 5 weeks. Biochemical, histopathological and immunohistochemical changes in testis tissue were evaluated at the end of 10 weeks. When used in repeated clinical doses, gadolinium was observed to increase apoptosis in the Leydig cells of the rat testis, and to increase serum Ca+2 levels and reduce testosterone levels (p < .05). Although the difference was not statistically significant, a greater loss of spermatozoa and immature germinal cell accumulation were observed in the seminiferous tubule lumen in the GBCA groups compared with the control and saline groups (p > .05). Both linear and macrocyclic contrast agents have toxic effects on testis tissue, irrespective of the type of drug.
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Affiliation(s)
- F Beyazal Celiker
- Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - L Tumkaya
- Department of Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - T Mercantepe
- Department of Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - G Turan
- Department of Pathology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - A Yılmaz
- Department of Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - M Beyazal
- Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - A Turan
- Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - M F Inecikli
- Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - M Kösem
- Department of Pathology, Faculty of Medicine, Sakarya University, Sakarya, Turkey
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Celiker FB, Tumkaya L, Yilmaz A, Coskun ZO, Celiker M, Oghan F, Mercantepe T, Terzi S, Dursun E. Effects of gadolinium-based contrast agents on submandibular gland tissue in rats. Eur Arch Otorhinolaryngol 2018; 275:1641-1647. [PMID: 29605866 DOI: 10.1007/s00405-018-4959-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 03/27/2018] [Indexed: 11/27/2022]
Abstract
AIM The aim of this prospective animal study is to investigate the influence of multiple administrations of macrocyclic ionic (gadoteric acid) and linear nonionic (gadodiamide) gadolinium-based contrast agents (GBCA) on submandibular gland tissue (SGT) of the rats. MATERIAL AND METHOD Twenty-four Sprague Dawley female rats were included the study. Group 1 was determined as a control group (n = 6). Group 2 was determined as saline group (n = 6). Group 3 was determined as Omniscan group (n = 6) and received only intraperitoneal (IP) 0.1 mmol (0.2 mL/kg)/kg gadodiamide for 8 days. Group 4 was determined as Dotarem group (n = 6) and received only IP 0.1 mmol (0.2 mL/kg)/mg/kg gadoteric acid daily for 8 days. On the 9th day of the administration, the rats were sedated with ketamine and xylazine through IP injection. The right SGT was removed after sedation. Histopathological and immunohistochemical changes in SGT were evaluated. RESULTS The SGT of the Omniscan and Dotarem groups decreased SGT acini surface area, and serous acinar cells number were observed. On the other hand, no pathology was observed. Mucous acinar cells' caspase-3 positivity for the same markers in Omniscan and Dotarem sections was similar to the control group. However, Omniscan and Dotarem groups serous acinar cells were caspase-3 (+) staining. The intensity of serous acinar cells' caspase-3 (+) for the same markers in Dotarem sections was similar to the Omniscan group. The results also revealed in the analysis of the mean area of the acinus area of the SGT; there were significantly decreased Dotarem group rats when compared to control rats (p < 0.05). CONCLUSION We consider that numerical increased apoptosis results arise from repeated doses of GBCAs. Being aware of this effect of the contrast agent may have significance for the chronic sialo-adenitis patients group when used for recurrent contrasted MRI for diagnosis of diseases like MS which requires in follow-up. We should be aware about the frequently contrasted MRI in routine investigations.
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Affiliation(s)
- Fatma Beyazal Celiker
- Department of Radiology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Levent Tumkaya
- Department of Histology-Embriology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Adnan Yilmaz
- Department of Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Zerrin Ozergin Coskun
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Metin Celiker
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
| | - Fatih Oghan
- Department of ORL & HNS, Faculty of Medicine, Dumlupinar University, Kutahya, Turkey
| | - Tolga Mercantepe
- Department of Histology-Embriology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Suat Terzi
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Engin Dursun
- Department of Otorhinolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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Moser FG, Watterson CT, Weiss S, Austin M, Mirocha J, Prasad R, Wang J. High Signal Intensity in the Dentate Nucleus and Globus Pallidus on Unenhanced T1-Weighted MR Images: Comparison between Gadobutrol and Linear Gadolinium-Based Contrast Agents. AJNR Am J Neuroradiol 2018; 39:421-426. [PMID: 29419400 DOI: 10.3174/ajnr.a5538] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/15/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In view of the recent observations that gadolinium deposits in brain tissue after intravenous injection, our aim of this study was to compare signal changes in the globus pallidus and dentate nucleus on unenhanced T1-weighted MR images in patients receiving serial doses of gadobutrol, a macrocyclic gadolinium-based contrast agent, with those seen in patients receiving linear gadolinium-based contrast agents. MATERIALS AND METHODS This was a retrospective analysis of on-site patients with brain tumors. Fifty-nine patients received only gadobutrol, and 60 patients received only linear gadolinium-based contrast agents. Linear gadolinium-based contrast agents included gadoversetamide, gadobenate dimeglumine, and gadodiamide. T1 signal intensity in the globus pallidus, dentate nucleus, and pons was measured on the precontrast portions of patients' first and seventh brain MRIs. Ratios of signal intensity comparing the globus pallidus with the pons (globus pallidus/pons) and dentate nucleus with the pons (dentate nucleus/pons) were calculated. Changes in the above signal intensity ratios were compared within the gadobutrol and linear agent groups, as well as between groups. RESULTS The dentate nucleus/pons signal ratio increased in the linear gadolinium-based contrast agent group (t = 4.215, P < .001), while no significant increase was seen in the gadobutrol group (t = -1.422, P = .08). The globus pallidus/pons ratios followed similarly, with an increase in the linear gadolinium-based contrast agent group (t = 2.931, P < .0001) and no significant change in those receiving gadobutrol (t = 0.684, P = .25). CONCLUSIONS Successive doses of gadobutrol do not result in T1 shortening compared with changes seen in linear gadolinium-based contrast agents.
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Affiliation(s)
- F G Moser
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - C T Watterson
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - S Weiss
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - M Austin
- Department of Radiology (M.A.), Lahey Clinic, Burlington, Massachusetts
| | - J Mirocha
- Samuel Oschin Comprehensive Cancer Institute (J.M.), Cedars Sinai Medical Center, Los Angeles, California
| | - R Prasad
- From the Department of Imaging (F.G.M., C.T.W., S.W., R.P.), S. Mark Taper Foundation Imaging Center
| | - J Wang
- Bayer Healthcare (J.W.), Whippany, New Jersey
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Kinner S, Schubert TB, Bruce RJ, Rebsamen SL, Diamond CA, Reeder SB, Rowley HA. Deep Brain Nuclei T1 Shortening after Gadobenate Dimeglumine in Children: Influence of Radiation and Chemotherapy. AJNR Am J Neuroradiol 2017; 39:24-30. [PMID: 29146718 DOI: 10.3174/ajnr.a5453] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 08/22/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Intrinsic T1-hyperintense signal has recently been reported in the deep gray nuclei on brain MR imaging after multiple doses of gadolinium-based contrast agents. Most reports have included adult patients and excluded those undergoing radiation or chemotherapy. We investigated whether T1 shortening is also observed in children and tried to determine whether radiochemotherapy is a risk factor for this phenomenon. MATERIALS AND METHODS In this single-center retrospective study, we reviewed clinical charts and images of all patients 18 years of age or younger with ≥4 gadobenate dimeglumine-enhanced MRIs for 6 years. Seventy-six children (mean age, 9.3 years; 60 unconfounded by treatment, 16 with radiochemotherapy) met the selection criteria (>4 MR imaging examinations; mean, 8). T1 signal intensity ratios for the dentate to pons and globus pallidus to thalamus were calculated and correlated with number of injections, time interval, and therapy. RESULTS Among the 60 children without radiochemotherapy, only 2 had elevated T1 signal intensity ratios (n = 20 and 16 injections). Twelve of the 16 children with radiochemotherapy showed elevated signal intensity ratios. Statistical analysis demonstrated a significant signal intensity ratio change for the number of injections (P < .001) and amount of gadolinium (P = .008), but not for the interscan time interval (P = .35). There was a significant difference in the average signal intensity ratio change between those with and without radiochemotherapy (P < .001). Chart review revealed no new neurologic deficits in any patients, related to their underlying conditions and prior surgeries. CONCLUSIONS Compared with published adult series, children show a similar pattern of T1 hyperintense signal changes of the dentate and globus pallidus after multiple gadobenate dimeglumine injections. The T1 signal changes in children may have a later onset but are accelerated by radiochemotherapy.
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Affiliation(s)
- S Kinner
- From the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.) .,Department of Diagnostic and Interventional Radiology and Neuroradiology (S.K.), University Hospital Essen, Essen, Germany
| | - T B Schubert
- From the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.).,Clinic of Radiology and Nuclear Medicine (T.B.S.), Basel University Hospital, Basel, Switzerland
| | - R J Bruce
- From the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
| | - S L Rebsamen
- From the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
| | | | - S B Reeder
- From the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.).,Medical Physics (S.B.R.).,Emergency Medicine (S.B.R.).,Biomedical Engineering (S.B.R.).,Medicine (S.B.R.), University of Wisconsin-Madison, Madison, Wisconsin
| | - H A Rowley
- From the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
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Multiparametric magnetic resonance imaging for transition zone prostate cancer: essential findings, limitations, and future directions. Abdom Radiol (NY) 2017; 42:2732-2744. [PMID: 28702787 DOI: 10.1007/s00261-017-1184-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Review the multiparametric MRI (mpMRI) findings of transition zone (TZ) prostate cancer (PCa) using T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI and to integrate mpMRI findings with clinical history, laboratory values, and histopathology. CONCLUSION TZ prostate tumors are challenging to detect clinically and at MRI. mpMRI using the combination of sequences has the potential to improve accuracy of TZ cancer detection and staging.
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Abstract
Contrast agents were introduced early in the history of medical imaging. Iodine-based intravascular agents became the radiographic compounds of choice and refinements of their chemical structures led to the highly tolerated low-osmolarity agents in use today. Gadolinium became the most popular compound for MR imaging; however, recognition of nephrogenic systemic fibrosis and in vivo dechelation intensified research on their safety profile. Ultrasonography contrast media evolved from manual injections of air through agitated saline solutions to microbubbles with different gases. Research has concentrated on bubble stabilization and development of small but sufficiently echogenic particles.
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Affiliation(s)
- Carlos A Zamora
- Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, 3320 Old Infirmary, Campus Box 7510, Chapel Hill, NC 27599-7510, USA.
| | - Mauricio Castillo
- Department of Radiology, University of North Carolina School of Medicine, 3326 Old Infirmary, Campus Box 7510, Chapel Hill, NC 27599-7510, USA
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Feingold B, Salgado CM, Reyes-Múgica M, Drant SE, Miller SA, Kennedy M, Kellman P, Schelbert EB, Wong TC. Diffuse myocardial fibrosis among healthy pediatric heart transplant recipients: Correlation of histology, cardiovascular magnetic resonance, and clinical phenotype. Pediatr Transplant 2017; 21. [PMID: 28574157 DOI: 10.1111/petr.12986] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2017] [Indexed: 02/02/2023]
Abstract
Fibrosis is commonly described in heart allografts lost late after transplantation. CMR-derived ECV is a validated measure of DMF in native adult hearts that may predict heart failure and mortality. We explored associations of ECV with histologic myocardial fibrosis and clinical features after pediatric heart transplantation. Twenty-five recipients (7.0±6.3 years at transplant and 10.7±6.5 years post-transplant) were prospectively recruited for CMR and BNP measurement at the time of surveillance biopsy. All had normal ejection fractions and lacked heart failure symptoms. Fibrosis was quantified on biopsy after picrosirius red staining as CVF. ECV was quantified using contemporaneous hematocrit on basal and mid-short-axis slices. ECV was moderately correlated with CVF (r=.47; P=.019). We found no associations of ECV with hemodynamics, ischemic time, time since transplantation, or number of prior biopsies or acute rejections. Compared to healthy non-transplant controls, there was no significant difference in ECV (25.1±3.0 vs 23.7±2.0%, P=.09). Log-transformed BNP was correlated with ECV (recipients: r=.46, P=.02; recipients and controls: r=.45, P=.006). These findings suggest ECV quantifies DMF and relates to biological indicators of cardiac function after pediatric heart transplantation.
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Affiliation(s)
- Brian Feingold
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Cláudia M Salgado
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Miguel Reyes-Múgica
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Stacey E Drant
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Susan A Miller
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Mark Kennedy
- Cardiovascular Magnetic Resonance Center, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA
| | - Peter Kellman
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Erik B Schelbert
- Clinical and Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Cardiovascular Magnetic Resonance Center, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Timothy C Wong
- Cardiovascular Magnetic Resonance Center, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA.,Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Blumfield E, Moore MM, Drake MK, Goodman TR, Lewis KN, Meyer LT, Ngo TD, Sammet C, Stanescu AL, Swenson DW, Slovis TL, Iyer RS. Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report. Pediatr Radiol 2017; 47:665-673. [PMID: 28283728 DOI: 10.1007/s00247-017-3807-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/06/2016] [Accepted: 02/10/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists. OBJECTIVE To assess the usage of GBCAs among SPR members. MATERIALS AND METHODS An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations. RESULTS A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations. CONCLUSION Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects.
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Affiliation(s)
- Einat Blumfield
- Department of Radiology, Albert Einstein College of Medicine, Jacobi Medical Center, 1400 Pelham Parkway, South Bronx, NY, 10461, USA.
| | - Michael M Moore
- Department of Radiology, Penn State Hershey Children's Hospital, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Mary K Drake
- Department of Radiology, Children's Hospital and Medical Center, University of Nebraska Medical Center, Omaha, NE, USA
| | - Thomas R Goodman
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Kristopher N Lewis
- Department of Radiology, Children's Hospital of Georgia, Augusta University, Augusta, GA, USA
| | | | - Thang D Ngo
- Department of Medical Imaging, Nemours Children's Hospital, Orlando, FL, USA
| | - Christina Sammet
- Department of Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Arta Luana Stanescu
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
| | - David W Swenson
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Thomas L Slovis
- Department of Radiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ramesh S Iyer
- Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA
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Ramalho M, Ramalho J, Burke LM, Semelka RC. Gadolinium Retention and Toxicity-An Update. Adv Chronic Kidney Dis 2017; 24:138-146. [PMID: 28501075 DOI: 10.1053/j.ackd.2017.03.004] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Until 2006, the main considerations regarding safety for all gadolinium-based contrast agents (GBCAs) were related to short-term adverse reactions. However, the administration of certain "high-risk" GBCAs to patients with renal failure resulted in multiple reported cases of nephrogenic systemic fibrosis. Findings have been reported regarding gadolinium deposition within the body and various reports of patients who report suffering from acute and chronic symptoms secondary to GBCA's exposure. At the present state of knowledge, it has been proved that gadolinium deposits also occur in the brain, irrespective of renal function and GBCAs stability class. To date, no definitive clinical findings are associated with gadolinium deposition in brain tissue. Gadolinium deposition disease is a newly described and probably infrequent entity. Patients presenting with gadolinium deposition disease may show signs and symptoms that somewhat follows a pattern similar but not identical, and also less severe, to those observed in nephrogenic systemic fibrosis. In this review, we will address gadolinium toxicity focusing on these 2 recently described concerns.
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MacFarlane D, Shah K, Wysong A, Wortsman X, Humphreys TR. The role of imaging in the management of patients with nonmelanoma skin cancer. J Am Acad Dermatol 2017; 76:579-588. [DOI: 10.1016/j.jaad.2015.10.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 10/18/2015] [Accepted: 10/20/2015] [Indexed: 02/03/2023]
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Khosroshahi HT, Abedi B, Daneshvar S, Sarbaz Y, Shakeri Bavil A. Future of the Renal Biopsy: Time to Change the Conventional Modality Using Nanotechnology. Int J Biomed Imaging 2017; 2017:6141734. [PMID: 28316612 PMCID: PMC5337808 DOI: 10.1155/2017/6141734] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 12/20/2016] [Accepted: 01/05/2017] [Indexed: 12/19/2022] Open
Abstract
At the present time, imaging guided renal biopsy is used to provide diagnoses in most types of primary and secondary renal diseases. It has been claimed that renal biopsy can provide a link between diagnosis of renal disease and its pathological conditions. However, sometimes there is a considerable mismatch between patient renal outcome and pathological findings in renal biopsy. This is the time to address some new diagnostic methods to resolve the insufficiency of conventional percutaneous guided renal biopsy. Nanotechnology is still in its infancy in renal imaging; however, it seems that it is the next step in renal biopsy, providing solutions to the limitations of conventional modalities.
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Affiliation(s)
| | - Behzad Abedi
- Medical Bioengineering Department, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sabalan Daneshvar
- Medical Bioengineering Department, School of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
- Faculty of Electrical and Computer Engineering, University of Tabriz, Tabriz, Iran
| | - Yashar Sarbaz
- School of Engineering-Emerging Technologies, University of Tabriz, Tabriz, Iran
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Weingärtner S, Meßner NM, Budjan J, Loßnitzer D, Mattler U, Papavassiliu T, Zöllner FG, Schad LR. Myocardial T 1-mapping at 3T using saturation-recovery: reference values, precision and comparison with MOLLI. J Cardiovasc Magn Reson 2016; 18:84. [PMID: 27855705 PMCID: PMC5114738 DOI: 10.1186/s12968-016-0302-x] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 11/01/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myocardial T1-mapping recently emerged as a promising quantitative method for non-invasive tissue characterization in numerous cardiomyopathies. Commonly performed with an inversion-recovery (IR) magnetization preparation at 1.5T, the application at 3T has gained due to increased quantification precision. Alternatively, saturation-recovery (SR) T1-mapping has recently been introduced at 1.5T for improved accuracy. Thus, the purpose of this study is to investigate the robustness and precision of SR T1-mapping at 3T and to establish accurate reference values for native T1-times and extracellular volume fraction (ECV) of healthy myocardium. METHODS Balanced Steady-State Free-Precession (bSSFP) Saturation-Pulse Prepared Heart-rate independent Inversion-REcovery (SAPPHIRE) and Saturation-recovery Single-SHot Acquisition (SASHA) T1-mapping were compared with the Modified Look-Locker inversion recovery (MOLLI) sequence at 3T. Accuracy and precision were studied in phantom. Native and post-contrast T1-times and regional ECV were determined in 20 healthy subjects (10 men, 27 ± 5 years). Subjective image quality, susceptibility artifact rating, in-vivo precision and reproducibility were analyzed. RESULTS SR T1-mapping showed <4 % deviation from the spin-echo reference in phantom in the range of T1 = 100-2300 ms. The average quality and artifact scores of the T1-mapping methods were: MOLLI:3.4/3.6, SAPPHIRE:3.1/3.4, SASHA:2.9/3.2; (1: poor - 4: excellent/1: strong - 4: none). SAPPHIRE and SASHA yielded significantly higher T1-times (SAPPHIRE: 1578 ± 42 ms, SASHA: 1523 ± 46 ms), in-vivo T1-time variation (SAPPHIRE: 60.1 ± 8.7 ms, SASHA: 70.0 ± 9.3 ms) and lower ECV-values (SAPPHIRE: 0.20 ± 0.02, SASHA: 0.21 ± 0.03) compared with MOLLI (T1: 1181 ± 47 ms, ECV: 0.26 ± 0.03, Precision: 53.7 ± 8.1 ms). No significant difference was found in the inter-subject variability of T1-times or ECV-values (T1: p = 0.90, ECV: p = 0.78), the observer agreement (inter: p > 0.19; intra: p > 0.09) or consistency (inter: p > 0.07; intra: p > 0.17) between the three methods. CONCLUSIONS Saturation-recovery T1-mapping at 3T yields higher accuracy, comparable inter-subject, inter- and intra-observer variability and less than 30 % precision-loss compared to MOLLI.
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Affiliation(s)
- Sebastian Weingärtner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
- Electrical and Computer Engineering, University of Minnesota, Minneapolis, MN USA
- Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN USA
| | - Nadja M. Meßner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
- DZHK (German Centre for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Johannes Budjan
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dirk Loßnitzer
- 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Uwe Mattler
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Theano Papavassiliu
- DZHK (German Centre for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, Germany
- 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frank G. Zöllner
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - Lothar R. Schad
- Computer Assisted Clinical Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
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Rangaswamy S, Varshney R, Tiwari AK, Sethi SK, Hemanth kumar BS, Ojha H, Sandeep Kaur‐Ghumaan, Mishra AK. Gd(III)‐DO3A‐SBMPP: An Effort to Develop the MRI Contrast Agent with Enhanced Relaxivity. ChemistrySelect 2016. [DOI: 10.1002/slct.201600814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sandhya Rangaswamy
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
- Department of Chemistry University of Delhi Delhi 110007 India
| | - Raunak Varshney
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
| | - Anjani K. Tiwari
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
| | - Swarndeep K. Sethi
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
- Department of Chemistry University of Delhi Delhi 110007 India
| | - B. S. Hemanth kumar
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
| | - Himanshu Ojha
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
| | | | - Anil K. Mishra
- Institute of Nuclear Medicine and Allied Sciences Brig. S. K. Mazumdar Marg Delhi 110054 India
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Lancelot E, Froehlich J, Heine O, Desché P. Effects of gadolinium-based contrast agent concentrations (0.5 M or 1.0 M) on the diagnostic performance of magnetic resonance imaging examinations: systematic review of the literature. Acta Radiol 2016; 57:1334-1343. [PMID: 26071496 DOI: 10.1177/0284185115590434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background To date there is no agreement as to what is the optimal concentration for gadolinium-based contrast agents (GBCAs). Purpose To assess whether diagnostic performance differences exist between 0.5 M and 1.0 M GBCAs used for magnetic resonance imaging (MRI). Material and Methods A PubMed literature search identified 21 clinical studies published between 2005 and 2013 which evaluated the diagnostic efficacy of both types of GBCAs. Study design, type of procedure, GBCA administration mode, imaging performances, impact on patient management, study limitations, and biases were analyzed. No statistical test was performed on pooled data. Results Sixteen comparative and five non-comparative studies were analyzed, involving 2183 patients who underwent MRI procedures for various indications. In 67% of the studies, 0.5 M and 1.0 M GBCAs were injected at equimolar gadolinium amounts per kg body weight. Only 33% applied the same molar flow rate for delivery of the GBCAs. No significant differences between GBCAs were reported for 23 out of 27 qualitative endpoints (mainly image quality, lesion, and vessel visualization) and 29 out of 40 quantitative endpoints. Three out of four studies with non-equimolar delivery rates showed better contrast-to-noise and signal-to-noise ratios for 1.0 M gadobutrol, without showing an impact on diagnostic performance. Methodological biases were identified in several studies impairing the interpretation of comparisons. Conclusion Imaging differences between 0.5 M and 1.0 M GBCAs were essentially observed under non-equimolar delivery rates. However, they did not result into greater diagnostic efficacy when performed under equimolar conditions.
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Fringuello Mingo A, Colombo Serra S, Baroni S, Cabella C, Napolitano R, Hawala I, Carnovale IM, Lattuada L, Tedoldi F, Aime S. Macrocyclic paramagnetic agents for MRI: Determinants of relaxivity and strategies for their improvement. Magn Reson Med 2016; 78:1523-1532. [DOI: 10.1002/mrm.26519] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 09/28/2016] [Accepted: 09/28/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Alberto Fringuello Mingo
- Bracco Imaging Spa, Bracco Research Center, Via Ribes 5; 10010 Colleretto Giacosa (TO) Italy
- Dipartimento di Fisica; Università degli Studi di Torino, Via Pietro Giuria 1; 10125 Torino (TO) Italy
| | - Sonia Colombo Serra
- Bracco Imaging Spa, Bracco Research Center, Via Ribes 5; 10010 Colleretto Giacosa (TO) Italy
| | - Simona Baroni
- Dipartimento di Biotecnologie Molecolari e Scienze per la salute - Centro di Molecular Imaging; Università degli Studi di Torino, Via Nizza 52; 10126 Torino (TO) Italy
| | - Claudia Cabella
- Bracco Imaging Spa, Bracco Research Center, Via Ribes 5; 10010 Colleretto Giacosa (TO) Italy
| | - Roberta Napolitano
- Bracco Imaging Spa, Bracco Research Center, Via Ribes 5; 10010 Colleretto Giacosa (TO) Italy
| | - Ivan Hawala
- Dipartimento di Biotecnologie Molecolari e Scienze per la salute - Centro di Molecular Imaging; Università degli Studi di Torino, Via Nizza 52; 10126 Torino (TO) Italy
| | - Irene Maria Carnovale
- Dipartimento di Scienza e Tecnologia del Farmaco; Università degli Studi di Torino, Via Pietro Giuria 9; 10125 Torino (TO) Italy
| | - Luciano Lattuada
- Bracco Imaging Spa, Bracco Research Center, Via Ribes 5; 10010 Colleretto Giacosa (TO) Italy
| | - Fabio Tedoldi
- Bracco Imaging Spa, Bracco Research Center, Via Ribes 5; 10010 Colleretto Giacosa (TO) Italy
| | - Silvio Aime
- Dipartimento di Chimica I.F.M; Università degli Studi di Torino, Via Pietro Giuria 7; 10125 Torino (TO) Italy
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Pinter NK, Klein JP, Mechtler LL. Potential Safety Issues Related to the Use of Gadolinium-based Contrast Agents. Continuum (Minneap Minn) 2016; 22:1678-1684. [PMID: 27740994 DOI: 10.1212/con.0000000000000378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article reviews recent research on gadolinium deposit formation in the brain linked to contrast-enhanced MRI studies. RECENT FINDINGS Human and animal studies have confirmed the presence of gadolinium in the brain following the serial administration of gadolinium-based contrast agents. This is a relatively new and growing field of research primarily driven by concerns regarding unknown and potentially harmful side effects of gadolinium-based contrast agents. Retrospective observational in vivo studies in humans demonstrated T1 shortening effects in the brain parenchyma resulting from gadolinium exposure. These studies were followed by postmortem human and animal studies. Evidence exists that gadolinium may cause deposits in the brain and that this may occur independently of impaired renal function and in the presence of an intact blood-brain barrier. Gadolinium deposition has been linked primarily with the use of linear, rather than macrocyclic, gadolinium-based contrast agents. SUMMARY The formation of gadolinium deposits and its implications have been the focus of only a small number of research groups. The currently available data must be verified, and the potential factors that may be linked to this phenomenon and the clinical significance must be explored. Depending on future findings, changes in the clinical application of gadolinium-based contrast agents may be expected.
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