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Ouyang M, Bao L. Gadolinium Contrast Agent Deposition in Children. J Magn Reson Imaging 2024. [PMID: 38597340 DOI: 10.1002/jmri.29389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024] Open
Abstract
Over the past few years, a large number of studies have evidenced increased signal intensity in the deep brain nuclei on unenhanced T1-MRI images achieved by the application of gadolinium-based contrast agents (GBCAs). The deposition of gadolinium in the brain, bone, and other tissues following administration of GBCAs has also been confirmed in histological studies in rodents and in necropsy studies in adults and children. Given the distinct physiological characteristics of children, this review focuses on examining the current research on gadolinium deposition in children, particularly studies utilizing novel methods and technologies. Furthermore, the article compares safety research findings of linear GBCAs and macrocyclic GBCAs in children, with the aim of offering clinicians practical guidance based on the most recent research outcomes. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Minglei Ouyang
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Li Bao
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Macdonald IR, Farhat Z, Amoako-Tuffor Y, Maianski I, Erker C, Romao R, Moineddin R, Mata-Mbemba D. MR Imaging of Pediatric Neuroblastoma: Is Gadolinium Enhancement Necessary for Evaluation of Image-Defined-Risk Factors? Can Assoc Radiol J 2023:8465371231218240. [PMID: 38146213 DOI: 10.1177/08465371231218240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
Background: Pre-treatment stratification and outcomes of neuroblastoma patients often depend on the assessment of image-defined risk factors (IDRFs) on MR Imaging, usually using Gadolinium-contrast materials which are cautioned in pediatrics. We aimed to address whether gadolinium contrast-enhanced sequences are necessary to identify the presence/absence of IDRFs. Methods: Patients with neuroblastoma with MR imaging were retrospectively identified from 2005 to 2021. Ninety confirmed IDRFs were evaluated in 23 patients. Corresponding MR studies were anonymized, randomized, and independently evaluated by 3 fellowship-trained pediatric radiologists. Each radiologist assessed the studies twice. At the first reading, all enhanced sequences were omitted, while in the second reading, the full study with enhanced sequences were included. Consensus reading was obtained among readers. Inter- and intra-rater agreements using Kappa statistics (κ) as well as the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of non-enhanced MR in assessing IDRFs with respect to enhanced MR were calculated. Results: There were substantial (ĸ: 0.64-0.73) intra-reader agreements, and moderate to substantial (ĸ: 0.57-0.62) inter-reader agreements among radiologists in identifying IDRFs using non-enhanced MR. Non-enhanced MR had a sensitivity of 87.8% (95% CI [79-94]), specificity of 93% (89-96), PPV of 82.3 (73-89), NPV of 95.4 (92-98), and accuracy of 91.6 (88-94) in identifying IDRFs. However, 5/23 patients (21.7%) had a change in staging with the inclusion of contrast sequences. Conclusion: Although contrast sequences have a role in IDRF assessment, the majority can be adequately assessed on MR without gadolinium-contrast enhancement. Validation in a larger cohort is an important next step.
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Affiliation(s)
- Ian R Macdonald
- Department of Diagnostic Imaging, IWK Health Centre and Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Ziad Farhat
- Department of Diagnostic Imaging, IWK Health Centre and Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Yaw Amoako-Tuffor
- Department of Diagnostic Imaging, IWK Health Centre and Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Irit Maianski
- Department of Diagnostic Imaging, IWK Health Centre and Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
| | - Craig Erker
- Department of Pediatrics, Division of Pediatric Hematology/Oncology, IWK Health Centre and Dalhousie University, Halifax, NS, Canada
| | - Rodrigo Romao
- Department of Pediatric General Surgery and Urology, IWK Health Centre and Dalhousie University, Halifax, NS, Canada
| | - Rahim Moineddin
- Departments of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Daddy Mata-Mbemba
- Department of Diagnostic Imaging, IWK Health Centre and Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada
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Mo Y, Huang C, Liu C, Duan Z, Liu J, Wu D. Recent Research Progress of 19 F Magnetic Resonance Imaging Probes: Principle, Design, and Their Application. Macromol Rapid Commun 2023; 44:e2200744. [PMID: 36512446 DOI: 10.1002/marc.202200744] [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: 09/14/2022] [Revised: 11/28/2022] [Indexed: 12/15/2022]
Abstract
Visualization of biomolecules, cells, and tissues, as well as metabolic processes in vivo is significant for studying the associated biological activities. Fluorine magnetic resonance imaging (19 F MRI) holds potential among various imaging technologies thanks to its negligible background signal and deep tissue penetration in vivo. To achieve detection on the targets with high resolution and accuracy, requirements of high-performance 19 F MRI probes are demanding. An ideal 19 F MRI probe is thought to have, first, fluorine tags with magnetically equivalent 19 F nuclei, second, high fluorine content, third, adequate fluorine nuclei mobility, as well as excellent water solubility or dispersity, but not limited to. This review summarizes the research progresses of 19 F MRI probes and mainly discusses the impacts of structures on in vitro and in vivo imaging performances. Additionally, the applications of 19 F MRI probes in ions sensing, molecular structures analysis, cells tracking, and in vivo diagnosis of disease lesions are also covered in this article. From authors' perspectives, this review is able to provide inspirations for relevant researchers on designing and synthesizing advanced 19 F MRI probes.
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Affiliation(s)
- Yongyi Mo
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Gongchang Road 66, Guangming, Shenzhen, Guangdong, 518107, China
| | - Chixiang Huang
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Gongchang Road 66, Guangming, Shenzhen, Guangdong, 518107, China
| | - Changjiang Liu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Gongchang Road 66, Guangming, Shenzhen, Guangdong, 518107, China
| | - Ziwei Duan
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Gongchang Road 66, Guangming, Shenzhen, Guangdong, 518107, China
| | - Juan Liu
- School of Pharmaceutical Sciences, Shenzhen Campus of Sun Yat-sen University, Gongchang Road 66, Guangming, Shenzhen, Guangdong, 518107, China
| | - Dalin Wu
- School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Gongchang Road 66, Guangming, Shenzhen, Guangdong, 518107, China
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Richter H, Koke A, Soschinski PN, Martin LF, Bücker P, Sperling M, Karst U, Radbruch A, Witten A, Jeibmann A. Elemental bioimaging and transcriptomics reveal unchanged gene expression in mouse cerebellum following a single injection of Gadolinium-based contrast agents. Sci Rep 2023; 13:6844. [PMID: 37100846 PMCID: PMC10133442 DOI: 10.1038/s41598-023-33066-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 04/06/2023] [Indexed: 04/28/2023] Open
Abstract
Gadolinium (Gd) deposition in the brain, first and foremost in the dentate nucleus in the cerebellum, following contrast enhanced MRI, rose awareness of potential adverse effects of gadolinium-based contrast agent (GBCA) administration. According to previous in vitro experiments, a conceivable side-effect of Gd deposition could be an alteration of gene expression. In the current study, we aimed to investigate the influence of GBCA administration on gene expression in the cerebellum of mice using a combination of elemental bioimaging and transcriptomics. In this prospective animal study, three groups of eight mice each were intravenously injected with either linear GBCA gadodiamide, macrocyclic GBCA gadoterate (1 mmol GBCA/kg body weight) or saline (NaCl 0.9%). Animals were euthanized four weeks after injection. Subsequently, Gd quantification via laser ablation-ICP-MS and whole genome gene expression analysis of the cerebellum were performed. Four weeks after single application of GBCAs to 24-31 days old female mice, traces of Gd were detectable in the cerebellum for both, the linear and macrocyclic group. Subsequent transcriptome analysis by RNA sequencing using principal component analysis did not reveal treatment-related clustering. Also differential expression analysis did not reveal any significantly differentially expressed genes between treatments.
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Affiliation(s)
- Henning Richter
- Diagnostic Imaging Research Unit, (DIRU), Clinic for Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Winterthurerstraße 258C, 8057, Zurich, Switzerland.
| | - Anke Koke
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Patrick N Soschinski
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
| | - Louise F Martin
- Institute of Laboratory Animal Science, Vetsuisse Faculty, University of Zurich, Winterthurerstraße 260, 8057, Zurich, Switzerland
| | - Patrick Bücker
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 30, 48149, Münster, Germany
| | - Michael Sperling
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 30, 48149, Münster, Germany
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, Corrensstraße 30, 48149, Münster, Germany
| | - Alexander Radbruch
- Clinic of Neuroradiology, University Hospital Bonn, Venusberg Campus 1, 53127, Bonn, Germany
| | - Anika Witten
- Core Facility Genomics, Medical Faculty, University of Münster, Domagkstrasse 3, 48149, Münster, Germany
| | - Astrid Jeibmann
- Institute of Neuropathology, University Hospital Münster, Pottkamp 2, 48149, Münster, Germany
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Li Y, Gao S, Jiang H, Ayat N, Laney V, Nicolescu C, Sun W, Tweedle MF, Lu ZR. Evaluation of Physicochemical Properties, Pharmacokinetics, Biodistribution, Toxicity, and Contrast-Enhanced Cancer MRI of a Cancer-Targeting Contrast Agent, MT218. Invest Radiol 2022; 57:639-654. [PMID: 35703463 PMCID: PMC9444296 DOI: 10.1097/rli.0000000000000881] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/12/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Preclinical assessments were performed according to the US Food and Drug Administration guidelines to determine the physicochemical properties, pharmacokinetics, clearance, safety, and tumor-specific magnetic resonance (MR) imaging of MT218, a peptidic gadolinium-based MR imaging agent targeting to extradomain B fibronectin for MR molecular imaging of aggressive tumors. MATERIALS AND METHODS Relaxivity, chelation stability, binding affinity, safety-related target profiling, and effects on CYP450 enzymes and transporters were evaluated in vitro. Magnetic resonance imaging was performed with rats bearing prostate cancer xenografts, immunocompetent mice bearing murine pancreatic cancer allografts, and mice bearing lung cancer xenografts at different doses of MT218. Pharmacological effects on cardiovascular, respiratory, and central nervous systems were determined in rats and conscious beagle dogs. Pharmacokinetics were tested in rats and dogs. Biodistribution and excretion were studied in rats. Single and repeated dosing toxicity was evaluated in rats and dogs. In vitro and in vivo genotoxicity, in vitro hemolysis, and anaphylactic reactivity were also performed. RESULTS At 1.4 T, the r1 and r2 relaxivities of MT218 were 5.43 and 7.40 mM -1 s -1 in pure water, 6.58 and 8.87 mM -1 s -1 in phosphate-buffered saline, and 6.54 and 8.70 mM -1 s -1 in aqueous solution of human serum albumin, respectively. The binding affinity of MT218 to extradomain B fragment is 3.45 μM. MT218 exhibited no dissociation of the Gd(III) chelates under physiological conditions. The peptide degradation half-life ( t1/2 ) of MT218 was 1.63, 5.85, and 2.63 hours in rat, dog, and human plasma, respectively. It had little effect on CYP450 enzymes and transporters. MT218 produced up to 7-fold increase of contrast-to-noise ratios in the extradomain B fibronectin-rich tumors with a dose of 0.04 mmol/kg for at least 30 minutes. MT218 had little pharmacological effect on central nervous, cardiovascular, or respiratory systems. MT218 had a mean plasma elimination half-life ( t1/2 ) of 0.31 and 0.89 hours in rats and dogs at 0.1 mmol/kg, respectively. No detectable Gd deposition was observed in the brain at 6 hours postinjection of MT218 at 0.1 mmol/kg in rats. MT218 was not mutagenic and had no mortality or morbidity in the rats or dogs up to 1.39 and 0.70 mmol/kg/d, respectively. The no observed adverse effect level of MT218 in Sprague-Dawley rats was 1.39 mmol/kg for single dosing and 0.46 mmol/kg/d for repeated dosing. The no observed adverse effect level in dogs was 0.07 mmol/kg/d. MT218 exhibited no genotoxicity, hemolysis, and anaphylactic reactivity. CONCLUSION The preclinical assessments showed that the targeted contrast agent MT218 has high r1 and r2 relaxivities, satisfactory physicochemical properties, pharmacokinetic, and safety profiles and produces effective tumor enhancement in multiple cancer types in rats and mice at reduced doses.
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Affiliation(s)
- Yajuan Li
- From the Molecular Theranostics, LLC, Cleveland
| | - Songqi Gao
- From the Molecular Theranostics, LLC, Cleveland
| | | | - Nadia Ayat
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland
| | - Victoria Laney
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland
| | - Calin Nicolescu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland
| | - Wenyu Sun
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland
| | - Michael F. Tweedle
- Wright Center of Innovation, Department of Radiology, the Ohio State University, Columbus
| | - Zheng-Rong Lu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH
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The Effect of Gadolinium-Based Contrast Agents on Longitudinal Changes of Magnetic Resonance Imaging Signal Intensities and Relaxation Times in the Aging Rat Brain. Invest Radiol 2022; 57:453-462. [PMID: 35125411 PMCID: PMC9172901 DOI: 10.1097/rli.0000000000000857] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the study was to investigate the possible influence of changes in the brain caused by age on relaxometric and relaxation time–weighted magnetic resonance imaging (MRI) parameters in the deep cerebellar nuclei (DCN) and the globus pallidus (GP) of Gd-exposed and control rats over the course of 1 year.
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Violas X, Rasschaert M, Santus R, Factor C, Corot C, Catoen S, Idée JM, Robert P. Small Brain Lesion Enhancement and Gadolinium Deposition in the Rat Brain: Comparison Between Gadopiclenol and Gadobenate Dimeglumine. Invest Radiol 2022; 57:130-139. [PMID: 34411032 PMCID: PMC8746880 DOI: 10.1097/rli.0000000000000819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/07/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the set of studies was to compare gadopiclenol, a new high relaxivity gadolinium (Gd)-based contrast agent (GBCA) to gadobenate dimeglumine in terms of small brain lesion enhancement and Gd retention, including T1 enhancement in the cerebellum. MATERIALS AND METHODS In a first study, T1 enhancement at 0.1 mmol/kg body weight (bw) of gadopiclenol or gadobenate dimeglumine was evaluated in a small brain lesions rat model at 2.35 T. The 2 GBCAs were injected in an alternated and cross-over manner separated by an interval of 4.4 ± 1.0 hours (minimum, 3.5 hours; maximum, 6.1 hours; n = 6). In a second study, the passage of the GBCAs into cerebrospinal fluid (CSF) was evaluated by measuring the fourth ventricle T1 enhancement in healthy rats at 4.7 T over 23 minutes after a single intravenous (IV) injection of 1.2 mmol/kg bw of gadopiclenol or gadobenate dimeglumine (n = 6/group). In a third study, Gd retention at 1 month was evaluated in healthy rats who had received 20 IV injections of 1 of the 2 GBCAs (0.6 mmol/kg bw) or a similar volume of saline (n = 10/group) over 5 weeks. T1 enhancement of the deep cerebellar nuclei (DCN) was assessed by T1-weighted magnetic resonance imaging at 2.35 T, performed before the injection and thereafter once a week up to 1 month after the last injection. Elemental Gd levels in central nervous system structures, in muscle and in plasma were determined by inductively coupled plasma mass spectrometry (ICP-MS) 1 month after the last injection. RESULTS The first study in a small brain lesion rat model showed a ≈2-fold higher number of enhanced voxels in lesions with gadopiclenol compared with gadobenate dimeglumine. T1 enhancement of the fourth ventricle was observed in the first minutes after a single IV injection of gadopiclenol or gadobenate dimeglumine (study 2), resulting, in the case of gadopiclenol, in transient enhancement during the injection period of the repeated administrations study (study 3). In terms of Gd retention, T1 enhancement of the DCN was noted in the gadobenate dimeglumine group during the month after the injection period. No such enhancement of the DCN was observed in the gadopiclenol group. Gadolinium concentrations 1 month after the injection period in the gadopiclenol group were slightly increased in plasma and lower by a factor of 2 to 3 in the CNS structures and muscles, compared with gadobenate dimeglumine. CONCLUSIONS In the small brain lesion rat model, gadopiclenol provides significantly higher enhancement of brain lesions compared with gadobentate dimeglumine at the same dose. After repeated IV injections, as expected for a macrocyclic GBCA, Gd retention is minimalized in the case of gadopiclenol compared with gadobenate dimeglumine, resulting in no T1 hypersignal in the DCN.
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Kartamihardja AAP, Ariyani W, Hanaoka H, Taketomi-Takahashi A, Koibuchi N, Tsushima Y. The Role of Ferrous Ion in the Effect of the Gadolinium-Based Contrast Agents (GBCA) on the Purkinje Cells Arborization: An In Vitro Study. Diagnostics (Basel) 2021; 11:diagnostics11122310. [PMID: 34943547 PMCID: PMC8699861 DOI: 10.3390/diagnostics11122310] [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: 10/29/2021] [Revised: 11/23/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022] Open
Abstract
Gadolinium deposition in the brain has been observed in areas rich in iron, such as the dentate nucleus of the cerebellum. We investigated the role of Fe2+ in the effect of gadolinium-based contrast agents (GBCA) on thyroid hormone-mediated Purkinje cell dendritogenesis in a cerebellar primary culture. The study comprises the control group, Fe2+ group, GBCA groups (gadopentetate group or gadobutrol group), and GBCA+Fe2+ groups. Immunocytochemistry was performed with an anti-calbindin-28K (anti-CaBP28k) antibody, and the nucleus was stained with 4′,6-diamidino-2-phenylindole (DAPI). The number of Purkinje cells and their arborization were evaluated with an analysis of variance with a post-hoc test. The number of Purkinje cells was similar to the control groups among all treated groups. There were no significant differences in dendrite arborization between the Fe2+ group and the control groups. The dendrite arborization was augmented in the gadopentetate and the gadobutrol groups when compared to the control group (p < 0.01, respectively). Fe2+ significantly increased the effect of gadopentetate on dendrite arborization (p < 0.01) but did not increase the effect of gadobutrol. These findings suggested that the chelate thermodynamic stability and Fe2+ may play important roles in attenuating the effect of GBCAs on the thyroid hormone-mediated dendritogenesis of Purkinje cells in in vitro settings.
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Affiliation(s)
- Achmad Adhipatria Perayabangsa Kartamihardja
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan; (A.A.P.K.); (A.T.-T.)
- Department of Nuclear Medicine and Molecular Imaging, Universitas Padjajaran, Bandung 40161, Indonesia
| | - Winda Ariyani
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan; (W.A.); (N.K.)
| | - Hirofumi Hanaoka
- Department of Bioimaging and Information Analysis, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan;
| | - Ayako Taketomi-Takahashi
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan; (A.A.P.K.); (A.T.-T.)
| | - Noriyuki Koibuchi
- Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan; (W.A.); (N.K.)
| | - Yoshito Tsushima
- Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan; (A.A.P.K.); (A.T.-T.)
- Division of Integrated Oncology Research, Gunma Initiative for Advanced Research, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
- Correspondence:
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Kobayashi M, Levendovszky SR, Hippe DS, Hasegawa M, Murata N, Murata K, Marshall DA, Gonzalez-Cuyar LF, Maravilla KR. Comparison of Human Tissue Gadolinium Retention and Elimination between Gadoteridol and Gadobenate. Radiology 2021; 300:559-569. [PMID: 34128720 DOI: 10.1148/radiol.2021204320] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Linear gadolinium-based contrast agents (GBCAs) are known to be retained at higher levels of gadolinium than macro-cyclic GBCAs. However, very little is known regarding their relative elimination rates and retained fraction of injected gadolinium. Purpose To quantify and compare gadolinium retention and elimination rates in human brain tissue, skin, and bone obtained from cadavers exposed to single-agent administration of either gadoteridol (macrocyclic GBCA) or gadobenate dimeglumine (linear GBCA). Materials and Methods Autopsy cases from August 2014 to July 2019 of patients exposed to a single type of GBCA, either gadoteridol or gadobenate dimeglumine, either single or multiple doses, were included. Gadolinium levels in the brain, skin, and bone were analyzed with inductively coupled plasma mass spectrometry. Linear regression was used to compare gadolinium retention between agents and estimate elimination rates of the retained gadolinium using the time between last injection and death. Results Twenty-eight cadavers with gadoteridol exposure and nine with gadobenate dimeglumine exposure were identified (22 men; age range, 19-83 years). The median gadolinium retention of gadobenate dimeglumine was 3.0-6.5 times higher than that of gadoteridol in the brain (P < .02), 4.4 times higher in bone (P = .002), and 2.9 times higher in skin (P = .05). Gadolinium retention in the globus pallidus (GP), dentate nucleus (DN), white matter (WM), bone, and skin decreased with time elapsed from last administration to death in both the gadobenate dimeglumine (GP: -3% per twofold increase in time, P = .69; DN: -2%, P = .83; WM: -20%, P = .01; bone: -22%, P = .07; skin: -47%, P < .001) and gadoteridol (GP: -17%, P = .11; DN: -16%, P = .15; WM: -30%, P < .001; bone: -11%, P = .16; skin: -24%, P = .01) groups (P values for elimination are compared with a null hypothesis of no elimination). Conclusion The linear agent gadobenate dimeglumine retains several-fold higher levels of gadolinium in the brain and bone compared with the macrocyclic agent gadoteridol. Nonzero elimination of retained gadolinium was detected in the white matter and skin for both agents. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Tweedle in this issue.
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Affiliation(s)
- Masahiro Kobayashi
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Swati Rane Levendovszky
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Daniel S Hippe
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Makoto Hasegawa
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Nozomu Murata
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Kiyoko Murata
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Desiree A Marshall
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Luis F Gonzalez-Cuyar
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
| | - Kenneth R Maravilla
- From the Department of Radiology (M.K., D.S.H., M.H., N.M., K.M., K.R.M.), Integrated Brain Imaging Center, Department of Radiology (S.R.L.), Department of Neurologic Surgery (K.R.M.), and Magnetic Resonance Research Laboratory (K.R.M.), University of Washington, 1959 NE Pacific St, Box 357115, Seattle, WA 98195; Departments of Radiology (M.K.) and Neurology (K.M.), Toho University Omori Medical Center, Tokyo, Japan; Department of Radiology, Toho University Ohashi Medical Center, Tokyo, Japan (M.H., N.M.); and Department of Pathology, University of Washington School of Medicine, Seattle, Wash (D.A.M., L.F.G.)
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Human Hair as a Possible Surrogate Marker of Retained Tissue Gadolinium: A Pilot Autopsy Study Correlating Gadolinium Concentrations in Hair With Brain and Other Tissues Among Decedents Who Received Gadolinium-Based Contrast Agents. Invest Radiol 2021; 55:636-642. [PMID: 32433314 DOI: 10.1097/rli.0000000000000681] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We used laser ablation inductively coupled plasma mass spectrometry to quantify gadolinium in hair samples from autopsy cases with gadolinium-based contrast agent (GBCA) exposure. Hair gadolinium data were correlated with gadolinium concentrations in brain, skin, and bone tissues from the same case to investigate a potential noninvasive method for gadolinium quantification and monitoring. MATERIALS AND METHODS Medical records from autopsy cases at our institution were screened for history of GBCA exposure. Cases with exposure to a single type of GBCA with the most recent injection occurring within 1 year were identified and included in the study. The concentration of gadolinium in hair samples was analyzed by laser ablation inductively coupled plasma mass spectrometry, and brain (globus pallidus, dentate nucleus, white matter), bone, and skin tissues were analyzed by bulk inductively coupled plasma mass spectrometry. The mean of the maximum value in the hair samples was used to generate a representative measurement of the hair gadolinium concentration for each case. A linear regression analysis between each tissue type and hair was conducted to assess for possible correlation. RESULTS Tissue and hair samples from 18 autopsies (16 cases with exposure to GBCA, 2 controls) were included in the study. Comparing the different tissues revealed good correlation between some tissue types. The best model fit occurred between white matter and hair (R = 0.83; P < 0.0001) followed by the comparison between dentate nucleus and hair (R = 0.72; P < 0.0001) and dentate nucleus and skin (R = 0.70; P < 0.0001). CONCLUSIONS A significant correlation in this study between hair gadolinium concentrations and brain and skin gadolinium concentrations suggests that hair may serve as a safe and effective biomonitoring tissue for patients who receive GBCA injections.
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Gulino P, Bianchi A, Diciotti S, Scionti A, Sali L, Papadopulos P, Mascalchi M. The switch from Gd-DTPA to Gd-DOTA is not associated with decrease of the T1 signal intensity of the pallidus and dentate in a pediatric population. Acta Radiol 2021; 62:368-376. [PMID: 32529894 DOI: 10.1177/0284185120927920] [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 The switch from the linear gadolinium-based contrast agent (GBCA) gadopentate dimeglumine (Gd_DTPA) to the macrocyclic GBCA gadobutrol is associated with a decrease of the T1 signal intensity (SI) in brain gray matter nuclei. The effects of the switch to other macrocyclic GBCAs are not yet established. PURPOSE To explore the effects of switching from Gd-DTPA to the macrocyclic GBCA gadoterate meglumine (Gd-DOTA) in pediatric patients. MATERIAL AND METHODS We measured the pallidus/middle cerebellar peduncle (MCP) SI ratio and the dentate/MCP SI ratio in pre-contrast sagittal T1-weighted spin-echo images in nine patients who had received ≥6 administrations of Gd-DTPA and then of Gd-DOTA, in 18 patients who had received ≥6 administrations of Gd-DOTA alone, and in nine age-matched controls without prior GBCA administrations. Serial assessment was performed in patients who switched from Gd-DTPA to Gd-DOTA. Finally, the rate of change of pallidal/MCP and dentate/MCP SI ratios between the first and last Gd-DOTA administrations was compared. RESULTS The pallidal/MCP and dentate/MCP SI ratios were (P < 0.05) higher in patients with prior Gd-DTPA and Gd-DOTA administrations compared to the controls. After the switch, the pallidal/MCP SI ratio increased in nine patients and the dentate/MCP ratio in seven patients. The rate of change of pallidal/MCP SI ratio after Gd-DOTA was higher (P < 0.01) in patients who had previously received Gd-DTPA (mean 2.89 ± 2.6%) than in patients who had received Gd-DOTA alone (mean 0.53 ± 0.89%). CONCLUSION T1 SI in gray matter nuclei does not decrease after switching from Gd-DTPA to Gd-DOTA. The switch effects from Gd-DTPA to each macrocyclic GBCA should be individually evaluated.
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Affiliation(s)
- Pietro Gulino
- Radiology Unit, Meyer Children’s Hospital, Florence, Italy
- Radiology Unit, Ospedale Maggiore “Carlo Alberto Pizzardi,” AUSL, Bologna, Italy
| | - Andrea Bianchi
- Neuroradiology Unit, Careggi University Hospital, Florence, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi,” University of Bologna, Cesena, Italy
| | | | - Lapo Sali
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Italy
| | | | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio”, University of Florence, Italy
- Neuroradiology Research Program, Meyer Children Hospital, Florence, Italy
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12
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Erdoğan MA, Apaydin M, Armagan G, Taskiran D. Evaluation of toxicity of gadolinium-based contrast agents on neuronal cells. Acta Radiol 2021; 62:206-214. [PMID: 32366109 DOI: 10.1177/0284185120920801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gadolinium-based contrast agents (GBCAs) are widely used in magnetic resonance imaging (MRI). Recently, increased signal intensity has been reported in specific brain areas after repeated administrations of GBCAs. PURPOSE To investigate the toxic effects of GBCAs on neuronal cells by using SH-SY5Y neuroblastoma cell cultures. MATERIAL AND METHODS For toxicity assays, SH-SY5Y cells were incubated with different doses (0-1000 µM) of several macrocyclic (gadoterate meglumine and gadobutrol) and linear GBCAs (gadoversetamide, gadopentetate dimeglumine, gadodiamide, and gadoxetate disodium) for 48 h. Cell viability and proliferation capacity were evaluated by using MTS assay, LDH assay, and colony-forming assay. In addition, Western blotting of Bcl-2 and Bax proteins and nuclear Hoechst 33258 staining were performed to evaluate apoptotic cell death. The results were expressed as mean ± SEM. The data were analyzed using Student's t-test. A P value < 0.05 was accepted as statistically significant. RESULTS Both macrocyclic and linear GBCAs significantly and dose-dependently reduced cell viability in neuronal cells compared to control. Cell viability was measured between 89.5% ± 4% and 61% ± 0.7% in GBCA-treated groups. In addition, neurotoxicity was more prominent in linear GBCA-treated cultures (P < 0.0005). Bax protein levels were increased in GBCA-treated cells particularly with linear agents whereas Bcl-2 expression was decreased concomitantly. CONCLUSION The results of the present study indicated that exposure to specific GBCAs, even at low micro-molar concentrations, may have detrimental effects on neuronal survival. Further investigations are required to clarify the molecular mechanism underlying GBCA-induced cell death.
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Affiliation(s)
- Mümin Alper Erdoğan
- Department of Physiology, İzmir Katip Çelebi University School of Medicine, Izmir, Turkey
| | - Melda Apaydin
- Department of Radiology, KCU Atatürk Education and Training Hospital, Izmir, Turkey
| | - Güliz Armagan
- Department of Biochemistry, Ege University School of Pharmacy, Izmir, Turkey
| | - Dilek Taskiran
- Department of Physiology, Ege University School of Medicine, Izmir, Turkey
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13
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Lattanzio SM. Toxicity associated with gadolinium-based contrast-enhanced examinations. AIMS BIOPHYSICS 2021. [DOI: 10.3934/biophy.2021015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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14
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Increased T1 Signal Intensity of the Anterior Pituitary Gland on Unenhanced Magnetic Resonance Images After Chronic Exposure to Gadodiamide. Invest Radiol 2020; 55:25-29. [PMID: 31498162 DOI: 10.1097/rli.0000000000000604] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to assess the signal intensity of the anterior pituitary (AP) gland on unenhanced T1-weighted images in patients with history of serial intravenous injections of gadodiamide and normal renal function. MATERIALS AND METHODS We included 53 patients who had undergone at least 5 injections of gadodiamide and a control group of 15 subjects who underwent at least 5 brain magnetic resonance imaging without gadolinium-based contrast agents. Using unenhanced sagittal T1-weighted images, values of mean signal intensity of the AP and of the central pons were obtained. Anterior pituitary-to-pons signal intensity ratios were calculated dividing the values of the AP by those of the pons. Then, the ratios were compared between the first and the last magnetic resonance imaging scans for all the subjects. To assess the difference between the first and the last ratios, nonparametric Wilcoxon signed-rank test with Monte Carlo resampling was applied. A P value less than 0.05 was considered as statistically significant. RESULTS The comparison between the first and the last scan revealed a statistically significant increase of AP-to-pons ratio in the last scan for the gadolinium-exposed group (P < 0.001), whereas nonsignificant results were found for the control group (P = nonsignificant). CONCLUSIONS We found an increased signal intensity of the AP on unenhanced T1-weighted images in patients with history of serial intravenous injections of gadodiamide and normal renal function, suggesting gadolinium deposition or long-term retention within the AP gland. Our findings need to be confirmed by further histochemical analysis of AP gland tissue samples.
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15
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Anterior pituitary gland T1 signal intensity is influenced by time delay after injection of gadodiamide. Sci Rep 2020; 10:14967. [PMID: 32917963 PMCID: PMC7486291 DOI: 10.1038/s41598-020-71981-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/20/2020] [Indexed: 01/01/2023] Open
Abstract
To test the hypothesis of washout from the anterior pituitary (AP) gland after serial injections of gadodiamide. We included 59 patients with history of at least 5 injections of gadodiamide. Values of mean signal intensity of the AP and of the central pons were measured on unenhanced sagittal T1-weighted images. AP-to-pons signal intensity ratios were calculated dividing the values of the AP by those of the pons. The measurements were performed using MR images acquired at four different time points including baseline (prior to any gadodiamide injection), minimum post-injection time delay, maximum post-injection time delay, and last available MR scans. Normalized ratios (i.e. ratios divided total volume of injected gadodiamide) were also calculated. To assess the difference between ratios, non-parametric Wilcoxon signed-rank test was applied. The correlations were tested with non-parametric Spearman correlation coefficient. A p-value < 0.05 was considered as statistically significant. A statistically significant increase of AP signal intensity was found by comparing the baseline scans with both the minimum time delay (p = 0.003) and maximum time delay scans (p = 0.005). We found significant higher normalized ratios for minimum post-injection time delay with respect to maximum post-injection time delay (p < 0.001). The normalized ratios demonstrated a statistically significant negative correlation with the post-injection time delay (r = − 0.31; p = 0.006). The findings of this study suggest that washout phenomena of retained/deposited gadolinium from the AP are influenced by the total injected volume and post-injection time delay.
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16
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Gerb J, Ahmadi SA, Kierig E, Ertl-Wagner B, Dieterich M, Kirsch V. VOLT: a novel open-source pipeline for automatic segmentation of endolymphatic space in inner ear MRI. J Neurol 2020; 267:185-196. [PMID: 32666134 PMCID: PMC7718192 DOI: 10.1007/s00415-020-10062-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/02/2020] [Accepted: 07/06/2020] [Indexed: 12/16/2022]
Abstract
Background Objective and volumetric quantification is a necessary step in the assessment and comparison of endolymphatic hydrops (ELH) results. Here, we introduce a novel tool for automatic volumetric segmentation of the endolymphatic space (ELS) for ELH detection in delayed intravenous gadolinium-enhanced magnetic resonance imaging of inner ear (iMRI) data. Methods The core component is a novel algorithm based on Volumetric Local Thresholding (VOLT). The study included three different data sets: a real-world data set (D1) to develop the novel ELH detection algorithm and two validating data sets, one artificial (D2) and one entirely unseen prospective real-world data set (D3). D1 included 210 inner ears of 105 patients (50 male; mean age 50.4 ± 17.1 years), and D3 included 20 inner ears of 10 patients (5 male; mean age 46.8 ± 14.4 years) with episodic vertigo attacks of different etiology. D1 and D3 did not differ significantly concerning age, gender, the grade of ELH, or data quality. As an artificial data set, D2 provided a known ground truth and consisted of an 8-bit cuboid volume using the same voxel-size and grid as real-world data with different sized cylindrical and cuboid-shaped cutouts (signal) whose grayscale values matched the real-world data set D1 (mean 68.7 ± 7.8; range 48.9–92.8). The evaluation included segmentation accuracy using the Sørensen-Dice overlap coefficient and segmentation precision by comparing the volume of the ELS. Results VOLT resulted in a high level of performance and accuracy in comparison with the respective gold standard. In the case of the artificial data set, VOLT outperformed the gold standard in higher noise levels. Data processing steps are fully automated and run without further user input in less than 60 s. ELS volume measured by automatic segmentation correlated significantly with the clinical grading of the ELS (p < 0.01). Conclusion VOLT enables an open-source reproducible, reliable, and automatic volumetric quantification of the inner ears’ fluid space using MR volumetric assessment of endolymphatic hydrops. This tool constitutes an important step towards comparable and systematic big data analyses of the ELS in patients with the frequent syndrome of episodic vertigo attacks. A generic version of our three-dimensional thresholding algorithm has been made available to the scientific community via GitHub as an ImageJ-plugin.
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Affiliation(s)
- J Gerb
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - S A Ahmadi
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität München, Munich, Germany
| | - E Kierig
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - B Ertl-Wagner
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Department of Radiology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität München, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - V Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany. .,German Center for Vertigo and Balance Disorders - IFB-LMU, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany. .,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität München, Munich, Germany.
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17
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Iancu SD, Albu C, Chiriac L, Moldovan R, Stefancu A, Moisoiu V, Coman V, Szabo L, Leopold N, Bálint Z. Assessment of Gold-Coated Iron Oxide Nanoparticles as Negative T2 Contrast Agent in Small Animal MRI Studies. Int J Nanomedicine 2020; 15:4811-4824. [PMID: 32753867 PMCID: PMC7355080 DOI: 10.2147/ijn.s253184] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/28/2020] [Indexed: 01/07/2023] Open
Abstract
PURPOSE Magnetic resonance imaging (MRI) contrast agents are pharmaceuticals that enable a better visualization of internal body structures. In this study, we present the synthesis, MRI signal enhancement capabilities, in vitro as well as in vivo cytotoxicity results of gold-coated iron oxide nanoparticles (Fe3O4@AuNPs) as potential contrast agents. METHODS Fe3O4@AuNPs were obtained by synthesizing iron oxide nanoparticles and gradually coating them with gold. The obtained Fe3O4@AuNPs were characterized by spectroscopies, transmission electron microscopy (TEM) and energy dispersive X-ray diffraction. The effect of the nanoparticles on the MRI signal was tested using a 7T Bruker PharmaScan system. Cytotoxicity tests were made in vitro on Fe3O4@AuNP-treated retinal pigment epithelium cells by WST-1 tests and in vivo by following histopathological changes in rats after injection of Fe3O4@AuNPs. RESULTS Stable Fe3O4@AuNPs were successfully prepared following a simple and fast protocol (<1h worktime) and identified using TEM. The cytotoxicity tests on cells have shown biocompatibility of Fe3O4@AuNPs at small concentrations of Fe (<1.95×10-8 mg/cell). Whereas, at higher Fe concentrations (eg 7.5×10-8 mg/cell), cell viability decreased to 80.88±5.03%, showing a mild cytotoxic effect. MRI tests on rats showed an optimal Fe3O4@AuNPs concentration of 6mg/100g body weight to obtain high-quality images. The histopathological studies revealed significant transient inflammatory responses in the time range from 2 hours to 14 days after injection and focal cellular alterations in several organs, with the lung being the most affected organ. These results were confirmed by hyperspectral microscopic imaging of the same, but unstained tissues. In most organs, the inflammatory responses and sublethal cellular damage appeared to be transitory, except for the kidneys, where the glomerular damage indicated progression towards glomerular sclerosis. CONCLUSION The obtained stable, gold covered, iron oxide nanoparticles with reduced cytotoxicity, gave a negative T2 signal in the MRI, which makes them suitable for candidates as contrast agent in small animal MRI applications.
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Affiliation(s)
- Stefania D Iancu
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca400084, Romania
| | - Camelia Albu
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca400349, Romania
| | - Liviu Chiriac
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca400349, Romania
- National Magnetic Resonance Center, Babeș-Bolyai University, Cluj-Napoca400084, Romania
| | - Remus Moldovan
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca400349, Romania
| | - Andrei Stefancu
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca400084, Romania
| | - Vlad Moisoiu
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca400084, Romania
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca400349, Romania
| | - Vasile Coman
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Institute of Life Sciences, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Cluj-Napoca400372, Romania
| | - Laszlo Szabo
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca400084, Romania
| | - Nicolae Leopold
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca400084, Romania
| | - Zoltán Bálint
- IMOGEN Medical Research Institute, County Clinical Emergency Hospital, Cluj-Napoca400012, Romania
- Faculty of Physics, Babeș-Bolyai University, Cluj-Napoca400084, Romania
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18
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Rasschaert M, Weller RO, Schroeder JA, Brochhausen C, Idée JM. Retention of Gadolinium in Brain Parenchyma: Pathways for Speciation, Access, and Distribution. A Critical Review. J Magn Reson Imaging 2020; 52:1293-1305. [PMID: 32246802 PMCID: PMC7687192 DOI: 10.1002/jmri.27124] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/21/2022] Open
Abstract
The unexpected appearance of T1 hyperintensities, mostly in the dentate nucleus and the globus pallidus, during nonenhanced MRI was reported in 2014. This effect is associated with prior repeated administrations of gadolinium (Gd)‐based contrast agents (GBCAs) in patients with a functional blood–brain barrier (BBB). It is widely assumed that GBCAs do not cross the intact BBB, but the observation of these hypersignals raises questions regarding this assumption. This review critically discusses the mechanisms of Gd accumulation in the brain with regard to access pathways, Gd species, tissue distribution, and subcellular location. We propose the hypothesis that there is early access of Gd species to cerebrospinal fluid, followed by passive diffusion into the brain parenchyma close to the cerebral ventricles. When accessing areas rich in endogenous metals or phosphorus, the less kinetically stable GBCAs would dissociate, and Gd would bind to endogenous macromolecules, and/or precipitate within the brain tissue. It is also proposed that Gd species enter the brain parenchyma along penetrating cortical arteries in periarterial pial‐glial basement membranes and leave the brain along intramural peri‐arterial drainage (IPAD) pathways. Lastly, Gd/GBCAs may access the brain parenchyma directly from the blood through the BBB in the walls of capillaries. It is crucial to distinguish between the physiological distribution and drainage pathways for GBCAs and the possible dissociation of less thermodynamically/kinetically stable GBCAs that lead to long‐term Gd deposition in the brain. Level of Evidence 5. Technical Efficacy Stage 3.
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Affiliation(s)
| | - Roy O Weller
- Neuropathology, Faculty of Medicine University of Southampton, Southampton General Hospital, Southampton, UK
| | - Josef A Schroeder
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | | | - Jean-Marc Idée
- Guerbet, Research and Innovation Division, Aulnay-sous-Bois, France
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Harrell AD, Johnson D, Samet J, Omar IM, Deshmukh S. With or without? A retrospective analysis of intravenous contrast utility in magnetic resonance neurography. Skeletal Radiol 2020; 49:577-584. [PMID: 31691835 DOI: 10.1007/s00256-019-03321-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the utility of intravenous contrast in magnetic resonance neurography (MRN). MATERIALS AND METHODS A search of our PACS for MRN studies performed in 2015 yielded 74 MRN exams, 57 of which included pre- and post-contrast images. All studies were independently reviewed by 3 musculoskeletal radiologists with peripheral nerve imaging experience for presence/absence of nerve pathology, presence/absence of muscle denervation, and contrast utility score based on a 4-point Likert scale. The medical record was reviewed for demographic and clinical data. RESULTS The mean contrast utility score across all readers and all cases was 1.65, where a score of 1 indicated no additional information and a score of 2 indicated mild additional information/supports interpretation. The mean contrast utility score was slightly higher in cases with a clinical indication of amputation/stump neuroma or mass (2.3 and 2.1 respectively) and lower in cases with a clinical indication of trauma (1.5). The mean contrast utility score was lowest in patients undergoing MRN for pain, numbness, and/or weakness (1.2). CONCLUSION Intravenous contrast provides mild to no additional information for the majority of MRN exams. Given the invasive nature of contrast and recent concerns regarding previously unrecognized risks of repetitive contrast exposure, assessment of the necessity of intravenous contrast in MRN is important. Consensus evidence-based practice guidelines regarding intravenous contrast use in MRN are necessary.
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Affiliation(s)
- Alan D Harrell
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA
| | - Daniel Johnson
- Department of Orthopedic Surgery, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA
| | - Jonathan Samet
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA.,Department of Radiology, Ann & Robert H Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA
| | - Imran M Omar
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA
| | - Swati Deshmukh
- Department of Radiology, Northwestern Memorial Hospital, 676 N St Clair St, Chicago, IL, 60611, USA.
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Comparison of the Relaxivities of Macrocyclic Gadolinium-Based Contrast Agents in Human Plasma at 1.5, 3, and 7 T, and Blood at 3 T. Invest Radiol 2020; 54:559-564. [PMID: 31124800 DOI: 10.1097/rli.0000000000000577] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE The relaxivities of 3 macrocyclic gadolinium-based contrast agents (GBCAs) were determined in human plasma and blood under standardized and clinically relevant laboratory conditions. METHODS The T1 relaxivity, r1, was determined in human plasma at 1.5, 3, and 7 T, and in human blood at 3 T at 37°C in phantoms containing 4 different concentrations of the macrocyclic GBCAs gadobutrol, gadoteridol, and gadoterate. An inversion recovery turbo spin echo sequence was used to generate images with several inversion times. The T1-times were obtained by fitting the signal intensities to the signal equation. r1 was obtained by a 1/y-weighted regression of the T1-rates over the concentration of the GBCAs. RESULTS For gadobutrol, the obtained r1 [L/(mmol·s)] in human plasma at 1.5 T, 3 T, and 7 T, and in human blood at 3 T was 4.78 ± 0.12, 4.97 ± 0.59, 3.83 ± 0.24, and 3.47 ± 0.16. For gadoteridol, r1 was 3.80 ± 0.10, 3.28 ± 0.09, 3.21 ± 0.07, and 2.61 ± 0.16, and for gadoterate, 3.32 ± 0.13, 3.00 ± 0.13, 2.84 ± 0.09, and 2.72 ± 0.17. CONCLUSIONS The relaxivity of gadobutrol is significantly higher than that of gadoteridol and gadoterate at all magnetic field strengths and in plasma as well as in blood, whereas that of gadoteridol was higher than gadoterate only in plasma at 1.5 and 7 T. This is in accordance with results from 3 previous studies obtained in different media.
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Kanal E, Patton TJ, Krefting I, Wang C. Nephrogenic Systemic Fibrosis Risk Assessment and Skin Biopsy Quantification in Patients with Renal Disease following Gadobenate Contrast Administration. AJNR Am J Neuroradiol 2020; 41:393-399. [PMID: 32115422 DOI: 10.3174/ajnr.a6448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/18/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND PURPOSE Nephrogenic systemic fibrosis following administration of intravenous gadobenate during MR imaging is rare. This study aimed to analyze any nephrogenic systemic fibrosis-related risks and quantify skin gadolinium levels in patients with impaired renal function but without nephrogenic systemic fibrosis who had received gadobenate. MATERIALS AND METHODS In this retrospective study with a prospective skin biopsy phase, patients with estimated glomerular filtration rates of <60 mL/min/1.73 m2 undergoing contrast-enhanced MR imaging from July 2007 through June 2014 were screened for nephrogenic systemic fibrosis using a questionnaire. This was highly sensitive but not specific and reliably excluded nephrogenic systemic fibrosis if responses to at least 6 of the 8 questions were negative. If no nephrogenic systemic fibrosis was detected, a skin biopsy was requested. RESULTS Of 2914 patients who met these criteria, 1988 were excluded for various reasons. Of the remaining 926 patients, 860 were screened negative for nephrogenic systemic fibrosis. Of these, 17 (2%) had estimated glomerular filtration rates of <15 mL/min/1.73 m2, 51 (6%) had levels of 15 < 30 mL/min/1.73 m2, 234 (27%) had levels of 30 < 45 mL/min/1.73 m2, and 534 (62%) had levels of 45 < 60 mL/min/1.73 m2. Of the 66 who were not cleared of nephrogenic systemic fibrosis by the questionnaire, 6 patients were evaluated by a dermatologist and confirmed not to have nephrogenic systemic fibrosis (no biopsy required). CONCLUSIONS A diagnosis of nephrogenic systemic fibrosis was excluded in 860 patients with impaired renal function who were followed up and received gadobenate during MR imaging. In 14 such patients who underwent at least 1 gadobenate-enhanced MR imaging examination and did not have nephrogenic systemic fibrosis, gadolinium levels in the skin were exceedingly low.
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Affiliation(s)
- E Kanal
- Departments of Radiology (E.K.)
| | - T J Patton
- Dermatology (T.J.P.), University of Pittsburgh Medical Center and University of Pittsburgh, Pittsburgh, Pennsylvania
| | - I Krefting
- Division of Medical Imaging and Radiation Medicine (I.K.)
| | - C Wang
- Office of Pharmacovigilance and Epidemiology (C.W.), US Food and Drug Administration, Silver Spring, Maryland
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22
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Dose Finding Study of Gadopiclenol, a New Macrocyclic Contrast Agent, in MRI of Central Nervous System. Invest Radiol 2020; 55:129-137. [DOI: 10.1097/rli.0000000000000624] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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23
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Gadolinium deposition in the brain of dogs after multiple intravenous administrations of linear gadolinium based contrast agents. PLoS One 2020; 15:e0227649. [PMID: 32012163 PMCID: PMC6996830 DOI: 10.1371/journal.pone.0227649] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 12/22/2019] [Indexed: 01/24/2023] Open
Abstract
Objective To determine the effect of a linear gadolinium-based contrast agent (GBCA) on the signal intensity (SI) of the deep cerebellar nuclei (DCN) in a retrospective clinical study on dogs after multiple magnetic resonance (MR) examinations with intravenous injections of gadodiamide and LA-ICP-MS analysis of a canine cerebellum after gadodiamide administration. Animals 15 client-owned dogs of different breeds and additionally 1 research beagle dog cadaver. Procedures In the retrospective study part, 15 dogs who underwent multiple consecutive MR imaging examinations with intravenous injection of linear GBCA gadodiamide were analyzed. SI ratio differences on unenhanced T1-weighted MR images before and after gadodiamide injections was calculated by subtracting SI ratios between DCN and pons of the first examination from the ratio of the last examination. Additionally, 1 research beagle dog cadaver was used for LA-ICP-MS (Laser ablation inductively coupled plasma mass spectrometry) analysis of gadolinium in the cerebellum as an add-on to another animal study. Descriptive and non-parametrical statistical analysis was performed and a p-value of < 0.05 was considered significant. Results No statistically significant differences of SI ratios, between DCN and pons, were detectable based on unenhanced T1-weighted MR images. LA-ICP-MS analyses showed between 1.5 to 2.5 μg gadolinium/g tissue in the cerebellum of the examined dog, 35 months after the last of 3 MRI examination with gadodiamide (two examinations at a dose of 1 x 0.1mmol/kg, last examination at a dose of 3 x 0.05mmol/kg). Conclusion and clinical relevance Although the retrospective MRI study did not indicate any visible effect of SI increase after multiple gadodiamide exposures, further studies based on LA-ICP-MS showed that the optical threshold was not reached for a potential visible effect. Gadolinium was detectable at a level of 1.5 to 2.5 μg gadolinium/g tissue by using LA-ICP-MS in the cerebellum 35 months after last MRI examination. The general importance of gadolinium retention of subvisible contents requires further investigation.
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Damme NM, Fernandez DP, Wang LM, Wu Q, Kirk RA, Towner RA, McNally JS, Hoffman JM, Morton KA. Analysis of retention of gadolinium by brain, bone, and blood following linear gadolinium-based contrast agent administration in rats with experimental sepsis. Magn Reson Med 2019; 83:1930-1939. [PMID: 31677194 DOI: 10.1002/mrm.28060] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE It is important to identify populations that may be vulnerable to the brain deposition of gadolinium (Gd) from MRI contrast agents. At intervals from 24 hours to 6 weeks following injection of a linear Gd contrast agent, the brain, blood and bone content of Gd were compared between control rats and those with experimental endotoxin-induced sepsis that results in neuroinflammation and blood-brain barrier disruption. METHODS Male rats were injected intraperitoneally with 10 mg/kg lipopolysaccharide. Control animals received no injection. Twenty-four hours later, 0.2 mmol/kg of gadobenate dimeglumine was injected intravenously. Brain, blood, and bone Gd levels were measured at 24 hours, 1 week, 3 weeks, and 6 weeks by inductively coupled plasma mass spectroscopy. RESULTS Blood Gd decreased rapidly between 24 hours and 1 week, and thereafter was undetectable, with no significant difference between lipopolysaccharide and control rats. Brain levels of Gd were significantly higher (4.29-2.36-fold) and bone levels slightly higher (1.35-1.11-fold) in lipopolysaccharide than control rats at all time points with significant retention at 6 weeks. CONCLUSION Experimental sepsis results in significantly higher deposition of Gd in the brain and bone in rats. While blood Gd clears rapidly, brain and bone retained substantial Gd even at 6 weeks following contrast injection.
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Affiliation(s)
- Nikolas M Damme
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Diego P Fernandez
- Department of Geology and Geophysics, University of Utah, Salt Lake City, Utah
| | - Li-Ming Wang
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Qi Wu
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Ryan A Kirk
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Rheal A Towner
- Advanced Magnetic Resonance Center, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma
| | - J Scott McNally
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - John M Hoffman
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
| | - Kathryn A Morton
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah
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Jost G, Frenzel T, Boyken J, Pietsch H. Impact of brain tumors and radiotherapy on the presence of gadolinium in the brain after repeated administration of gadolinium-based contrast agents: an experimental study in rats. Neuroradiology 2019; 61:1273-1280. [PMID: 31297571 PMCID: PMC6817760 DOI: 10.1007/s00234-019-02256-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 07/01/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE To investigate the impact of blood-brain barrier (BBB) alterations induced by an experimental tumor and radiotherapy on MRI signal intensity (SI) in deep cerebellar nuclei (DCN) and the presence of gadolinium after repeated administration of a linear gadolinium-based contrast agent in rats. METHODS Eighteen Fischer rats were divided into a tumor (gliosarcoma, GS9L model), a radiotherapy, and a control group. All animals received 5 daily injections (1.8 mmol/kg) of gadopentetate dimeglumine. For tumor-bearing animals, the BBB disruption was confirmed by contrast-enhanced MRI. Animals from the tumor and radiation group underwent radiotherapy in 6 fractions of 5 Gray. The SI ratio between DCN and brain stem was evaluated on T1-weigthed MRI at baseline and 1 week after the last administration. Subsequently, the brain was dissected for gadolinium quantification by inductively coupled plasma-mass spectrometry. Statistical analysis was done with the Kruskal-Wallis test. RESULTS An increased but similar DCN/brain stem SI ratio was found for all three groups (p = 0.14). The gadolinium tissue concentrations (median, nmol/g) were 6.7 (tumor), 6.3 (radiotherapy), and 6.8 (control) in the cerebellum (p = 0.64) and 17.8/14.6 (tumor), 20.0/18.9 (radiotherapy), and 17.8/15.9 (control) for the primary tumor (p = 0.98) and the contralateral hemisphere (p = 0.41) of the cerebrum, respectively. CONCLUSION An experimental brain tumor treated by radiotherapy or radiotherapy alone did not alter DCN signal hyperintensity and gadolinium concentration in the rat brain 1 week after repeated administration of gadopentetate. This suggests that a local BBB disruption does not affect the amount of retained gadolinium in the brain.
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Affiliation(s)
- Gregor Jost
- Bayer AG, MR & CT Contrast Media Research, Muellerstrasse 178, 13353, Berlin, Germany.
| | - Thomas Frenzel
- Bayer AG, MR & CT Contrast Media Research, Muellerstrasse 178, 13353, Berlin, Germany
| | - Janina Boyken
- Bayer AG, MR & CT Contrast Media Research, Muellerstrasse 178, 13353, Berlin, Germany
| | - Hubertus Pietsch
- Bayer AG, MR & CT Contrast Media Research, Muellerstrasse 178, 13353, Berlin, Germany
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26
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Increased Retention of Gadolinium in the Inflamed Brain After Repeated Administration of Gadopentetate Dimeglumine. Invest Radiol 2019; 54:617-626. [DOI: 10.1097/rli.0000000000000571] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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27
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Splendiani A, Corridore A, Torlone S, Martino M, Barile A, Di Cesare E, Masciocchi C. Visible T1-hyperintensity of the dentate nucleus after multiple administrations of macrocyclic gadolinium-based contrast agents: yes or no? Insights Imaging 2019; 10:82. [PMID: 31482392 PMCID: PMC6722174 DOI: 10.1186/s13244-019-0767-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 07/11/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate the appearance of visible dentate nucleus (DN) T1-hyperintensity and quantify changes in DN/pons (DN/P) signal intensity (SI) ratio in MS patients after the exclusive administration of macrocyclic GBCAs. MATERIALS AND METHODS One hundred forty-nine patients with confirmed MS were evaluated. Patients received at least two administrations of gadobutrol (n = 63), gadoterate (n = 57), or both (n = 29). Two experienced neuroradiologists in consensus evaluated unenhanced T1-weighted MR images from all examinations in each patient for evidence of visible DN hyperintensity. Thereafter, SI measurements were made in the left and right DN and pons on unenhanced T1-weighted images from the first and last scans. A two-sample t test compared the DN/P SI ratios for patients with and without visible T1-hyperintensity. RESULTS Visible T1-hyperintensity was observed in 42/149 (28.2%) patients (19 after gadobutrol only, 15 after gadoterate only, 8 after both), typically at the 4th or 5th follow-up exam at 3-4 years after the initial examination. Significant increases in DN/P SI ratio from first to last examination were determined for patients with visible T1-hyperintensity (0.998 ± 0.002 to 1.153 ± 0.016, p < 0.0001 for gadobutrol; 1.003 ± 0.004 to 1.110 ± 0.014, p < 0.0001 for gadoterate; 1.004 ± 0.011 to 1.163 ± 0.032, p = 0.0004 for both) but not for patients without visible T1-hyperintensity (p > 0.05; all groups). CONCLUSION Multiple injections of gadobutrol and/or gadoterate can lead to visible and quantifiable increases in DN/P SI ratio in some patients with MS.
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Affiliation(s)
- Alessandra Splendiani
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy.
| | - Antonella Corridore
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Silvia Torlone
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Milvia Martino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Antonio Barile
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Ernesto Di Cesare
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Carlo Masciocchi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
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Evaluation of Gadopiclenol and P846, 2 High-Relaxivity Macrocyclic Magnetic Resonance Contrast Agents Without Protein Binding, in a Rodent Model of Hepatic Metastases. Invest Radiol 2019; 54:549-558. [DOI: 10.1097/rli.0000000000000572] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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29
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Kirsch V, Nejatbakhshesfahani F, Ahmadi SA, Dieterich M, Ertl-Wagner B. A probabilistic atlas of the human inner ear's bony labyrinth enables reliable atlas-based segmentation of the total fluid space. J Neurol 2019; 266:52-61. [PMID: 31422454 DOI: 10.1007/s00415-019-09488-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/25/2019] [Accepted: 07/26/2019] [Indexed: 12/20/2022]
Abstract
Intravenous contrast agent-enhanced magnetic resonance imaging of the endolymphatic space (ELS) of the inner ear permits direct, in-vivo, non-invasive visualization of labyrinthine structures and thus verification of endolymphatic hydrops (ELH). However, current volumetric assessment approaches lack normalization. The aim of this study was to develop a probabilistic atlas of the inner ear's bony labyrinth as a first step towards an automated and reproducible volume-based quantification of the ELS. The study included three different datasets: a source dataset (D1) to build the probabilistic atlas and two testing sets (D2, D3). D1 included 24 right-handed patients (12 females; mean age 51.5 ± 3.9 years) and D2 5 patients (3 female; mean age 48.8 ± 5.01 years) with vestibular migraine without ELH or any measurable vestibular deficits. D3 consisted of five patients (one female; mean age 46 ± 5.2 years) suffering from unilateral Menière's disease and ELH. Data processing comprised three steps: preprocessing using an affine and deformable fusion registration pipeline, computation of an atlas for the left and right inner ear using a label-assisted approach, and validation of the atlas based on localizing and segmenting previously unseen ears. The three-dimensional probabilistic atlas of the inner ear's bony labyrinth consisted of the internal acoustic meatus and inner ears (including cochlea, otoliths, and semicircular canals) for both sides separately. The analyses showed a high level of agreement between the atlas-based segmentation and the manual gold standard with an overlap of 89% for the right ear and 86% for the left ear (measured by dice scores). This probabilistic in vivo atlas of the human inner ear's bony labyrinth and thus of the inner ear's total fluid space for both ears represents a necessary step towards a normalized, easily reproducible and reliable volumetric quantification of the perilymphatic and endolymphatic space in view of MR volumetric assessment of ELH. The proposed atlas lays the groundwork for state-of-the-art approaches (e.g., deep learning) and will be provided to the scientific community.
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Affiliation(s)
- Valerie Kirsch
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany. .,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany. .,German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.
| | - F Nejatbakhshesfahani
- Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - S-A Ahmadi
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - M Dieterich
- Department of Neurology, University Hospital, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377, Munich, Germany.,Graduate School of Systemic Neuroscience (GSN), Ludwig-Maximilians-Universität, Munich, Germany.,German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - B Ertl-Wagner
- German Center for Vertigo and Balance Disorders- IFB, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Department of Radiology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,Department of Radiology, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Zivadinov R, Bergsland N, Hagemeier J, Ramasamy DP, Dwyer MG, Schweser F, Kolb C, Weinstock-Guttman B, Hojnacki D. Cumulative gadodiamide administration leads to brain gadolinium deposition in early MS. Neurology 2019; 93:e611-e623. [PMID: 31285398 PMCID: PMC6709999 DOI: 10.1212/wnl.0000000000007892] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Accepted: 04/02/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Frequent administration of gadolinium-based contrast agents in multiple sclerosis (MS) may increase signal intensity (SI) unenhanced T1-weighted imaging MRI throughout the brain. We evaluated the association between lifetime cumulative doses of gadodiamide administration and increased SI within the dentate nucleus (DN), globus pallidus (GP), and thalamus in patients with early MS. METHODS A total of 203 patients with MS (107 with baseline and follow-up MRI assessments) and 262 age- and sex-matched controls were included in this retrospective, longitudinal, 3T MRI-reader-blinded study. Patients with MS had disease duration <2 years at baseline and received exclusively gadodiamide at all MRI time points. SI ratio (SIR) to pons and CSF of lateral ventricle volume (CSF-LVV) were assessed. Analysis of covariance and correlation analyses, adjusted for age, sex, and region of interest volume, were used. RESULTS The mean follow-up time was 55.4 months, and the mean number of gadolinium-based contrast agents administrations was 9.2. At follow-up, 49.3% of patients with MS and no controls showed DN T1 hyperintensity (p < 0.001). The mean SIR of DN (p < 0.001) and of GP (p = 0.005) to pons and the mean SIR of DN, GP, and thalamus to CSF-LVV were higher in patients with MS compared to controls (p < 0.001). SIR of DN to pons was associated with number of gadodiamide doses (p < 0.001). No associations between SIR of DN, GP, and thalamus and clinical and MRI outcomes of disease severity were detected over the follow-up. CONCLUSIONS DN, GP, and thalamus gadolinium deposition in early MS is associated with lifetime cumulative gadodiamide administration without clinical or radiologic correlates of more aggressive disease.
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Affiliation(s)
- Robert Zivadinov
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York.
| | - Niels Bergsland
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Jesper Hagemeier
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Deepa P Ramasamy
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Michael G Dwyer
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Ferdinand Schweser
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Channa Kolb
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - Bianca Weinstock-Guttman
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
| | - David Hojnacki
- From the Buffalo Neuroimaging Analysis Center (R.Z., N.B., J.H., D.P.R.) and Jacobs Comprehensive MS Treatment and Research Center (C.K., B.W.-G., D.H.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z., M.G.D., F.S.), University at Buffalo, State University of New York
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Methodological Aspects for Preclinical Evaluation of Gadolinium Presence in Brain Tissue: Critical Appraisal and Suggestions for Harmonization-A Joint Initiative. Invest Radiol 2019; 53:499-517. [PMID: 29659381 PMCID: PMC6092104 DOI: 10.1097/rli.0000000000000467] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Gadolinium (Gd)-based contrast agents (GBCAs) are pharmaceuticals that have been approved for 30 years and used daily in millions of patients worldwide. Their clinical benefits are indisputable. Recently, unexpected long-term presence of Gd in the brain has been reported by numerous retrospective clinical studies and confirmed in preclinical models particularly after linear GBCA (L-GBCA) compared with macrocyclic GBCA (M-GBCA). Even if no clinical consequences of Gd presence in brain tissue has been demonstrated so far, in-depth investigations on potential toxicological consequences and the fate of Gd in the body remain crucial to potentially adapt the clinical use of GBCAs, as done during the nephrogenic systemic fibrosis crisis. Preclinical models are instrumental in the understanding of the mechanism of action as well as the potential safety consequences. However, such models may be associated with risks of biases, often related to the protocol design. Selection of adequate terminology is also crucial. This review of the literature intends to summarize and critically discuss the main methodological aspects for accurate design and translational character of preclinical studies.
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Fluorinated MRI contrast agents and their versatile applications in the biomedical field. Future Med Chem 2019; 11:1157-1175. [DOI: 10.4155/fmc-2018-0463] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
MRI has been recognized as one of the most applied medical imaging techniques in clinical practice. However, the presence of background signal coming from water protons in surrounding tissues makes sometimes the visualization of local contrast agents difficult. To remedy this, fluorine has been introduced as a reliable perspective, thanks to its magnetic properties being relatively close to those of protons. In this review, we aim to give an overall description of fluorine incorporation in contrast agents for MRI. The different kinds of fluorinated probes such as perfluorocarbons, fluorinated dendrimers, polymers and paramagnetic probes will be described, as will their imaging applications such as chemical exchange saturation transfer (CEST) imaging, physico-chemical changes detection, drug delivery, cell tracking and inflammation or tumors detection.
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Saake M, Schmidle A, Kopp M, Hanspach J, Hepp T, Laun FB, Nagel AM, Dörfler A, Uder M, Bäuerle T. MRI Brain Signal Intensity and Relaxation Times in Individuals with Prior Exposure to Gadobutrol. Radiology 2019; 290:659-668. [DOI: 10.1148/radiol.2018181927] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Marc Saake
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Alexandra Schmidle
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Markus Kopp
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Jannis Hanspach
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Tobias Hepp
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Frederik B. Laun
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Armin M. Nagel
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Arnd Dörfler
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Michael Uder
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
| | - Tobias Bäuerle
- From the Institute of Radiology (M.S., A.S., M.K., J.H., F.B.L., A.M.N., M.U., T.B.) and Department of Neuroradiology (A.D.), University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany; Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany (T.H.); and Institute of Medical Informatics, Biometry and Epidemiology, University of Erlangen, Erlangen, Germany (T.H.)
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De Sarno F, Ponsiglione AM, Russo M, Grimaldi AM, Forte E, Netti PA, Torino E. Water-Mediated Nanostructures for Enhanced MRI: Impact of Water Dynamics on Relaxometric Properties of Gd-DTPA. Theranostics 2019; 9:1809-1824. [PMID: 31037140 PMCID: PMC6485182 DOI: 10.7150/thno.27313] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 01/19/2019] [Indexed: 02/07/2023] Open
Abstract
Recently, rational design of a new class of contrast agents (CAs), based on biopolymers (hydrogels), have received considerable attention in Magnetic Resonance Imaging (MRI) diagnostic field. Several strategies have been adopted to improve relaxivity without chemical modification of the commercial CAs, however, understanding the MRI enhancement mechanism remains a challenge. Methods: A multidisciplinary approach is used to highlight the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA. Changes in polymer conformation and thermodynamic interactions of CAs and polymers in aqueous solutions are detected by isothermal titration calorimetric (ITC) measurements and later, these interactions are investigated at the molecular level using NMR to better understand the involved phenomena. Water molecular dynamics of these systems is also studied using Differential Scanning Calorimetry (DSC). To observe relaxometric properties variations, we have monitored the MRI enhancement of the examined structures over all the experiments. The study of polymer-CA solutions reveals that thermodynamic interactions between biopolymers and CAs could be used to improve MRI Gd-based CA efficiency. High-Pressure Homogenization is used to obtain nanoparticles. Results: The effect of the hydration of the hydrogel structure on the relaxometric properties, called Hydrodenticity and its application to the nanomedicine field, is exploited. The explanation of this concept takes place through several key aspects underlying biopolymer-CA's interactions mediated by the water. In addition, Hydrodenticity is applied to develop Gadolinium-based polymer nanovectors with size around 200 nm with improved MRI relaxation time (10-times). Conclusions: The experimental results indicate that the entrapment of metal chelates in hydrogel nanostructures offers a versatile platform for developing different high performing CAs for disease diagnosis.
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Affiliation(s)
- Franca De Sarno
- Department of Chemical, Materials Engineering & Industrial Production, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy
- Center for Advanced Biomaterials for Health Care, CABHC, Istituto Italiano di Tecnologia, IIT@CRIB, Largo Barsanti e Matteucci 53, 80125 Naples, Italy
| | - Alfonso Maria Ponsiglione
- Department of Chemical, Materials Engineering & Industrial Production, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy
- Center for Advanced Biomaterials for Health Care, CABHC, Istituto Italiano di Tecnologia, IIT@CRIB, Largo Barsanti e Matteucci 53, 80125 Naples, Italy
| | - Maria Russo
- Department of Chemical, Materials Engineering & Industrial Production, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy
- Center for Advanced Biomaterials for Health Care, CABHC, Istituto Italiano di Tecnologia, IIT@CRIB, Largo Barsanti e Matteucci 53, 80125 Naples, Italy
| | | | - Ernesto Forte
- IRCCS SDN, Via E. Gianturco 113, 80143 Naples, Italy
| | - Paolo Antonio Netti
- Department of Chemical, Materials Engineering & Industrial Production, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy
- Center for Advanced Biomaterials for Health Care, CABHC, Istituto Italiano di Tecnologia, IIT@CRIB, Largo Barsanti e Matteucci 53, 80125 Naples, Italy
- Interdisciplinary Research Center on Biomaterials, CRIB, Piazzale Tecchio 80, 80125 Naples, Italy
| | - Enza Torino
- Department of Chemical, Materials Engineering & Industrial Production, University of Naples Federico II, Piazzale Tecchio 80, 80125 Naples, Italy
- Center for Advanced Biomaterials for Health Care, CABHC, Istituto Italiano di Tecnologia, IIT@CRIB, Largo Barsanti e Matteucci 53, 80125 Naples, Italy
- Interdisciplinary Research Center on Biomaterials, CRIB, Piazzale Tecchio 80, 80125 Naples, Italy
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Jost G, Frenzel T, Boyken J, Lohrke J, Nischwitz V, Pietsch H. Long-term Excretion of Gadolinium-based Contrast Agents: Linear versus Macrocyclic Agents in an Experimental Rat Model. Radiology 2019; 290:340-348. [DOI: 10.1148/radiol.2018180135] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Gregor Jost
- From the Department of MR and CT Contrast Media Research, Bayer, Muellerstr 178, Berlin 13353, Germany (G.J., T.F., J.L., H.P.); Institute of Physiology, Charité, Berlin, Germany (J.B.); and Forschungszentrum Juelich, Juelich, Germany (V.N.)
| | - Thomas Frenzel
- From the Department of MR and CT Contrast Media Research, Bayer, Muellerstr 178, Berlin 13353, Germany (G.J., T.F., J.L., H.P.); Institute of Physiology, Charité, Berlin, Germany (J.B.); and Forschungszentrum Juelich, Juelich, Germany (V.N.)
| | - Janina Boyken
- From the Department of MR and CT Contrast Media Research, Bayer, Muellerstr 178, Berlin 13353, Germany (G.J., T.F., J.L., H.P.); Institute of Physiology, Charité, Berlin, Germany (J.B.); and Forschungszentrum Juelich, Juelich, Germany (V.N.)
| | - Jessica Lohrke
- From the Department of MR and CT Contrast Media Research, Bayer, Muellerstr 178, Berlin 13353, Germany (G.J., T.F., J.L., H.P.); Institute of Physiology, Charité, Berlin, Germany (J.B.); and Forschungszentrum Juelich, Juelich, Germany (V.N.)
| | - Volker Nischwitz
- From the Department of MR and CT Contrast Media Research, Bayer, Muellerstr 178, Berlin 13353, Germany (G.J., T.F., J.L., H.P.); Institute of Physiology, Charité, Berlin, Germany (J.B.); and Forschungszentrum Juelich, Juelich, Germany (V.N.)
| | - Hubertus Pietsch
- From the Department of MR and CT Contrast Media Research, Bayer, Muellerstr 178, Berlin 13353, Germany (G.J., T.F., J.L., H.P.); Institute of Physiology, Charité, Berlin, Germany (J.B.); and Forschungszentrum Juelich, Juelich, Germany (V.N.)
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Choi JW, Moon WJ. Gadolinium Deposition in the Brain: Current Updates. Korean J Radiol 2018; 20:134-147. [PMID: 30627029 PMCID: PMC6315073 DOI: 10.3348/kjr.2018.0356] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022] Open
Abstract
Gadolinium-based contrast agents (GBCAs) are commonly used for enhancement in MR imaging and have long been considered safe when administered at recommended doses. However, since the report that nephrogenic systemic fibrosis is linked to the use of GBCAs in subjects with severe renal diseases, accumulating evidence has suggested that GBCAs are not cleared entirely from our bodies; some GBCAs are deposited in our tissues, including the brain. GBCA deposition in the brain is mostly linked to the specific chelate structure of the GBCA: linear GBCAs were responsible for brain deposition in almost all reported studies. This review aimed to summarize the current knowledge about GBCA brain deposition and discuss its clinical implications.
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Affiliation(s)
- Jin Woo Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Won-Jin Moon
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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Exposure of Macrophages to Low-Dose Gadolinium-Based Contrast Medium: Impact on Oxidative Stress and Cytokines Production. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:3535769. [PMID: 30627059 PMCID: PMC6305030 DOI: 10.1155/2018/3535769] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/25/2018] [Accepted: 10/17/2018] [Indexed: 01/30/2023]
Abstract
The toxicity of gadolinium-based contrast agents (GBCAs) has drawn a lot of attention. Nephrogenic systemic fibrosis (NSF), a lethal disease related to the use of GBCAs, is still not understood. Recently, gadolinium retention is found in brain tissues after repeated use of GBCAs in magnetic resonance imaging (MRI). However, most of the works investigating the toxicity of GBCAs are focusing on its high-concentration (0.5–10 mM) part, which is not reflective of the physiological conditions in human beings. Macrophages play a regulatory role in immune responses and are responsible for the fibrosis process. Their role in gadolinium retention and the pathogenesis of NSF, however, has seldom been investigated. This study aimed to evaluate the immune response generated by macrophages (RAW 264.7) exposing to low levels of GBCAs. The incubation concentration of GBCAs, including Omniscan®, Primovist®, Magnevist®, and Gadovist®, is proportional to the level of gadolinium uptake when detected via inductively coupled plasma mass spectrometry (ICP-MS) and imaged by MRI, whereas Primovist® treatment groups have highest gadolinium uptake among all of the tested concentrations. Low-concentration (2.5 μmol/L) Gd chloride or GBCAs exposure promoted the reactive production of oxygen species (ROS), nitrate/nitrite, prostaglandin E2 (PGE2), and suppressed the potential of mitochondrial membrane. There was higher ROS, nitrate/nitrite, and PGE2 production in the Primovist®, Omniscan®, and Magnevist® groups compared to the Gadovist® group. In face of lipopolysaccharide (LPS) stimulation, Primovist®, Omniscan®, and Magnevist® groups exhibited elevated nitrite/nitrate and suppressed IL-1β secretion and IL-6 and IL-10 secretion. Moreover, upon LPS stimulation, there is decreased TNF-α secretion 4 hours after Primovist® or Omiscan® exposure but the TNF-α secretion increased at 24 hours. Our data suggest that there is upregulated inflammation even in the presence of low levels of GBCAs, even similar to the physiological condition in murine macrophage. Further investigation of GBCAs on the human macrophage or in vivo animal study may clarify the role of macrophage on the pathogenesis of NSF and other GBCAs-related disease.
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Guo BJ, Yang ZL, Zhang LJ. Gadolinium Deposition in Brain: Current Scientific Evidence and Future Perspectives. Front Mol Neurosci 2018; 11:335. [PMID: 30294259 PMCID: PMC6158336 DOI: 10.3389/fnmol.2018.00335] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 08/27/2018] [Indexed: 01/18/2023] Open
Abstract
In the past 4 years, many publications described a concentration-dependent deposition of gadolinium in the brain both in adults and children, seen as high signal intensities in the globus pallidus and dentate nucleus on unenhanced T1-weighted images. Postmortem human or animal studies have validated gadolinium deposition in these T1-hyperintensity areas, raising new concerns on the safety of gadolinium-based contrast agents (GBCAs). Residual gadolinium is deposited not only in brain, but also in extracranial tissues such as liver, skin, and bone. This review summarizes the current evidence on gadolinium deposition in the human and animal bodies, evaluates the effects of different types of GBCAs on the gadolinium deposition, introduces the possible entrance or clearance mechanism of the gadolinium and potential side effects that may be related to the gadolinium deposition on human or animals, and puts forward some suggestions for further research.
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Affiliation(s)
- Bang J. Guo
- Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing, China
| | - Zhen L. Yang
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Long J. Zhang
- Department of Medical Imaging, Jinling Hospital, Nanjing Clinical School, Southern Medical University, Nanjing, China
- Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, China
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Influence of Gadolinium-Based Contrast Agents on Tissue Sodium Quantification in Sodium Magnetic Resonance Imaging. Invest Radiol 2018; 53:555-562. [DOI: 10.1097/rli.0000000000000487] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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