Gadopentatic acid affects in vitro proliferation and doxorubicin response in human breast adenocarcinoma cells

Contrasting agents (CAs) that are administered to patients during magnetic resonance imaging to facilitate tumor identification are generally considered harmless. However, gadolinium (Gd) based contrast agents can be retained in the body, inflicting specific cell line cytotoxicity. We investigate the effect of Gadopentatic acid (Gd-DTPA) on human breast adenocarcinoma MCF-7 cells. These cells exhibit a toggle switch response: exposure to 0.1 and 1 mM concentrations of Gd-DTPA enhances proliferation, which is hindered at a higher 10 mM concentration. Proliferation is enhanced when cells transition to 3D morphologies in post confluent conditions. The proliferation dependence on the concentration of CA is absent for Hs 578T and MDA-MB-231 triple negative cell lines. MCF-7 cells reveal a double toggle switch related to the expression of VEGF, which goes through high-low-high downregulation when cells are exposed to 0.1, 1, and 10 mM Gd-DTPA, respectively. Finally, doxorubicin drug response is assessed, which also reveals a double toggle switch behavior, where drug cytotoxicity exhibits a nonlinear dependence on the CA concentration. A toggle switch in cell characteristics that are exposed to 1 mM of Gd-DTPA amplifies the importance of this threshold, affecting several cell behaviors if surpassed. This work emphasizes the important effects that CAs can have on cells, specifically Gd-DTPA on MCF-7 cells, and the implications for cell growth and drug response during clinical and synthetic biology procedures.

Diagnostic Value of Gadoxetic Acid-Enhanced MR Imaging to Distinguish HCA and Its Subtype from FNH: A Systematic Review

Objective: The purpose of this study was to systematically review the diagnostic performance of gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) for differentiation of hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH), as well as HCA classification by using the low signal intensity (SI) in the hepatobiliary phase (HBP). Methods: A systematic process was used to review all published data in MEDLINE database about Gd-EOB-DTPA-MRI applied to differentiation of HCA and FNH, and classification of HCA by using low SI in the HBP. The pooled sensitivity and specificity were calculated to assess the diagnostic value of low SI in the HBP. Results: A review of 45 articles identified 10 eligible studies with a total of 288 HCA lesions. The pooled proportion of low SI in the HBP of HCA were 91% (95% CI: 0.81-0.97). In specific, the subtypes of HCA were 75% (95% CI: 0.64-0.85) for I-HCA, 100% (95% CI: 0.95-1.00) for H-HCA, 92% (95% CI: 0.70-1.00) for U-HCA, and 59% (95% CI: 0.00-1.00) for b-HCA, respectively. The pooled specificity and sensitivity of low SI in the HBP for distinguishing FNH from HCA were 95% (95% CI: 0.92-0.98) and 92% (95% CI: 0.87-0.96), respectively. Conclusion: Low SI in the HBP of Gd-EOB-DTPA-MRI is associated with higher accuracy for distinguishing HCA from FNH. However, the diagnostic accuracy may be overvalued, especially for the diagnosis of subtypes of b-HCA and I-HCA. Therefore, the risk factors and conventional imaging findings should be take into account simultaneously.

The utility of gadoxetic acid-enhanced magnetic resonance imaging in the surveillance for postoperative recurrence of hepatocellular carcinoma

This study aimed to investigate the utility of gadoxetic acid-enhanced magnetic resonance imaging (Gd-MRI) in surveillance for recurrent hepatocellular carcinoma (HCC) after hepatectomy.This retrospective study analyzed 147 patients who underwent surveillance with alternating multidetector computed tomography (MDCT) and Gd-MRI after hepatectomy for HCC. The patients were followed-up every 3 months during the first 2 years, and every 6 months thereafter. At each visit, MDCT was performed but once a year (every 12 months), Gd-MRI was performed instead of MDCT. Each HCC recurrence detection rate of MDCT and Gd-MRI was evaluated, and recurrent HCC characteristics were compared according to the detection test.A total of 63 patients had recurrent HCC. Among them, 9 were detected with Gd-MRI and 29 with MDCT. The baseline characteristics of patients with recurrent HCC showed no significant differences according to the detection test. The HCC recurrence detection rate of Gd-MRI and MDCT was 4.8% (9/180) and 4.3% (29/580), respectively, on the per test basis (P = 0.764). However, in the population with a follow-up period of ≥12 months, the detection rate of Gd-MRI and MDCT was 4.3% (7/150) and 1.5% (19/400), respectively (P = 0.035). Recurrent HCCs detected with Gd-MRI were smaller than those detected with MDCT (tumor size < 2 cm, 100% vs 65.5%, P = 0.040).Our data suggest that Gd-MRI has advantages in detecting recurrent HCC after hepatectomy. Surveillance with alternating MDCT and Gd-MRI may identify more recurrent HCC in an early stage than with MDCT alone in patients who received hepatectomy for HCC.

Nano assembly and encapsulation; a versatile platform for slowing the rotation of polyanionic Gd(3+) -based MRI contrast agents

Encapsulating discrete Gd(3+) chelates in nano-assembled capsules (NACs) is a simple and effective method of preparing an MRI contrast agent capable of delivering a large payload of high relaxivity imaging agent. The preparation of contrast agent containing NACs had previously focussed on preparations incorporating GdDOTP(5-) into the internal aggregate. In this report we demonstrate that other Gd(3+) chelates bearing overall charges as low as 2- can also be used to prepare NACs. This discovery opens up the possibility of using Gd(3+) chelates that have inner-sphere water molecules that could further increase the relaxivity enhancement associated with the long τR that arises from encapsulation. However, encapsulation of the q = 1 chelate GdDTPA(2-) did not give rise to a significant increase in relaxivity relative to encapsulation of the outer-sphere chelate GdTTHA(3-). This leads us to the conclusion that in the NAC interior proton transport is not mediated by movement of whole water molecules and the enhanced relaxivity of Gd(3+) chelate encapsulated within NACs arises primarily from second sphere effects.

Noninvasive evaluation of endolymphatic space in healthy volunteers using magnetic resonance imaging

CONCLUSIONS

A new method for noninvasive standard evaluation of normal endolymphatic space and endolymphatic hydrops using magnetic resonance imaging (MRI) is indicated.

OBJECTIVE

To standardize the evaluation of endolymphatic space in the cochlea and the vestibule in healthy volunteers by applying noninvasive intratympanic gadolinium (Gd) perfusion through the eustachian tube and three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging (3D-FLAIR MRI).

METHODS

This was a prospective study. 3D-FLAIR MRI was performed with a 3 Tesla (3 T) unit 24 h after intratympanic administration of Gd through the eustachian tube in 20 healthy volunteers. Pure tone test and tympanometry were performed 24 h before Gd was administered, and 24 h and 1 month after Gd administration.

RESULTS

Gd was present in the perilymph of the inner ear, which clearly displayed the endolymphatic space on 3D-FLAIR MRI with a visible borderline between the perilymph and the endolymph. In healthy volunteers, the normal value for the endolymphatic space in the cochlea ranged between 9% and 28%, and that in the vestibule was between 14% and 40%. No significant changes in pure tone test and tympanometry were noted.

Assessment of craniospinal arteriovenous malformations at 3T with highly temporally and highly spatially resolved contrast-enhanced MR angiography

BACKGROUND AND PURPOSE

Patients with arteriovenous malformation (AVM) are known to have an elevated risk of complications with conventional catheter angiography (CCA) but nonetheless require monitoring of hemodynamics. Thus, we aimed to evaluate both anatomy and hemodynamics in patients with AVM noninvasively by using contrast-enhanced MR angiography (CE-MRA) at 3T and to compare the results with CCA.

MATERIALS AND METHODS

Institutional review board approval and informed consent were obtained for this Health Insurance Portability and Accountability Act-compliant study. Twenty control subjects without vascular malformation (6 men, 18-70 years of age) and 10 patients with AVMs (6 men, 20-74 years of age) underwent supra-aortic time-resolved and high-spatial-resolution CE-MRA at 3T. Large-field-of-view coronal acquisitions extending from the root of the aorta to the cranial vertex were obtained for both MRA techniques. Image quality was assessed by 2 specialized radiologists by using a 4-point scale. AVM characteristics and nidus size were evaluated by using both CE-MRA and CCA in all patients.

RESULTS

In patients, 96.6% (319/330) of arterial segments on high-spatial-resolution MRA and 87.7% (272/310) of arterial segments on time-resolved MRA were graded excellent/good. MRA showed 100% specificity for detecting feeding arteries and venous drainage (n = 8) and complete obliteration of the AVM in 2 cases (concordance with CCA). Nidus diameters measured by both MRA and CCA resulted in a very strong correlation (r = 0.99) with a mild overestimation by MRA (0.10 cm by using the Bland-Altman plot).

CONCLUSION

By combining highly temporally resolved and highly spatially resolved MRA at 3T as complementary studies, one can assess vascular anatomy and hemodynamics noninvasively in patients with AVM.

Safety and utility of uterine artery embolization with CO2 and a gadolinium-based contrast medium

The authors evaluated the safety and clinical outcomes of uterine artery embolization (UAE) without the use of conventional iodinated contrast media for symptomatic uterine leiomyomata. Patients underwent UAE with use of CO(2) gas and a gadolinium-based contrast medium. The safety and feasibility of the technique were assessed. Patients were followed up at 24 hours, 1 month, and 6 months after UAE and yearly thereafter. UAE without iodinated contrast medium was attempted in eight patients (mean age, 42.7 years +/- 4.1), and bilateral UAE was successful in all patients. The mean fluoroscopy time was 14.9 minutes. The mean amount of gadolinium-based contrast medium used was 30.6 mL or 0.181 mmol/kg. No major complications were noted. The mean improvement in the symptom severity score was 53.8. The mean reduction in leiomyoma volume was 42%. To date, no repeat interventions have been performed. UAE with CO(2) and a gadolinium-based contrast medium is a viable treatment option for patients with a severe allergy to iodinated contrast media or renal insufficiency.

[Estimation of cardiac output from dynamic contrast multispiral tomographic data]

OBJECTIVE

To describe and apply a method for programmatically calculating central hemodynamic parameters from the data of dynamic contrast X-ray computed tomography (CT).

MATERIAL AND METHODS

A procedure is proposed to calculate cardiac output (CO) on the basis of the tracer dilution method as a ratio of the injected dose of a contrast agent (Urografin, Shering AG, Austria) to the area under the concentration-time curve derived for one of the cardiac chambers: [see text]. The blood concentration of the agent was estimated from the blood iodine (I) concentration-X-ray density (XD) regression dependence: [XD] = 0.49+22.07 x [I]. Thirty-three patients were studied on a multispiral X-ray Somatom Sensation 4 computed tomograph (Siemens), by injecting 15-20 ml of Urografin. The calculating method was realized as a software package for processing dynamic contrast CT data.

RESULTS

The proposed method could exactly determine the values of cardiac output: the correlation with the results of the reference technique (Doppler echo measurement) was highly significant (r = 0.95; p < 0.001) in the whole range of values. Moreover, the data on XD could accurately determine the blood concentration of both iodine (I): [XD] = 0.49+22.07 x [I] and gadolinium as a component of the contrast paramagnetic Gd-DTPA for which the solution concentration-XR dependence was as follows: XD 1.2+33.6 x [Gd].

CONCLUSIONS

Thus, dynamic spiral CT may be also used for the estimation of cardiac output by the tracer dilution method.

Dual-contrast echo planar imaging with keyhole: application to dynamic contrast-enhanced perfusion studies

A new EPI-based method is presented which features optimized sampling of k-space enabling the integrated acquisition of two gradient echo images. The first of these images is predominantly T1 weighted and the second is T*2 weighted. The new method combines echo sharing of sparsely acquired high spatial frequency components with the keyhole technique and half-Fourier image reconstruction. The feasibility of acquiring high spatial and temporal resolution in vivo images for perfusion mapping is demonstrated. In contrast to most current perfusion methods, which acquire the T1- and T*2-weighted images in separate acquisitions, the need for image co-registration here is obviated since both sets of images are EPI-based and are acquired within the same measurement.

Spurious Hypocalcemia After Omniscan- or OptiMARK-Enhanced Magnetic Resonance Imaging: An Algorithm for Minimizing a False-Positive Laboratory Value

Contrast-enhanced magnetic resonance imaging has become a routine diagnostic imaging procedure. Reports in the literature document that 2 of the 4 available gadolinium-based magnetic resonance imaging contrast agents, gadodiamide (Omniscan) and gadoversetamide (OptiMARK), are less stable and readily undergo dechelation. In vitro, this dechelation can result in interference with the most common laboratory methods used to measure total plasma or serum calcium. The result of total calcium measurement soon after contrast-enhanced magnetic resonance imaging with these interfering contrast agents is a spurious lowering of the total calcium level. This low calcium measurement may result in a value consistent with hypocalcemia and can persist in patients with renal insufficiency and in patients receiving higher doses of contrast agent. Alternatively, a clinically significant elevated calcium level may be overlooked because of the artificially lowered value. Two of the available gadolinium-based contrast agents, gadoteridol (ProHance) and gadopentetate dimeglumine (Magnevist), have not been to shown to interfere with total calcium measurement. A clinical practice algorithm for the laboratorian, the radiologist, and the clinician is presented to minimize the occurrence and consequences of a spuriously lowered total calcium level due to Omniscan- or OptiMARK-enhanced magnetic resonance imaging.

Dynamic micro-magnetic resonance imaging of liver micrometastasis in mice with a novel liver macromolecular magnetic resonance contrast agent DAB-Am64-(1B4M-Gd)(64)

DAB-Am64-(1B4M-Gd)(64) is a newly synthesized macromolecular liver magnetic resonance imaging (MRI) contrast agent with a polypropylenimine diaminobutane (DAB) dendrimer conjugated with a bifunctional diethylenetriaminepentaacetic acid (DTPA) derivative for complexing Gd(III) atoms. The characteristics of DAB-Am64-(1B4M-Gd)(64), which quickly accumulated in the liver, have been reported recently. In the present study, the dynamic micro-MRI with DAB-Am64-(1B4M-Gd)(64) was obtained in the mouse liver metastasis model using colon carcinoma cells to evaluate the ability to visualize the micrometastatic tumors compared with that using Gd-DTPA. The dynamic micro-MRI with DAB-Am64-(1B4M-Gd)(64) was able to homogeneously enhance the normal liver parenchyma and visualize micrometastatic tumors of 0.3-mm diameter in the liver of the mice with better contrast than that with Gd-DTPA. In conclusion, DAB-Am64-(1B4M-Gd)(64) is a new liver MRI contrast agent potentially useful for diagnosis of micrometastasis in the liver.

Hepatocyte targeting with Gd-EOB-DTPA: potential application for gene therapy

RATIONALE AND OBJECTIVES

To evaluate the suitability of the liver-specific MRI contrast agent Gd-EOB-DTPA as a nonviral vector for gene therapy of hepatocellular carcinoma.

METHODS

Specific uptake of Gd-EOB-DTPA was quantified by relaxometry in rat cultured hepatocytes and the hepatoma cells HepG2 and Huh7. Nonviral vectors for gene transfer were synthesized by coupling Gd-EOB-DTPA to polyethyleneimine or polylysine as DNA condensing agents, and their efficiency was studied using beta-galactosidase (lacZ) as the reporter gene.

RESULTS

Gd-EOB-DTPA was specifically taken up by rat cultured hepatocytes (4.32 vs. 1.08 mmol/L in nonhepatocyte control cells) but not by the hepatoma cells; this uptake was concentration-dependently inhibited by Bromsulphtalein. Polycation linkages were achieved with yields of 0.9 Gd-EOB-DTPA molecule per polyethyleneimine molecule and 10 Gd-EOB-DTPA molecules per polylysine molecule. Incubating the cells with plasmids containing lacZ reporter gene and polyethyleneimine-Gd-EOB-DTPA resulted in a few blue (transfected) cells, whereas no blue cells were observed on incubation with polylysine-Gd-EOB-DTPA.

CONCLUSIONS

Gd-EOB-DTPA is taken up by normal hepatocytes but not by HepG2 and Huh7 cells, probably because of the lack of the organic anion transporter in these hepatoma cells. The Gd-EOB-DTPA polycation conjugates, such as polyethyleneimine-Gd-EOB-DTPA, could serve as transfer vectors of interest for gene targeting imagery at the early stage of hepatocarcinogenesis. However, the transfer efficiency of such conjugates is low and requires improvement.

Biodistribution of gadolinium incorporated in lipid emulsions intraperitoneally administered for neutron-capture therapy with tumor-bearing hamsters

Emulsions containing a distearylamide (Gd-DTPA-SA) or a distearylester (Gd-DTPA-SE) of Gd (gadolinium)-diethylenetriaminepentaacetic acid (Gd-DTPA) were intraperitoneally injected in Greene's melanoma-bearing hamsters at a dose of 2.0 ml (3.0 or 6.0 mg Gd) per hamster. In the standard-Gd and high-Gd formulations used, the weight ratios of soybean oil, water, Gd-DTPA derivative (Gd-DTPA-SA or Gd-DTPA-SE), hydrogenated L-alpha-phosphatidylcholine from egg yolk (HEPC) and co-surfactant (HCO-60, Myrj 53, Myrj 59 or Brij 700) were 7.36:92:1:2:3 and 7.36:92:2:1:3, respectively. When the effects of the co-surfactants on the biodistribution of Gd from Gd-DTPA-SA-containing emulsions in the standard-Gd formulation were compared, the HCO-60 emulsion exhibited the highest Gd accumulation in tumors, possibly resulting from its fast and complete absorption, its small particle size (78 nm) and the stable coat on the particle surfaces with polyoxyethylene. Brij 700 emulsion kept the highest blood Gd concentration for a prolonged period, possibly due to particle properties similar to those of HCO-60. However, it exhibited a slower Gd accumulation in tumors, only reaching an identical level, in comparison with the HCO-60 emulsion. This suggested the tumor to be saturated with lipid particles. When Gd-DTPA-SE was used instead of Gd-DTPA-SA, its HCO-60 emulsion exhibited only very poor Gd-accumulation due to its easy degradation. The HCO-60 emulsion particles containing Gd-DTPA-SA in the high-Gd formulation (6.0 mg Gd in 2 ml) exhibited in vivo behavior identical to those in the standard-Gd formulation; then the Gd level in tumors reached 107 micrograms Gd/g tumor (wet), and the tumor:blood (T/B) and tumor:skin (T/Sk) Gd concentration ratios were 13.2 and 5.6, respectively, at 48 h after intraperitoneal administration. These results suggest that when intraperitoneally administered, this HCO-60 emulsion, and possibly also the corresponding Brij 700 emulsion, may be an excellent delivery system for accumulating Gd in tumors in neutron-capture therapy (NCT).

Neutron capture therapy with gadopentetate dimeglumine: experiments on tumor-bearing rats

RATIONALE AND OBJECTIVES

The therapeutic effect of neutron capture therapy with the gadolinium (Gd) complex gadopentetate dimeglumine was studied in vivo in rats using a beam of thermal neutrons.

METHODS

Rats with Jensen sarcomas 10-15 mm in diameter in their right thigh were irradiated with a thermal neutron beam that had fluences of 3.6 x 10(11) (20 min) or 5.4 x 10(11) n/cm2 (30 min) in the absence and presence of 5,500 or 13,750 ppm gadopentetate dimeglumine. Gadopentetate dimeglumine was administered directly into the tumor prior to neutron irradiation. Four groups of rats were studied: two groups of nonirradiated controls (Gd-n- and Gd+n-) and two irradiated groups (Gd-n+ and Gd+n+). In the follow-up period, we measured the subjects' clinical status and tumor size as a function of time postirradiation.

RESULTS

In both control groups (Gd-n- and Gd+n-), the tumor progressively grew. Pure irradiation by thermal neutrons in the Gd-n+ group resulted in a transient inhibition of tumor growth with total regressions of 15%. Intratumoral administration of 13,750 ppm gadolinium per gram of tumor and subsequent neutron irradiation (the Gd+n+ group; fluence = 3.6.10(11) n/cm2) significantly increased the tumoricidal effects (i.e., decrease of tumor growth up to a complete regression of the tumors in about 80%). Treatment-specific differences between the groups were confirmed by histologic observations.

CONCLUSION

The intratumoral administration of the hydrophilic magnetic resonance imaging contrast medium gadopentetate dimeglumine prior to irradiation with thermal neutrons leads to a therapeutic gain (i.e., reduction) on experimental Jensen sarcomas.