Up to 52 administrations of macrocyclic ionic MR contrast agent are not associated with intracranial gadolinium deposition: multifactorial analysis in 385 patients

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Congress:

ECR 2017

Poster Number:

C-2615

Type:

Scientific Exhibit

Keywords:

CNS, Neuroradiology brain, MR, Comparative studies

Authors:

H. S. Kim¹, J. E. Park², J. Y. Lee², S. C. Jung², C. G. Choi², S. J. Kim²; ¹Seoul, seoul/KR, ²Seoul/KR

DOI:

10.1594/ecr2017/C-2615

DOI-Link:

https://dx.doi.org/10.1594/ecr2017/C-2615

Fig. 1: Flow diagram of patient selection.

Fig. 2: Axial T1-weighted MR images at the level of the basal ganglia and of the...

Fig. 3: Scatterplot of the mean dentate nucleus-to-pons signal intensity ratio...

Fig. 4: Scatterplot of mean globus pallidus-to-thalamus signal intensity ratio...

Aims and objectives

To determine whether multiple repeated administrations of macrocyclic ionic MR contrast agent (gadoterate) are associated with increasing T1 signal intensity in the dentate nuclei and globus pallidus and identify the predisposing factors for T1 signal increase in various clinical situations.

Methods and materials

Patient Inclusion (Figure 1) Patients were evaluated with routine laboratory tests before the MR examinations. Patient data were obtained from electronic medical record, including the sex and age of the patients, indication for MR imaging, renal and hepatic function, and a history of chemotherapy or radiation therapy. Abnormal renal function was defined as an estimated glomerular filtration rate (eGFR) ≤ 60mL/min/m². Severely impaired renal function was defined as an estimated glomerular filtration rate of 45 mL/min/1.73 m2 or acute renal failure. Abnormal hepatic function was...

Results

The mean DN/P SI ratio difference was not different from zero (P = .08), even in patients with ≥20 administrations (n = 24). The mean DN/P SI ratio difference was not associated with any predisposing factors. However, the mean GP/Th SI ratio difference decreased (P < .0001), which was associated with longer mean time interval (P = .012), number of radiotherapy sessions (P = .018), and left side of ROI placement (P = .045) on multivariate analysis. Table:Possible predisposing factors for the mean dentate-to-pons (DN/P)...

Conclusion

Multiple repeated administrations of gadoterate in various clinical situations are not associated with intracranial T1 signal increase in the dentate nuclei and globus pallidus.

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References

1. Kanda T, Ishii K, Kawaguchi H, Kitajima K, Takenaka D. High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 2014;270(3):834-841. 2. Ramalho J, Castillo M, AlObaidy M, et al. High Signal Intensity in Globus Pallidus and Dentate Nucleus on Unenhanced T1-weighted MR Images: Evaluation of Two Linear Gadolinium-based Contrast Agents. Radiology 2015;276(3):836-844. 3. Ramalho J, Ramalho M, AlObaidy M, Nunes RH, Castillo M, Semelka RC. T1 Signal-Intensity...