ISMRM 24th Annual Meeting & Exhibition • 07-13 May 2016 • Singapore

Focus Session: Gd in the Brain

Tuesday, May 10, 2016
Hall 606
16:00 - 18:00
Moderators: Robert Turner, Juregen Hennig

Deep brain nuclei T1 shortening after gadolinium in children: influence of radiation and chemotherapy
Sonja Kinner1,2, Tilman B Schubert1,3, Susan Rebsamen1, Richard Bruce1, Scott B Reeder1,4,5,6,7, and Howard A Rowley1
1Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, 2Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany, 3Clinic for Radiology and Nuclear Medicine, Basel University Hospital, Basel, Switzerland, 4Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, 5Department of Emergency Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, 6Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States, 7Department of Biomedical Engineering, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
Recent studies report intrinsic T1 hyperintense signal in deep brain nuclei on MRI after multiple doses of gadolinium-based contrast agents in adults. We investigated whether similar T1 shortening was also found in children, and furthermore evaluated the influence of radiochemotherapy (RCTX) on its appearance. Signal increases were found in 2/60 children without RCTX and in 12/16 children with RCTX. Signal ratio changes were significantly different between the two groups and appeared with fewer doses in children with RCTX. 

T1 relaxometry indicate cerebral gadolinium retention after multiple administration of a macrocyclic Gd-based contrast agent: A Retrospective Study in 27 patients with Glioblastoma Multiforme
Svein Are Vatnehol1, Inge Rasmus Groote1, Christopher Larsson1, Magne Kleppestř1, Jonas Vardal1, and Atle Bjřrnerud1,2
1The Intervention Center, Oslo University Hospital, Oslo, Norway, 2Department of Physics, University of Oslo, Oslo, Norway
Recent publications have shown an increase in signal intensity on non-enhanced T1w-images for the Dentate Nucleus and Globus Pallidus. This effect seems to be linked to multiple administrations of linear gadolinium chelate. In this retrospective study we have analyzed the quantitative T1 values (qT1) and the normalized native T1 signal intensity (nSI) for the Globus Pallidus and the nSI for the Dentate Nucleus in patients with multiple injections of gadobutrol (Gadovist™). Our analysis suggest a significant change in the qT1 and nSI for the Globus Pallidus as well as in the nSI for the Dentate Nucleus

Gadolinium Deposition in the brain: Pre-clinical Investigation of differences in concentration, Distribution and histology in animals after repeated Administrations of linear and macrocyclic GBCAs - Permission Withheld
Hubertus Pietsch1, Thomas Frenzel1, Anna-Lena Frisk1, Diana Constanze Lenhard2, Gregor Jost1, Martin Andrew Sieber1, Astrid Zimmermann3, Volker Nischwitz3, and Jessica Lohrke1
1Bayer Healthcare, Berlin, Germany, 2Charité, Humboldt University Berlin, Berlin, Germany, 3Forschungszentrum Jülich, Jülich, Germany
Recent publications reported increased T1-weighted signal intensities in the dentate nucleus of patients who received multiple contrast-enhanced MRI scans. In this animal study histopathological changes and gadolinium retention in the skin and brain of rats after twenty intravenous injections of linear and macrocyclic GBCAs at high doses (2.5mmol/kgbw) were systematically investigated. The Gd brain concentrations of linear GBCAs (gadodiamide, gadopentetate dimeglumine) were significantly higher than those of macrocyclic agents (gadobutrol, gadoteridol). Since no morphological changes could be detected by routine H&E microscopic examination, immunohistochemistry and special stains, these findings are considered be of no toxicological relevance in rats.

T1-weighted signal increase in the rat brain after multiple, high-dose administrations of gadolinium based contrast agents:  Comparison of linear and macrocyclic agents - Permission Withheld
Gregor Jost1, Diana Lenhard2, Jessica Lohrke1, Thomas Frenzel1, and Hubertus Pietsch1
1MR and CT Contrast Media Research, Bayer Healthcare, Berlin, Germany, 2Institute of Vegetative Physiology, Charité, Berlin, Germany
Recent publications reported increased T1-weighted (T1w) signal intensities (SI) in the dentate nucleus and globus pallidus after repeated administrations of gadolinium based contrast agents (GBCAs). In the present animal study the T1w SI of three linear and two macrocyclic GBCAs were systematically evaluated after ten administrations each with a dose of 2.5 mmol/kg. Increased cerebellar nuclei to pons SI ratios were found after administration of linear GBCAs (significantly increased for gadodiamide and gadobenate dimeglumine, and non-significantly increased for gadopentetate dimeglumine). In contrast no elevated SI ratios were observed after administration of the macrocyclic GBCAs gadobutrol and gadoterate meglumine or saline.

Regional uptake and clearance of Gd(III) DTPA in the healthy adult mouse brain
Daniel Calle1, Irene Guadilla1, Pilar López-Larrubia1, and Sebastián Cerdán1
1Instituto de Investigaciones Biomédicas "Alberto Sols", CSIC, Madrid, Spain
We report on the kinetics of uptake and clearance of Gd(III)DTPA from different brain structures to healthy mice. We fitted a biexponential  model to cerebral time courses of increase and decrease of T1w MRI signal intensity, calculating rate constants for the uptake (kabs) and elimination (kel).  kabs showed the rapid absorption in the ventricles and hypothalamus, slowing down significantly in the cortex, globus pallidus and dentante nucleus. These latter structures required 617 h. (cortex), 245 h. (globus pallidus) and approximately 100h (hypothalamus and dentate nucleus), to remove 99% of the administered agent, revealing very high cerebral residence times of Magnevist.

Contrast enhancement of perivascular spaces in the basal ganglia
Shinji Naganawa1 and Toshiaki Taoka1
1Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Perivascular spaces (PVS) have been described as non-enhancing structures with a fluid signal. In this study, we confirmed that PVS signals are enhanced in images obtained 4 hours after intravenous administration of gadolinium based contrast agent (GBCA) in human subjects without renal insufficiency. Contrast enhancement of CSF was also observed. It is possible that GBCA in the blood vessels might have permeated into the CSF space and PVS. This could be the route by which GBCA is distributed to brain parenchyma through the glymphatic system in subjects with a normal blood brain barrier.

Regional and global assessment on relaxometric quantitative MRI in patients with previous administration of a linear gadolinium-based contrast agent
Hirofumi Kuno1, Hernan Jara1, Karen Buch1, Andrew Mills1, Muhammad Mustafa Quresh1, Neil Thayil 1, Margaret N Chapman1, and Osamu Sakai1
1Radiology, Boston University, Boston Medical Center, Boston, MA, United States
To assess potential regional and global correlations between brain relaxation times and the number of prior administrations of linear gadolinium-based contrast agents (GBCA) using quantitative MRI. The subjects consisted of 40 patients (7 patients with multiple prior linear GBCA exposures and 33 patients with no prior GBCA exposures) with brain MRI using the mixed turbo spin-echo pulse sequence. T1 and T2 relaxation times were assessed in selected regions of brain parenchyma (GP, DN, thalamus, and pons) and the whole brain, and were demonstrated to be associated with the number of gadolinium administrations. A stronger relationship was demonstrated in gray matter.

The International Society for Magnetic Resonance in Medicine is accredited by the Accreditation Council for
Continuing Medical Education to provide continuing medical education for physicians.