Deep Brain Nuclei T1 Shortening After Gadobenate Dimeglumine in Children: Influence of Radiation and Chemotherapy

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2017 Nov 18

PMID 29146718

Citations 7

Authors

S Kinner

T B Schubert

R J Bruce

S L Rebsamen

C A Diamond

S B Reeder

H A Rowley

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: Intrinsic T1-hyperintense signal has recently been reported in the deep gray nuclei on brain MR imaging after multiple doses of gadolinium-based contrast agents. Most reports have included adult patients and excluded those undergoing radiation or chemotherapy. We investigated whether T1 shortening is also observed in children and tried to determine whether radiochemotherapy is a risk factor for this phenomenon.

Materials And Methods: In this single-center retrospective study, we reviewed clinical charts and images of all patients 18 years of age or younger with ≥4 gadobenate dimeglumine-enhanced MRIs for 6 years. Seventy-six children (mean age, 9.3 years; 60 unconfounded by treatment, 16 with radiochemotherapy) met the selection criteria (>4 MR imaging examinations; mean, 8). T1 signal intensity ratios for the dentate to pons and globus pallidus to thalamus were calculated and correlated with number of injections, time interval, and therapy.

Results: Among the 60 children without radiochemotherapy, only 2 had elevated T1 signal intensity ratios ( = 20 and 16 injections). Twelve of the 16 children with radiochemotherapy showed elevated signal intensity ratios. Statistical analysis demonstrated a significant signal intensity ratio change for the number of injections ( < .001) and amount of gadolinium ( = .008), but not for the interscan time interval ( = .35). There was a significant difference in the average signal intensity ratio change between those with and without radiochemotherapy ( < .001). Chart review revealed no new neurologic deficits in any patients, related to their underlying conditions and prior surgeries.

Conclusions: Compared with published adult series, children show a similar pattern of T1 hyperintense signal changes of the dentate and globus pallidus after multiple gadobenate dimeglumine injections. The T1 signal changes in children may have a later onset but are accelerated by radiochemotherapy.

Citing Articles

Safety and Diagnostic Efficacy of Gadobenate Dimeglumine in MRI of the Brain and Spine of Neonates and Infants.

Enterline D, Martin K, Parmar H, Triulzi F, Colosimo C AJNR Am J Neuroradiol. 2019; 40(12):2001-2009.

PMID: 31727753 PMC: 6975343. DOI: 10.3174/ajnr.A6319.

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.

Jost G, Frenzel T, Boyken J, Pietsch H Neuroradiology. 2019; 61(11):1273-1280.

PMID: 31297571 PMC: 6817760. DOI: 10.1007/s00234-019-02256-3.

Detection of recurrent brain tumors in children: No significant difference in sensitivity between unenhanced and contrast-enhanced MRI.

Bouzidi Y, Barteau E, Lejeune J, Dejobert M, Gravellier B, Sirinelli D Neuroradiol J. 2019; 32(4):259-266.

PMID: 31017042 PMC: 6639645. DOI: 10.1177/1971400919845619.

Standardized assessment of the signal intensity increase on unenhanced T1-weighted images in the brain: the European Gadolinium Retention Evaluation Consortium (GREC) Task Force position statement.

Quattrocchi C, Ramalho J, van der Molen A, Rovira A, Radbruch A Eur Radiol. 2018; 29(8):3959-3967.

PMID: 30413951 DOI: 10.1007/s00330-018-5803-6.

Does Age Interfere With Gadolinium Toxicity and Presence in Brain and Bone Tissues?: A Comparative Gadoterate Versus Gadodiamide Study in Juvenile and Adult Rats.

Fretellier N, Granottier A, Rasschaert M, Grindel A, Baudimont F, Robert P Invest Radiol. 2018; 54(2):61-71.

PMID: 30394964 PMC: 6310471. DOI: 10.1097/RLI.0000000000000517.

References

Montagne A, Barnes S, Sweeney M, Halliday M, Sagare A, Zhao Z . Blood-brain barrier breakdown in the aging human hippocampus. Neuron. 2015; 85(2):296-302. PMC: 4350773. DOI: 10.1016/j.neuron.2014.12.032. View

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):834-41. DOI: 10.1148/radiol.13131669. View

Robert P, Lehericy S, Grand S, Violas X, Fretellier N, Idee J . T1-Weighted Hypersignal in the Deep Cerebellar Nuclei After Repeated Administrations of Gadolinium-Based Contrast Agents in Healthy Rats: Difference Between Linear and Macrocyclic Agents. Invest Radiol. 2015; 50(8):473-80. PMC: 4494686. DOI: 10.1097/RLI.0000000000000181. View

Doyle K, Quach L, Arceuil H, Buckwalter M . Ferumoxytol administration does not alter infarct volume or the inflammatory response to stroke in mice. Neurosci Lett. 2014; 584:236-40. PMC: 4268374. DOI: 10.1016/j.neulet.2014.10.041. View

Roberts D, Chatterjee A, Yazdani M, Marebwa B, Brown T, Collins H . Pediatric Patients Demonstrate Progressive T1-Weighted Hyperintensity in the Dentate Nucleus following Multiple Doses of Gadolinium-Based Contrast Agent. AJNR Am J Neuroradiol. 2016; 37(12):2340-2347. PMC: 5161565. DOI: 10.3174/ajnr.A4891. View

Radbruch A, Weberling L, Kieslich P, Hepp J, Kickingereder P, Wick W . High-Signal Intensity in the Dentate Nucleus and Globus Pallidus on Unenhanced T1-Weighted Images: Evaluation of the Macrocyclic Gadolinium-Based Contrast Agent Gadobutrol. Invest Radiol. 2015; 50(12):805-10. DOI: 10.1097/RLI.0000000000000227. View

Radbruch A, Haase R, Kickingereder P, Baumer P, Bickelhaupt S, Paech D . Pediatric Brain: No Increased Signal Intensity in the Dentate Nucleus on Unenhanced T1-weighted MR Images after Consecutive Exposure to a Macrocyclic Gadolinium-based Contrast Agent. Radiology. 2017; 283(3):828-836. DOI: 10.1148/radiol.2017162980. View

Errante Y, Cirimele V, Mallio C, Di Lazzaro V, Zobel B, Cosimo Quattrocchi C . Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered gadodiamide in patients with normal renal function, suggesting dechelation. Invest Radiol. 2014; 49(10):685-90. DOI: 10.1097/RLI.0000000000000072. View

Zhang Y, Cao Y, Shih G, Hecht E, Prince M . Extent of Signal Hyperintensity on Unenhanced T1-weighted Brain MR Images after More than 35 Administrations of Linear Gadolinium-based Contrast Agents. Radiology. 2016; 282(2):516-525. DOI: 10.1148/radiol.2016152864. View

10.

Cao Y, Huang D, Shih G, Prince M . Signal Change in the Dentate Nucleus on T1-Weighted MR Images After Multiple Administrations of Gadopentetate Dimeglumine Versus Gadobutrol. AJR Am J Roentgenol. 2015; 206(2):414-9. DOI: 10.2214/AJR.15.15327. View

11.

Cosimo Quattrocchi C, Mallio C, Errante Y, Cirimele V, Carideo L, Ax A . Gadodiamide and Dentate Nucleus T1 Hyperintensity in Patients With Meningioma Evaluated by Multiple Follow-Up Contrast-Enhanced Magnetic Resonance Examinations With No Systemic Interval Therapy. Invest Radiol. 2015; 50(7):470-2. DOI: 10.1097/RLI.0000000000000154. View

12.

Corot C, Petry K, Trivedi R, Saleh A, Jonkmanns C, Le Bas J . Macrophage imaging in central nervous system and in carotid atherosclerotic plaque using ultrasmall superparamagnetic iron oxide in magnetic resonance imaging. Invest Radiol. 2004; 39(10):619-25. DOI: 10.1097/01.rli.0000135980.08491.33. View

13.

Eisele P, Alonso A, Szabo K, Ebert A, Ong M, Schoenberg S . Lack of increased signal intensity in the dentate nucleus after repeated administration of a macrocyclic contrast agent in multiple sclerosis: An observational study. Medicine (Baltimore). 2016; 95(39):e4624. PMC: 5265887. DOI: 10.1097/MD.0000000000004624. View

14.

Ramalho J, Castillo M, AlObaidy M, Nunes R, Ramalho M, Dale B . 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):836-44. DOI: 10.1148/radiol.2015150872. View

15.

Radbruch A, Weberling L, Kieslich P, Eidel O, Burth S, Kickingereder P . Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent. Radiology. 2015; 275(3):783-91. DOI: 10.1148/radiol.2015150337. View

16.

Kanda T, Oba H, Toyoda K, Furui S . Recent Advances in Understanding Gadolinium Retention in the Brain. AJNR Am J Neuroradiol. 2015; 37(1):E1-2. PMC: 7960213. DOI: 10.3174/ajnr.A4586. View

17.

Murata N, Gonzalez-Cuyar L, Murata K, Fligner C, Dills R, Hippe D . Macrocyclic and Other Non-Group 1 Gadolinium Contrast Agents Deposit Low Levels of Gadolinium in Brain and Bone Tissue: Preliminary Results From 9 Patients With Normal Renal Function. Invest Radiol. 2016; 51(7):447-53. DOI: 10.1097/RLI.0000000000000252. View

18.

Frenzel T, Apte C, Jost G, Schockel L, Lohrke J, Pietsch H . Quantification and Assessment of the Chemical Form of Residual Gadolinium in the Brain After Repeated Administration of Gadolinium-Based Contrast Agents: Comparative Study in Rats. Invest Radiol. 2017; 52(7):396-404. PMC: 5464750. DOI: 10.1097/RLI.0000000000000352. View

19.

Stojanov D, Aracki-Trenkic A, Vojinovic S, Benedeto-Stojanov D, Ljubisavljevic S . Increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W magnetic resonance images in patients with relapsing-remitting multiple sclerosis: correlation with cumulative dose of a macrocyclic gadolinium-based.... Eur Radiol. 2015; 26(3):807-15. DOI: 10.1007/s00330-015-3879-9. View

20.

Bruce R, Wentland A, Haemel A, Garrett R, Sadowski D, Djamali A . Incidence of Nephrogenic Systemic Fibrosis Using Gadobenate Dimeglumine in 1423 Patients With Renal Insufficiency Compared With Gadodiamide. Invest Radiol. 2016; 51(11):701-705. DOI: 10.1097/RLI.0000000000000259. View