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Gadolinium deposition in the brain: association with various GBCAs using a generalized additive model

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Abstract

Objectives

To determine the relationship between the number of administrations of various gadolinium-based contrast agents (GBCAs) and increased T1 signal intensity in the globus pallidus (GP) and dentate nucleus (DN).

Methods

This retrospective study included 122 patients who underwent double-dose GBCA-enhanced magnetic resonance imaging. Two radiologists calculated GP-to-thalamus (TH) signal intensity ratio, DN-to-pons signal intensity ratio and relative change (Rchange) between the baseline and final examinations. Interobserver agreement was evaluated. The relationships between Rchange and several factors, including number of each GBCA administrations, were analysed using a generalized additive model.

Results

Six patients (4.9%) received linear GBCAs (mean 20.8 number of administration; range 15–30), 44 patients (36.1%) received macrocyclic GBCAs (mean 26.1; range 14–51) and 72 patients (59.0%) received both types of GBCAs (mean 31.5; range 12–65). Interobserver agreement was almost perfect (0.99; 95% CI: 0.99–0.99). Rchange (DN:pons) was associated with gadodiamide (p = 0.006) and gadopentetate dimeglumine (p < 0.001), but not with other GBCAs. Rchange (GP:TH) was not associated with GBCA administration.

Conclusions

Previous administration of linear agents gadoiamide and gadopentetate dimeglumine is associated with increased T1 signal intensity in the DN, whereas macrocyclic GBCAs do not show an association.

Key points

• Certain linear GBCAs are associated with T1 signal change in the dentate nucleus.

• The signal change is related to the administration number of certain linear GBCAs.

• Difference in signal change may reflect differences in stability of agents.

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Abbreviations

BBB:

Blood-brain barrier

CSF:

Cerebrospinal fluid

DN:

Dentate nucleus

eGFR:

Estimated glomerular infiltration rate

GAM:

Generalized additive model

GBCA:

Gadolinium-based contrast agent

GP:

Globus pallidus

MRI:

Magnetic resonance imaging

NSF:

Nephrogenic systemic fibrosis

Rchange :

Relative change

ROI:

Region of interest

TH:

Thalamus

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Authors and Affiliations

  1. Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Sohi Bae, Ho-Joon Lee, Kyunghwa Han, Yae-Won Park, Yoon Seong Choi, Sung Soo Ahn, Jinna Kim & Seung-Koo Lee

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  1. Sohi Bae
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Correspondence to Seung-Koo Lee.

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Retrospective, diagnostic or prognostic study, performed at one institution.

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Bae, S., Lee, HJ., Han, K. et al. Gadolinium deposition in the brain: association with various GBCAs using a generalized additive model. Eur Radiol 27, 3353–3361 (2017). https://doi.org/10.1007/s00330-016-4724-5

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  • DOI: https://doi.org/10.1007/s00330-016-4724-5

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