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
Synopsis
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.Purpose
Recent
publications have reported increased signal intensities (SI) in the brain
regions dentate nucleus (1-7) and globus pallidus (1,3,5) on unenhanced
T1-weighted images after repeated administrations of gadolinium based contrast
agents (GBCAs). The aim of the present animal study was to reproduce the
reported clinical observations in a rat model after repeated, high-dose
administrations of linear and macrocyclic GBCAs using analogous imaging and
evaluation methods.
Materials and Methods
Sixty healthy
Han-Wistar rats were divided into a control and five GBCA groups (10 animals
per group). The animals received either one linear GBCA (gadodiamide,
gadopentetate dimeglumine, or gadobenate dimeglumine) or one macrocyclic GBCA (gadobutrol
or gadoterate meglumine). Over a time period of two weeks the animals received
10 intravenous injections each at a dose of 2.5 mmol Gd/kg body weight on five
consecutive days per week. The control group received identical volumes of
saline. The GBCAs were administered by slow hand injection in their marketed
formulation. Before GBCA administration, as well as three and twenty-four days
after the last injection, a whole brain MRI was performed using a T1-weighted
3D Turbo-Spinecho sequence (TR/TE = 500/19 ms) on a clinical 1.5T scanner equipped
with a dedicated rat head coil. The ratios of signal intensities in cerebellar
nuclei to pons (CN/Po) and globus pallidus to thalamus were analyzed by two
experienced readers.
Results
The experimental groups that received the linear GBCAs
gadodiamide, gadobenate dimeglumine and gadopentetate dimeglumine showed enhanced
SI of the cerebellar nuclei compared to baseline (Fig.1). The evaluation of the
CN/Po SI ratio exhibited a statistically significant increase for gadodiamide
and gadobenate dimeglumine three and twenty-four days after the last injection
(Fig.2). No significant changes were observed between the two time points.
Gadopentetate dimeglumine injection led to a moderate, but statistically not
significant, increase of the CN/Po ratio. In the MRI images of rats that
received the macrocyclic GBCAs gadobutrol and gadoterate meglumine or saline no
increased CN/Po SI ratios were observed. The ratio of SI in globus pallidus
versus thalamus was not elevated in any rats injected with GBCAs or saline
(Fig.2).
Conclusion
Differences exist between linear and macrocyclic GBCAs
with respect to increased SI in the cerebellar nuclei in this animal model. Enhanced
SI of the cerebellar nuclei were found after multiple, high-dose
administrations of linear GBCAs. In contrast, no changes of SI were found for
the investigated macrocyclic GBCAs. The clinical observation of increased SI in
the globus pallidus after administration of linear GBCAs was not reproduced in
this animal model.
Acknowledgements
No acknowledgement found.References
[1] Kanda et al. Radiology 2014; 270(3): 834-41
[2] Errante et al. Invest Radiol. 2014; 49(10):685-90
[3] McDonald et al., Radiology 2015, 275(3): 772-82
[4] Kanda et al. Radiology 2015; 275(3): 803-9
[5] Radbruch et al. Radiology 2015; 275(3): 783-91
[6] Robert et al. Invest Radiol.
2015; 50: 473-80
[7] Weberling et al. Invest Radiol. 2015; 50:743-80