T1-weighted signal increase in the rat brain after multiple, high-dose administrations of gadolinium based contrast agents:  Comparison of linear and macrocyclic agents
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

Figures

Representative T1-weighted MR image after repeated, high-dose administration with gadodiamide. Increased signal intensities in the cerebellar nuclei are indicated by arrows.

Percent change of cerebellar nuclei to pons (CN/Po) and globus pallidus to thalamus signal intensity ratio (GP/Th) on day 24 after the last injection compared to baseline. “**” indicate a significant (p<0.01) difference of the respective signal intensity ratio compared to baseline.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
0512