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Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol

PURPOSE: A possible pathway behind gadolinium retention in brain is leakage of contrast agents from blood to cerebrospinal fluid and entry into brain along perivascular (glymphatic) pathways. The object of this study was to assess for signs of gadolinium retention in brain 4 weeks after intrathecal...

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Autores principales: Ringstad, Geir, Valnes, Lars Magnus, Vatnehol, Svein Are Sirirud, Pripp, Are Hugo, Eide, Per Kristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425514/
https://www.ncbi.nlm.nih.gov/pubmed/37479768
http://dx.doi.org/10.1007/s00234-023-03198-7
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author Ringstad, Geir
Valnes, Lars Magnus
Vatnehol, Svein Are Sirirud
Pripp, Are Hugo
Eide, Per Kristian
author_facet Ringstad, Geir
Valnes, Lars Magnus
Vatnehol, Svein Are Sirirud
Pripp, Are Hugo
Eide, Per Kristian
author_sort Ringstad, Geir
collection PubMed
description PURPOSE: A possible pathway behind gadolinium retention in brain is leakage of contrast agents from blood to cerebrospinal fluid and entry into brain along perivascular (glymphatic) pathways. The object of this study was to assess for signs of gadolinium retention in brain 4 weeks after intrathecal contrast enhanced MRI. METHODS: We prospectively applied standardized T1 mapping of the brain before and 4 weeks after intrathecal administration of 0.5 mmol gadobutrol in patients under work-up of cerebrospinal fluid circulation disorders. Due to methodological limitations, a safety margin for percentage change in T1 time was set to 3%. Region-wise differences were assessed by pairwise comparison using t-tests and forest plots, and statistical significance was accepted at .05 level (two-tailed). RESULTS: In a cohort of 76 participants (mean age 47.2 years ± 17.9 [standard deviation], 47 women), T1 relaxation times remained unchanged in cerebral cortex and basal ganglia 4 weeks after intrathecal gadobutrol. T1 was reduced from 1082 ± 46.7 ms to 1070.6 ± 36.5 ms (0.98 ±2.9%) (mean [standard deviation]) (p=0.001) in white matter, thus within the pre-defined 3% safety margin. The brain stem and cerebellum could not be assessed due to poor alignment of posterior fossa structures at scans from different time points. CONCLUSION: Gadolinium retention was not detected in the cerebral hemispheres 4 weeks after an intrathecal dose of 0.5 mmol gadobutrol, implying that presence of contrast agents in cerebrospinal fluid is of minor importance for gadolinium retention in brain.
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spelling pubmed-104255142023-08-16 Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol Ringstad, Geir Valnes, Lars Magnus Vatnehol, Svein Are Sirirud Pripp, Are Hugo Eide, Per Kristian Neuroradiology Diagnostic Neuroradiology PURPOSE: A possible pathway behind gadolinium retention in brain is leakage of contrast agents from blood to cerebrospinal fluid and entry into brain along perivascular (glymphatic) pathways. The object of this study was to assess for signs of gadolinium retention in brain 4 weeks after intrathecal contrast enhanced MRI. METHODS: We prospectively applied standardized T1 mapping of the brain before and 4 weeks after intrathecal administration of 0.5 mmol gadobutrol in patients under work-up of cerebrospinal fluid circulation disorders. Due to methodological limitations, a safety margin for percentage change in T1 time was set to 3%. Region-wise differences were assessed by pairwise comparison using t-tests and forest plots, and statistical significance was accepted at .05 level (two-tailed). RESULTS: In a cohort of 76 participants (mean age 47.2 years ± 17.9 [standard deviation], 47 women), T1 relaxation times remained unchanged in cerebral cortex and basal ganglia 4 weeks after intrathecal gadobutrol. T1 was reduced from 1082 ± 46.7 ms to 1070.6 ± 36.5 ms (0.98 ±2.9%) (mean [standard deviation]) (p=0.001) in white matter, thus within the pre-defined 3% safety margin. The brain stem and cerebellum could not be assessed due to poor alignment of posterior fossa structures at scans from different time points. CONCLUSION: Gadolinium retention was not detected in the cerebral hemispheres 4 weeks after an intrathecal dose of 0.5 mmol gadobutrol, implying that presence of contrast agents in cerebrospinal fluid is of minor importance for gadolinium retention in brain. Springer Berlin Heidelberg 2023-07-21 2023 /pmc/articles/PMC10425514/ /pubmed/37479768 http://dx.doi.org/10.1007/s00234-023-03198-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Diagnostic Neuroradiology
Ringstad, Geir
Valnes, Lars Magnus
Vatnehol, Svein Are Sirirud
Pripp, Are Hugo
Eide, Per Kristian
Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
title Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
title_full Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
title_fullStr Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
title_full_unstemmed Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
title_short Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
title_sort prospective t1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
topic Diagnostic Neuroradiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10425514/
https://www.ncbi.nlm.nih.gov/pubmed/37479768
http://dx.doi.org/10.1007/s00234-023-03198-7
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