PT  - JOURNAL ARTICLE
AU  - D.M. Sudarshana
AU  - G. Nair
AU  - J.T. Dwyer
AU  - B. Dewey
AU  - S.U. Steele
AU  - D.J. Suto
AU  - T. Wu
AU  - B.A. Berkowitz
AU  - A.P. Koretsky
AU  - I.C.M. Cortese
AU  - D.S. Reich
TI  - Manganese-Enhanced MRI of the Brain in Healthy Volunteers
AID  - 10.3174/ajnr.A6152
DP  - 2019 Aug 01
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2019/08/01/ajnr.A6152.short
4100  - http://www.ajnr.org/content/early/2019/08/01/ajnr.A6152.full
AB  - BACKGROUND AND PURPOSE: The manganese ion is used as an intracellular MR imaging contrast agent to study neuronal function in animal models, but it remains unclear whether manganese-enhanced MR imaging can be similarly useful in humans. Using mangafodipir (Teslascan, a chelated manganese-based contrast agent that is FDA-approved), we evaluated the dynamics of manganese enhancement of the brain and glandular structures in the rostral head and neck in healthy volunteers.MATERIALS AND METHODS: We administered mangafodipir intravenously at a rate of 1 mL/minute for a total dose of 5 μmol/kg body weight. Nine healthy adult volunteers (6 men/3 women; median age, 43 years) completed baseline history and physical examination, 3T MR imaging, and blood work. MR imaging also followed mangafodipir administration at various time points from immediate to 7 days, with delayed scans at 1–3 months.RESULTS: The choroid plexus and anterior pituitary gland enhanced within 10 minutes of infusion, with enhancement persisting up to 7 and 30 days, respectively. Exocrine (parotid, submandibular, sublingual, and lacrimal) glands also enhanced avidly as early as 1 hour postadministration, generally resolving by 1 month; 3 volunteers had residual exocrine gland enhancement, which resolved by 2 months in 1 and by 3 months in the other 2. Mangafodipir did not affect clinical parameters, laboratory values, or T1-weighted signal in the basal ganglia.CONCLUSIONS: Manganese ions released from mangafodipir successfully enable noninvasive visualization of intra- and extracranial structures that lie outside the blood-brain barrier without adverse clinical effects, setting the stage for future neuroradiologic investigation in disease.FAflip angleGREgradient recalled-echoMEMRImanganese-enhanced MRI