Effects of serial macrocyclic-based contrast materials gadoterate meglumine and gadobutrol administrations on gadolinium-related dentate nuclei signal increases in unenhanced T1-weighted brain: a retrospective study in 158 multiple sclerosis (MS) patients

Radiol Med. 2018 Feb;123(2):125-134. doi: 10.1007/s11547-017-0816-9. Epub 2017 Sep 27.

Abstract

Purpose: To perform T1 signal intensity (SI) measurements in the dentate nuclei of adult patients with confirmed multiple sclerosis (MS) after serial administrations of the macrocyclic gadolinium-based contrast agents (GBCAs), gadoterate meglumine and gadobutrol.

Materials and methods: This retrospective study was approved by the institutional review board and informed consent was waived. A review of our PACS database for the period from March 1, 2007 to July 31, 2016 revealed 158 confirmed MS patients who received exclusively either gadoterate meglumine (n = 81) or gadobutrol (n = 77) for diagnosis and follow-up. SI measurements on unenhanced T1-weighted images were performed on all scans of all patients and at regions of interest (ROIs) positioned on the dentate nucleus (DN) and pons. The dentate nucleus-to-pons (DNP) T1-SI ratio was subsequently calculated. Unpaired T test and regression analysis were used to evaluate statistical differences.

Results: An increase in DNP was noted between the first and last MR examinations for both gadoterate meglumine (0.0032 ± 0.0216) and gadobutrol (0.0019 ± 0.0346). Although the differences were not statistically significant based across the entire patient population, visible T1 hyperintensity in the DN was noted in approximately one-third of all patients in each group that received at least five administrations of either GBCA.

Conclusions: SI increases on unenhanced T1-weighted images possibly indicative of gadolinium retention occur after serial administrations of the macrocyclic GBCAs, gadoterate meglumine and gadobutrol.

Keywords: Gadolinium; Gadolinium-related dentate nuclei signal; MRI; Multiple sclerosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Brain / diagnostic imaging
  • Cerebellar Nuclei / diagnostic imaging*
  • Contrast Media / pharmacology*
  • Female
  • Gadolinium / pharmacology
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Meglumine / pharmacology*
  • Middle Aged
  • Multiple Sclerosis / diagnostic imaging*
  • Organometallic Compounds / pharmacology*
  • Predictive Value of Tests
  • Retrospective Studies
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Organometallic Compounds
  • gadobutrol
  • Meglumine
  • Gadolinium
  • gadoterate meglumine