T1-Weighted Intensity Increase After a Single Administration of a Linear Gadolinium-Based Contrast Agent in Multiple...

Area of Science:

• Neuroradiology
• Neuroimaging
• Toxicology

Background:

• Multiple sclerosis (MS) patients often undergo serial MRI scans, necessitating the use of gadolinium-based contrast agents (GBCAs).
• Concerns exist regarding potential long-term gadolinium (Gd) deposition in the brain following GBCA administration.
• Different types of GBCAs, linear and cyclic, may have varying deposition profiles.

Purpose of the Study:

• To investigate and compare brain Gd deposition after administration of linear (gadopentetic acid) versus cyclic (gadoteric acid) GBCAs in MS patients.
• To assess Gd deposition in specific brain regions, including the dentate nucleus and globus pallidus.
• To evaluate the potential reversibility of Gd deposition in the brain.

Main Methods:

• Retrospective analysis of 3233 T1-weighted MRI scans from 881 MS patients.
• Spatial normalization and intensity scaling of images to quantify signal changes.
• Comparison of signal intensity differences between sequential scans attributed to linear GBCA, cyclic GBCA, or no GBCA.

Main Results:

• Significant Gd deposition was observed in the dentate nucleus following administration of linear GBCA, even after a single dose.
• T1-weighted imaging revealed Gd deposition in the dentate nucleus and globus pallidus exclusively after linear GBCA administration.
• No significant decline in Gd deposition was detected in the brain across the analyzed scans.

Conclusions:

• Linear GBCAs lead to Gd deposition in the brain, irrespective of the number of administrations.
• Cyclic GBCAs did not show significant Gd deposition in the analyzed brain regions.
• The findings suggest a need for careful consideration of GBCA type in MS patients undergoing long-term MRI surveillance.