Related Experiment Video
Updated: Jul 22, 2025
Magnetic Resonance-Guided Stereotaxy for Infusions to the Pig Brain
Published on: March 31, 2023
Prospective T1 mapping to assess gadolinium retention in brain after intrathecal gadobutrol
Geir Ringstad1,2, Lars Magnus Valnes3, Svein Are Sirirud Vatnehol4,5
1Department of Radiology, Oslo University Hospital- Rikshospitalet, Oslo, Norway.
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.
Insights
Gadolinium retention in the brain was not detected 4 weeks after intrathecal contrast administration. This suggests cerebrospinal fluid contrast agent presence has minimal impact on brain gadolinium accumulation.
Area of Science:
- Neuroradiology
- Neuroimaging
- Pharmacokinetics
Background:
- Gadolinium-based contrast agents (GBCAs) are used in MRI.
- Concerns exist regarding gadolinium retention in the brain.
- Intrathecal administration offers a direct route to cerebrospinal fluid (CSF).
Purpose of the Study:
- To investigate gadolinium retention in the brain following intrathecal administration.
- To assess gadolinium accumulation in brain tissues 4 weeks post-injection.
- To evaluate the role of CSF contrast leakage in brain retention.
Main Methods:
- Prospective study involving 76 participants undergoing intrathecal gadobutrol (0.5 mmol).
- Standardized brain T1 mapping performed before and 4 weeks after contrast administration.
- Statistical analysis included pairwise comparisons with a 3% safety margin for T1 change.
Main Results:
- No significant gadolinium retention detected in the cerebral cortex or basal ganglia.
- A minor, statistically significant reduction in white matter T1 relaxation time (0.98%) was observed, within the safety margin.
- Posterior fossa structures showed poor alignment, precluding assessment of brain stem and cerebellum.
Conclusions:
- Intrathecal gadobutrol did not result in detectable gadolinium retention in the cerebral hemispheres.
- Gadolinium accumulation in brain tissue appears to be of minor importance following intrathecal contrast administration.
- The pathway of contrast leakage into CSF may not be a primary driver of brain gadolinium retention.
More Related Videos
Related Concept Videos
01:14Imaging Studies I: CT and MRI
Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...
01:24Magnetic Resonance Imaging