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Late/delayed gadolinium enhancement in MRI after intravenous administration of extracellular gadolinium-based contrast agents: is it worth waiting?

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Abstract

The acquisition of images minutes or even hours after intravenous extracellular gadolinium-based contrast agents (GBCA) administration (“Late/Delayed Gadolinium Enhancement” imaging; in this review, further termed LGE) has gained significant prominence in recent years in magnetic resonance imaging. The major limitation of LGE is the long examination time; thus, it becomes necessary to understand when it is worth waiting time after the intravenous injection of GBCA and which additional information comes from LGE. LGE can potentially be applied to various anatomical sites, such as heart, arterial vessels, lung, brain, abdomen, breast, and the musculoskeletal system, with different pathophysiological mechanisms. One of the most popular clinical applications of LGE regards the assessment of myocardial tissue thanks to its ability to highlight areas of acute myocardial damage and fibrotic tissues. Other frequently applied clinical contexts involve the study of the urinary tract with magnetic resonance urography and identifying pathological abdominal processes characterized by high fibrous stroma, such as biliary tract tumors, autoimmune pancreatitis, or intestinal fibrosis in Crohn’s disease. One of the current areas of heightened research interest revolves around the possibility of non-invasively studying the dynamics of neurofluids in the brain (the glymphatic system), the disruption of which could underlie many neurological disorders.

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Abbreviations

3D:

Three dimensional

AF:

Atrial fibrillation

BBB:

Blood–brain barrier

CNS:

Central nervous system

CSF:

Cerebrospinal fluid

dGEMRIC:

Delayed gadolinium enhanced magnetic resonance imaging

dGEMRIM:

Delayed gadolinium enhanced magnetic resonance imaging of the meniscus

ECG:

Electrocardiogram

FLAIR:

Fluid attenuated inversion recovery

FLASH:

Fast low angle shot

GAG:

Glycosaminoglycan

GBCA:

Gadolinium-based contrast agents

Gd-DTPA2− :

Gadolinium diethylene triaminepentaacetic acid

GRE:

Gradient-echo

HIV:

Human immunodeficiency virus

IR:

Inversion recovery

LGE:

Late gadolinium enhancement

MRI:

Magnetic resonance imaging

MRU:

Magnetic resonance urography

PVS:

Perivascular spaces

SE:

Spin-echo

TI:

Inversion time

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Acknowledgements

The ESMRMB-GREC (Gadolinium Research & Education Committee) is a group of multidisciplinary ESMRMB members, including clinicians, scientists, chemists, physicists, pathologists, and clinical epidemiologists who all share a common interest in the study of gadolinium-based contrast agents in a wide variety of clinical and preclinical conditions. The authors thank all the members for their insights despite their specific competence and experience. The list of authors includes the members who developed the project and those experts who have revised and approved the final version of the manuscript.

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Authors and Affiliations

  1. Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128, Rome, Italy

    Marco Parillo & Carlo Augusto Mallio

  2. Operative Research Unit of Diagnostic Imaging and Interventional Radiology, Department of Medicine and Surgery, Università Campus Bio-Medico Di Roma, Via Alvaro del Portillo, 200, 00128, Rome, Italy

    Marco Parillo & Carlo Augusto Mallio

  3. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

    Ilona A. Dekkers & Aart J. van der Molen

  4. Section of Neuroradiology, Department of Radiology, Autonomous University of Barcelona and Hospital Vall d’Hebron, Passeig Vall d’Hebron, Barcelona, Spain

    Àlex Rovira

  5. Centre for Medical Sciences, CISMed, University of Trento, Trento, Italy

    Carlo Cosimo Quattrocchi

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The ESMRMB-GREC (Gadolinium Research & Education Committee) is a group of multidisciplinary ESMRMB members, including academic experts of industries. GREC annual meetings are sponsored by the unconditional support of Bayer AG, Bracco, GE Healthcare and Guerbet.

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Parillo, M., Mallio, C.A., Dekkers, I.A. et al. Late/delayed gadolinium enhancement in MRI after intravenous administration of extracellular gadolinium-based contrast agents: is it worth waiting?. Magn Reson Mater Phy 37, 151–168 (2024). https://doi.org/10.1007/s10334-024-01151-0

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