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Signal intensity change on unenhanced T1-weighted images in dentate nucleus following gadobenate dimeglumine in patients with and without previous multiple administrations of gadodiamide

Abstract

Objectives

To evaluate the impact of previous administration of gadodiamide and neural tissue gadolinium deposition in patients who received gadobenate dimeglumine.

Methods

Our population included 62 patients who underwent at least three administrations of gadobenate dimeglumine, plus an additional contrast-enhanced last MRI for reference, divided into two groups: group 1, patients who in addition to gadobenate dimeglumine administrations had prior exposure to multiple doses of gadodiamide; group 2, patients without previous exposure to other gadolinium-based contrast agent (GBCAs). Quantitative analysis was performed on the first and last gadobenate dimeglumine MRIs in both groups. Dentate nucleus-to-middle cerebellar peduncle signal intensity ratios (DN/MCP) and relative change (RC) in signal over time were calculated and compared between groups using generalized additive model.

Results

Group 1 showed significant increase in baseline and follow-up DN/MCP compared to group 2 (p < 0.0001). The RC DN/MCP showed a non-statistically significant trend towards an increase in patients who underwent previous gadodiamide (p = 0.0735).

Conclusion

There is increased T1 signal change over time in patients who underwent gadobenate dimeglumine and had received prior gadodiamide compared to those without known exposure to previous gadodiamide. A potentiating effect from prior gadodiamide on subsequent administered gadobenate dimeglumine may occur.

Key Points

Neural gadolinium deposition is associated with multiple administrations of less stable GBCAs.

Less stable GBCA effect on subsequent more stable GBCA administrations is undetermined.

Significant increase of DN/MCP was seen in patients with previous gadodiamide exposure.

RC DN/MCP showed a non-significant increase in patients who received previous gadodiamide.

Potentiating effects from prior gadodiamide on subsequent administered gadobenate dimeglumine may occur.

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Abbreviations

DN:

dentate nucleus

GBCA:

gadolinium-based contrast agent

MCP:

middle cerebellar peduncle

RC:

relative change

SI:

signal intensity

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Acknowledgments

The scientific guarantor of this publication is Richard C. Semelka. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. No study subjects or cohorts have been previously reported. Methodology: retrospective, case-control study, performed at one institution.

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Correspondence to Miguel Ramalho.

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Ramalho, J., Semelka, R.C., AlObaidy, M. et al. Signal intensity change on unenhanced T1-weighted images in dentate nucleus following gadobenate dimeglumine in patients with and without previous multiple administrations of gadodiamide. Eur Radiol 26, 4080–4088 (2016). https://doi.org/10.1007/s00330-016-4269-7

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Keywords

  • Gadolinium deposition
  • Gadodiamide
  • Gadobenate dimeglumine
  • Neural tissue
  • Dentate nucleus