European Radiology

, Volume 27, Issue 8, pp 3353–3361 | Cite as

Gadolinium deposition in the brain: association with various GBCAs using a generalized additive model

  • Sohi Bae
  • Ho-Joon Lee
  • Kyunghwa Han
  • Yae-Won Park
  • Yoon Seong Choi
  • Sung Soo Ahn
  • Jinna Kim
  • Seung-Koo Lee
Contrast Media



To determine the relationship between the number of administrations of various gadolinium-based contrast agents (GBCAs) and increased T1 signal intensity in the globus pallidus (GP) and dentate nucleus (DN).


This retrospective study included 122 patients who underwent double-dose GBCA-enhanced magnetic resonance imaging. Two radiologists calculated GP-to-thalamus (TH) signal intensity ratio, DN-to-pons signal intensity ratio and relative change (Rchange) between the baseline and final examinations. Interobserver agreement was evaluated. The relationships between Rchange and several factors, including number of each GBCA administrations, were analysed using a generalized additive model.


Six patients (4.9%) received linear GBCAs (mean 20.8 number of administration; range 15–30), 44 patients (36.1%) received macrocyclic GBCAs (mean 26.1; range 14–51) and 72 patients (59.0%) received both types of GBCAs (mean 31.5; range 12–65). Interobserver agreement was almost perfect (0.99; 95% CI: 0.99–0.99). Rchange (DN:pons) was associated with gadodiamide (p = 0.006) and gadopentetate dimeglumine (p < 0.001), but not with other GBCAs. Rchange (GP:TH) was not associated with GBCA administration.


Previous administration of linear agents gadoiamide and gadopentetate dimeglumine is associated with increased T1 signal intensity in the DN, whereas macrocyclic GBCAs do not show an association.

Key points

Certain linear GBCAs are associated with T1 signal change in the dentate nucleus.

The signal change is related to the administration number of certain linear GBCAs.

Difference in signal change may reflect differences in stability of agents.


Gadolinium Magnetic resonance imaging Dentate nucleus Globus pallidus Contrast media 



Blood-brain barrier


Cerebrospinal fluid


Dentate nucleus


Estimated glomerular infiltration rate


Generalized additive model


Gadolinium-based contrast agent


Globus pallidus


Magnetic resonance imaging


Nephrogenic systemic fibrosis


Relative change


Region of interest




Compliance with ethical standards


The scientific guarantor of this publication is Seung-Koo Lee.

Conflict of interest

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.

Statistics and biometry

One of the authors has significant statistical expertise.

Ethical approval

Institutional Review Board approval was obtained.

Informed consent

Written informed consent was waived by the Institutional Review Board.


Retrospective, diagnostic or prognostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Sohi Bae
    • 1
  • Ho-Joon Lee
    • 1
  • Kyunghwa Han
    • 1
  • Yae-Won Park
    • 1
  • Yoon Seong Choi
    • 1
  • Sung Soo Ahn
    • 1
  • Jinna Kim
    • 1
  • Seung-Koo Lee
    • 1
  1. 1.Department of Radiology, Severance Hospital, Research Institute of Radiological ScienceYonsei University College of MedicineSeoulKorea

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