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In vivo dentate nucleus MRI relaxometry correlates with previous administration of Gadolinium-based contrast agents

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To evaluate changes in T1 and T2* relaxometry of dentate nuclei (DN) with respect to the number of previous administrations of Gadolinium-based contrast agents (GBCA).

Methods

In 74 relapsing-remitting multiple sclerosis (RR-MS) patients with variable disease duration (9.8±6.8 years) and severity (Expanded Disability Status Scale scores:3.1±0.9), the DN R1 (1/T1) and R2* (1/T2*) relaxation rates were measured using two unenhanced 3D Dual-Echo spoiled Gradient-Echo sequences with different flip angles. Correlations of the number of previous GBCA administrations with DN R1 and R2* relaxation rates were tested, including gender and age effect, in a multivariate regression analysis.

Results

The DN R1 (normalized by brainstem) significantly correlated with the number of GBCA administrations (p<0.001), maintaining the same significance even when including MS-related factors. Instead, the DN R2* values correlated only with age (p=0.003), and not with GBCA administrations (p=0.67). In a subgroup of 35 patients for whom the administered GBCA subtype was known, the effect of GBCA on DN R1 appeared mainly related to linear GBCA.

Conclusions

In RR-MS patients, the number of previous GBCA administrations correlates with R1 relaxation rates of DN, while R2* values remain unaffected, suggesting that T1-shortening in these patients is related to the amount of Gadolinium given.

Key Points

• In multiple sclerosis, previous Gadolinium administrations correlate with dentate nuclei T1 relaxometry.

• Such correlation is linked to linear Gadolinium chelates and unrelated to disease duration or severity.

• Dentate nuclei T2* relaxometry is age-related and independent of previous Gadolinium administrations.

• Changes in dentate nuclei T1 relaxometry are not determined by iron accumulation.

• MR relaxometry can quantitatively assess Gadolinium accumulation in dentate nuclei.

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Abbreviations

BBB:

Blood-Brain-Barrier

CNS:

Central Nervous System

CE-MRI:

Contrast-Enhanced MR scans

DN:

Dentate Nuclei

DD:

Disease Duration

EDSS:

Expanded Disability Status Scale

FLAIR:

Fluid Attenuated Inversion Recovery

GRE:

Gradient Echo

Gd:

Gadolinium

GBCA:

Gadolinium-Based Contrast Agents

GM:

Gray Matter

MPRAGE:

Magnetization Prepared Rapid Acquisition Gradient Echo

MRI:

Magnetic Resonance Imaging

ms:

milliseconds

MS:

Multiple Sclerosis

NSF:

Nephrogenic Systemic Fibrosis

RR-MS:

Relapsing-Remitting Multiple Sclerosis

nR1:

Normalized R1 relaxation rate

SP-MS:

Secondary-Progressive Multiple Sclerosis

WM:

White Matter

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Acknowledgments

The help of Raffaele Palladino, MD in reviewing the statistical analyses is gratefully acknowledged. The scientific guarantor of this publication is Enrico Tedeschi, MD. 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. This study has received funding by Italian Ministry of Education, University, and Research (MIUR) within the PRIN framework (2010XE5L2R). One of the authors (MQ) has significant statistical expertise. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective.

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Authors and Affiliations

  1. Neuroradiology, Department of Advanced Biomedical Sciences, University “Federico II”, Via Sergio Pansini, 5, 80131, Naples, Italy

    Enrico Tedeschi, Antonietta Canna, Sirio Cocozza, Carmela Russo, Valentina Angelini & Arturo Brunetti

  2. Institute of Biostructure and Bioimaging, National Research Council, Naples, Italy

    Giuseppe Palma & Mario Quarantelli

  3. IRCCS SDN, Naples, Italy

    Pasquale Borrelli & Marco Salvatore

  4. Department of Neurosciences, Reproductive and Odontostomatological Sciences, University “Federico II”, Naples, Italy

    Roberta Lanzillo, Emanuela Postiglione & Vincenzo Brescia Morra

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  1. Enrico Tedeschi
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Correspondence to Enrico Tedeschi.

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Tedeschi, E., Palma, G., Canna, A. et al. In vivo dentate nucleus MRI relaxometry correlates with previous administration of Gadolinium-based contrast agents. Eur Radiol 26, 4577–4584 (2016). https://doi.org/10.1007/s00330-016-4245-2

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  • DOI: https://doi.org/10.1007/s00330-016-4245-2

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