Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Medline ® Abstract for Reference 53

of 'Principles of magnetic resonance imaging'

No Signal Intensity Increase in the Dentate Nucleus on Unenhanced T1-weighted MR Images after More than 20 Serial Injections of Macrocyclic Gadolinium-based Contrast Agents.
Radbruch A, Haase R, Kieslich PJ, Weberling LD, Kickingereder P, Wick W, Schlemmer HP, Bendszus M
Radiology. 2017 Mar;282(3):699-707.
Purpose To determine the effect of more than 20 serial injections of macrocyclic gadolinium-based contrast agents (GBCAs) on the signal intensity (SI) of the dentate nucleus (DN) on unenhanced T1-weighted magnetic resonance (MR) images. Materials and Methods In this retrospective, institutional review board-approved study, 33 patients who underwent at least 20 consecutive MR imaging examinations (plus an additional MR imaging for reference) with the exclusive use of macrocyclic GBCAs gadoterate meglumine and gadobutrol were analyzed. SI ratio differences were calculated for DN-to-pons and DN-to-middle cerebellar peduncle (MCP) ratios by subtracting the SI ratio at the first MR imaging examination from the SI ratio at the last MR imaging examination. One-samplet tests were used to examine if the SI ratio differences differed from 0, and Bayes factors were calculated to quantify the strength of evidence for each test. Results Patients underwent a mean of 23.03±(standard deviation) 4.20 GBCA administrations (mean accumulated dose, 491.21 mL±87.04 of a 0.5 M GBCA solution) with an average of 12.09 weeks±2.16 between every administration. Both ratio differences did not differ significantly from 0 (DN-to-pons ratio: -0.0032±0.0154, P = .248; DN-to-MCP ratio: -0.0011±0.0093, P = .521), and one-sided Bayes factors provided substantial to strong evidence against an SI ratio increase (Bayes factor for DN-to-pons ratio = 0.09 and that for DN-to-MCP ratio = 0.12). Conclusion The study indicates that 20 or more serial injections of macrocyclic GBCAs administered with on average 3 months between each injection are not associated with an SI increase in the DN. (©) RSNA, 2016.
From the Department of Neuroradiology (A.R., R.H., L.D.W., P.K., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., L.D.W., H.P.S.); German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H., L.D.W.); Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.); and Department of Psychology, University of Mannheim, Mannheim, Germany (P.J.K.).