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

Medline ® Abstract for Reference 55

of 'Principles of magnetic resonance imaging'

Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent.
Radbruch A, Weberling LD, Kieslich PJ, Eidel O, Burth S, Kickingereder P, Heiland S, Wick W, Schlemmer HP, Bendszus M
Radiology. 2015 Jun;275(3):783-91. Epub 2015 Apr 6.
PURPOSE: To compare changes in signal intensity (SI) ratios of the dentate nucleus (DN) and the globus pallidus (GP) to those of other structures on unenhanced T1-weighted magnetic resonance (MR) images between linear and macrocyclic gadolinium-based contrast agents (GBCAs).
MATERIALS AND METHODS: The study was approved by the ethical committee of the University of Heidelberg (reference no. S-324/2014). Owing to the retrospective character of the study, the ethical committee did not require any written informed consent. Two groups of 50 patients who underwent at least six consecutive MR imaging examinations with the exclusive use of either a linear GBCA (gadopentetate dimeglumine) or a macrocyclic GBCA (gadoterate meglumine) were analyzed retrospectively. The difference in mean SI ratios of DN to pons and GP to thalamus on unenhanced T1-weighted imagesfrom the last and first examinations was calculated. One-sample and independent-sample t tests were used to assess the difference in SI ratios for both groups, and regression analysis was performed to account for potential confounders.
RESULTS: The SI ratio difference in the linear group was greater than 0 (mean DN difference±standard deviation, 0.0407±0.0398 [P<.001]; GP, 0.0287±0.0275 [P<.001]) and significantly larger (DN, P<.001 and standardized difference of 1.16; GP, P<.001 and standardized difference of 0.81) than that in the macrocyclic group, which did not differ from 0 (DN, 0.0016±0.0266 [P = .680]; GP, 0.0031±0.0354 [P = .538]). The SI ratio difference between the last and first examinations for the DN remained significantly different between the two groups in the regression analysis (P<.001).
CONCLUSION: This study indicates that an SI increase in the DN and GP on T1-weighted images is caused by serial application of the linear GBCA gadopentetate dimeglumine but not by the macrocyclic GBCA gadoterate meglumine. Clinical implications of this observation remain unclear.
From the Department of Neuroradiology, University of Heidelberg Medical Center, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany (A.R., L.D.W., O.E., S.B., P.K., S.H., M.B.); Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., H.P.S.); Department of Psychology, University of Mannheim, Mannheim, Germany (P.J.K.); and Neurology Clinic, University of Heidelberg, Heidelberg, Germany (W.W.).