Quantitative assessment of gadolinium deposition in dentate nucleus using quantitative susceptibility mapping

Abstract

PurposeGadolinium deposition in dentate nucleus (DN) has been reported after serial administration of gadoliniumbased contrast agents (GBCAs). Gadolinium complexes have paramagnetic properties, therefore, we evaluated susceptibility changes of gadolinium deposition in dentate nucleus (DN), using quantitative susceptibility mapping (QSM) for patients after serial administration of GBCAs. Materials and Methods48 patients with brain tumors, who had had serial GBCA administrations (GBCA group), and 48 healthy volunteers without any history of GBCA administrations (non-GBCA group) were enrolled to this study.Susceptibility values in DN on QSM and DN-to-cerebellum signal intensity ratios on unenhanced T1-weighted images (T1 ratios) on 3T were analyzed. The relationship between the number of times of GBCA administrations and susceptibility values or T1 ratios were evaluated in GBCA group. ResultsSusceptibility values at DN in GBCA group were 0.107 ±0.029 ppm, and significantly higher than those of non-GBCA group (0.079 ±0.025 ppm) (P<0.0001). T1 ratios in DN of GBCA group was 1.059 ±0.070, and also significantly higher than that of non-GBCA group (0.993 ±0.016) (P<0.0001). Spearman rank correlation coefficient between susceptibility values and the number of times of linear GBCA administration showed a modest significant correlation (ρ=0.45, P=0.0015). There is good correlation between T1 ratios and the number of times of linear GBCA administration as reported previously (ρ=0.76, P<0.0001). ConclusionSusceptibility values on QSM in DN of GBCA group, after serial administration of GBCAs, were significantly higher than those of non-GBCA group. INTRODUCTIONGadolinium-based contrast agents (GBCAs) have been widely used for contrast-material-enhanced magnetic resonance (MR) imaging. It is well known that the blood brain barrier (BBB) failure leads to the leakage of the GBCAs and high signal intensity on T1-weighted images in the central nervous system (CNS), GBCAs have been frequently used for evaluation of the central nervous system diseases such as brain tumors and demyelinating diseases. In addition to the alert of nephrogenic systemic fibrosis (NSF) due to free gadolinium deposition to cutaneous tissues, gadolinium accumulation in the dentate nucleus (DN) has gained attention after recent reports of Kanda, et al, In this study, we hypothesized that serial usage of GBCA will increase magnetic susceptibility values in DN of humans on QSM images. Serial usage of GBCA was performed for limited purposes such as followup studies of patients with brain tumors and multiple sclerosis. Therefore, we retrospectively investigated susceptibility values in DN of brain tumor patients who had serial GBCA administration in comparison with healthy volunteers who had no history of GBCA administration MATERIALS AND METHODS SubjectsThis single-center, retrospective observational study was performed after institutional review board approval, with waiver of the informed consent requirement. We assessed 53 consecutive patients with brain tumor...

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