The effect of intravenous gadolinium-DTPA on diffusion-weighted imaging

Fırat, Ahmet; Şanlı, Bayram; Karakaş, Hakkı Muammer; Erdem, Gülnur

doi:10.1007/s00234-006-0091-2

Cited by 34 publications

(44 citation statements)

References 15 publications

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“…The effect of contrast agent at diffusion-weighted imaging has been discussed in several studies (58)(59)(60)(61)(62). The majority of studies show a tendency for the ADC value to decrease after contrast enhancement, although this decrease was not statistically significant in some studies (58)(59)(60)(61)(62).…”

Section: Influence Of Contrast Agent At Diffusion-weighted Imagingmentioning

confidence: 96%

Diffusion-weighted Imaging of the Breast: Principles and Clinical Applications

Woodhams¹,

Ramadan²,

Stanwell³

et al. 2011

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Diffusion-weighted imaging provides a novel contrast mechanism in magnetic resonance (MR) imaging and has a high sensitivity in the detection of changes in the local biologic environment. A significant advantage of diffusion-weighted MR imaging over conventional contrast material-enhanced MR imaging is its high sensitivity to change in the microscopic cellular environment without the need for intravenous contrast material injection. Approaches to the assessment of diffusion-weighted breast imaging findings include assessment of these data alone and interpretation of the data in conjunction with T2-weighted imaging findings. In addition, the analysis of apparent diffusion coefficient (ADC) value can be undertaken either in isolation or in combination with diffusion-weighted and T2-weighted imaging. Most previous studies have evaluated ADC value alone; however, overlap in the ADC values of malignant and benign disease has been observed. This overlap may be partly due to selection of b value, which can influence the concomitant effect of perfusion and emphasize the contribution of multicomponent model influences. The simultaneous assessment of diffusion-weighted and T2-weighted imaging data and ADC value has the potential to improve specificity. In addition, the use of diffusion-weighted imaging in a standard breast MR imaging protocol may heighten sensitivity and thereby improve diagnostic accuracy. Standardization of diffusion-weighted imaging parameters is needed to allow comparison of multicenter studies and assessment of the clinical utility of diffusion-weighted imaging and ADC values in breast evaluation.

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Section: Influence Of Contrast Agent At Diffusion-weighted Imagingmentioning

confidence: 96%

Diffusion-weighted Imaging of the Breast: Principles and Clinical Applications

Woodhams¹,

Ramadan²,

Stanwell³

et al. 2011

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“…Yamada et al found a significant decrease of the ADC value after CM administration [20], while there was no difference in the study of Fitzek et al [21]. In the study of Yamada et al, DWI was obtained immediately after CM application, while there was a longer time interval in the study of Fitzek et al Firat et al combined both protocols and found a significant decrease of the ADC value of normal brain tissue and infarct immediately after CM application which normalized in the late post-contrast DW images [22]. They explained this phenomenon as an effect of the intravascular CM on the diffusion-weighted images.…”

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confidence: 99%

Diffusion-Weighted MR Imaging of Benign and Malignant Breast Lesions Before and After Contrast Enhancement

Janka

Hammon

Geppert

et al. 2013

Fortschr Röntgenstr

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Mamma 130Janka R et al. 50, 400 und 800) wurde vor und nach KM-Gabe gemessen und die entsprechenden ADC-Werte der Läsionen verglichen. Vor der Berechnung der ADC-Werte wurden die Läsionen bezüglich ihrer konstanten Lokalisation in den diffusionsgewichteten Sequenzen analysiert. Ergebnisse: Die mittlere Größe der Läsionen war 1,5 ± 0,8 cm. Auf der Basis der b50-und b400-Messung betrug der durchschnittliche ADC-Wert der benignen Läsionen 1,89 ± 0,30 × 10 -3 mm 2 /s vor und 1,85 ± 0,28 × 10 -3 mm 2 /s nach KM-Gabe. Die entsprechenden Werte für zwei muzinöse Karzinome betrugen 1,88 × 10 -3 mm 2 /s und 1,81 × 10 3 mm 2 /s und für die übrigen malignen Läsionen 1,00 ± 0,18 × 10 -3 mm 2 /s und 0,88 ± 0,21 × 10 -3 mm 2 . Auf der Basis der b50-, b400-und b800-Messung betrug der durchschnittliche ADC-Wert der benignen Läsionen 1,99 ± 0,37 × 10 -3 mm 2 /s vor und 1,97 ± 0,30 × 10 -3 mm 2 /s nach KM-Gabe. Der mittlere ADC-Wert der malignen Läsionen betrug 0,90 ± 0,14 × 10 -3 mm 2 /s vor und 0,80 ± 0,14 × 10 -3 mm 2 /s nach KM-Gabe. Während der ADC-Wert der gutartigen Läsionen durch das Kontrastmittel nicht signifikant beinflusst wurde, war er bei den malignen Läsionen nach Kontrastmittelgabe signifikant niedriger. Abstract !Purpose: Many publications describe the use of diffusion-weighted imaging (DWI) in breast MRI. This article addresses the question of when to apply the DWI sequence in the course of the scan protocol. The effect of T1-shortening contrast media (CM) on the ADC values of breast lesions is investigated. Materials and Methods: Data were acquired on a 1.5 T scanner. 60 patients with 79 lesions (20 benign, 59 malignant) were included. The DWI sequence (4 mm slice thickness, b-values: 50, 400, 800) was applied before and after CM administration. Before calculating the ADC map, the b50, b400 and b800 series were analyzed concerning lesion displacement. ADC values before and after CM application were compared.

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“…. .,'' none of their data were acquired with T2*-sensitive sequences and apparently the mechanisms relating T2* changes to ADC alterations have not been appreciated in either their work or the previous pre-postcontrast studies in neurological applications (2,3). Additional experimentation is required before definitive conclusions regarding the mechanisms for observed ADC reductions following Gd contrast in high uptake lesions is warranted.…”

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Comment on ADC reductions in postcontrast breast tumors

Ramadan

Mulkern

2009

Magnetic Resonance Imaging

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It was with interest that we read the article by Yuen et al (1) who reported measurable decreases in the apparent diffusion coefficient (ADC) of breast tumors following Gd contrast agent administration. The reduction was largest (34%) in lesions deemed to have particularly high vascularity. The observation of contrast agent-induced ADC reductions, and the mechanisms responsible for this effect, have a bearing on the timing, pre-or postcontrast, and interpretation of diffusion weighted imaging (DWI) in the clinical setting. The authors interpret their findings in terms of an oft-discussed two-compartment model in which two distinct water pools contribute to the overall diffusion coefficient: a perfusion component with a relatively high ''pseudo-diffusion'' coefficient (2-4) and an extravascular component with a slower diffusion coefficient. The suggestion is made that the Gd contrast material results in a ''suppression of microperfusioninduced effect'' as also inferred in some neurological studies of postcontrast ADC changes (2,3). Little evidence was put forward to support this reasoning, however, and we believe such reasoning is at fault for at least two reasons. First, negligible physiological effects of commercial Gd contrast agents suggest that blood perfusion throughout the lesion is the same pre-and postcontrast. Second, extinguishing blood signal from T2 and/or T2* shortening effects would require vascular Gd concentrations far higher than anticipated several min after contrast injection, when the post-DWI experiments appear to have been performed.We propose rather that the Gd contrast alters the local magnetic susceptibilities within specific tissue compartments, which in turn produce background magnetic field gradients that can add to, or detract from, diffusion sensitization gradients and subsequently alter measured diffusion coefficients. This effect has been studied both experimentally and theoretically (5,6). Does et al demonstrated substantial decreases in brain ADC values in a rat model as the magnetic susceptibility of blood was increased with the intravascular contrast agent AMI-227 (5), while Zhong et al provided a theoretical description of how an intravoxel Gaussian distribution of background gradients results in a decrease of the apparent diffusion coefficient (6).We thus propose that the sequestration of Gd contrast material within the interstitial, extracellular space of the breast lesions results in background gradients that reduce ADC values as discussed in Does et al and Zhong et al (5,6). Of course, such an effect would also result in reduced T2* values as demonstrated by Does et al. Unfortunately, though Yuen et al state that the ''. . .T2* effect is negligible. . .,'' none of their data were acquired with T2*-sensitive sequences and apparently the mechanisms relating T2* changes to ADC alterations have not been appreciated in either their work or the previous pre-postcontrast studies in neurological applications (2,3). Additional experimentation is required before definitive conclusi...

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The effect of intravenous gadolinium-DTPA on diffusion-weighted imaging

Abstract: Contrast medium injection had significant and time-dependent effects on ADC values. Therefore, only pre-contrast and late DW images should be used in quantitative ADC studies.

Cited by 34 publications

References 15 publications

Diffusion-weighted Imaging of the Breast: Principles and Clinical Applications

Diffusion-weighted Imaging of the Breast: Principles and Clinical Applications

Diffusion-Weighted MR Imaging of Benign and Malignant Breast Lesions Before and After Contrast Enhancement

Comment on ADC reductions in postcontrast breast tumors

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