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PT  - JOURNAL ARTICLE
AU  - Kang, H.
AU  - Hii, M.
AU  - Le, M.
AU  - Tam, R.
AU  - Riddehough, A.
AU  - Traboulsee, A.
AU  - Kolind, S.
AU  - Freedman, M.S.
AU  - Li, D.K.B.
TI  - Gadolinium Deposition in Deep Brain Structures: Relationship with Dose and Ionization of Linear Gadolinium-Based Contrast Agents
AID  - 10.3174/ajnr.A5751
DP  - 2018 Sep 01
TA  - American Journal of Neuroradiology
PG  - 1597--1603
VI  - 39
IP  - 9
4099  - http://www.ajnr.org/content/39/9/1597.short
4100  - http://www.ajnr.org/content/39/9/1597.full
SO  - Am. J. Neuroradiol.2018 Sep 01; 39
AB  - BACKGROUND AND PURPOSE: Dose-dependent association between hyperintensity in deep brain structures on unenhanced T1WIs and gadolinium-based contrast agent administrations has been demonstrated with subsequent histopathological confirmation of gadolinium deposition. Our aim was to determine whether greater exposure to linear gadolinium-based contrast agent administration is associated with higher signal intensity in deep brain structures on unenhanced T1-weighted MR imaging. Secondary objective was to compare signal intensity differences between ionic and nonionic linear gadolinium-based contrast agents.MATERIALS AND METHODS: Subjects with secondary-progressive MS originally enrolled in a multicenter clinical trial were studied retrospectively. Eighty subjects (high-exposure cohort) received 9 linear gadolinium-based contrast agent administrations (30 nonionic/50 ionic) between week −4 and year 1 and a tenth administration by year 2. One hundred fifteen subjects (low-exposure cohort) received 2 administrations (40 nonionic/75 ionic) between week −4 and year 1 and a third administration by year 2. Signal intensities were measured on unenhanced T1WIs by placing sample-points on the dentate nucleus, globus pallidus, caudate, thalamus, pons, and white matter, and they were normalized using the following ratios: dentate/pons, globus pallidus/white matter, caudate/white matter, and thalamus/white matter.RESULTS: Between week −4 and year 1, subjects in the high-exposure cohort showed increased signal intensity ratios in all regions (P &amp;lt; .01), while the low-exposure cohort showed only an increase in the dentate nucleus (P = .003). Between years 1 and 2, when both cohorts received only 1 additional gadolinium-based contrast agent, no significant changes were observed. In the high-exposure cohort, significantly higher changes in signal intensity ratios were observed in subjects receiving linear nonionic than in those receiving linear ionic gadolinium-based contrast agents.CONCLUSIONS: Hyperintensity in deep brain structures from gadolinium deposition is related to the number of doses and the type of linear gadolinium-based contrast agent (nonionic greater than ionic) administration.CDcaudateDNdentate nucleusGBCAgadolinium-based contrast agentGPglobus pallidusSIsignal intensityTHthalamus