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gadolinium deposition disease radiology

3, 7 April 2017 | RadioGraphics, Vol. A–D, Changes in T1-weighted signal intensities in globus pallidus, thalamus, dentate, and pons are plotted against cumulative intravenous gadolinium exposure. 9, 3 May 2018 | La radiologia medica, Vol. Gadolinium is the primary metal ion that is used for making such contrast or dye, primarily due to their unique interaction wit… 1, Magnetic Resonance in Medical Sciences, Vol. 59, No. 6, Journal of the American College of Radiology, Vol. 24, No. 1, American Journal of Roentgenology, Vol. 3, 27 September 2016 | Multiple Sclerosis Journal, Vol. 29, No. Pediatric Brain: No Increased Signal Intensity in the Dentate Nucleus on Unenhanced T1-weighted MR Images after Consecutive Exposure to a Macrocyclic Gadolinium-based Contrast Agent, Gadopentetate but not gadobutrol accumulates in the dentate nucleus of multiple sclerosis patients, Myocardial Architecture, Mechanics, and Fibrosis in Congenital Heart Disease, Signal intensity at unenhanced T1-weighted magnetic resonance in the globus pallidus and dentate nucleus after serial administrations of a macrocyclic gadolinium-based contrast agent in children, First † Cumulative gadolinium dose from all intravenous gadolinium-enhanced MR examinations. 10, 22 October 2016 | Pigment Cell & Melanoma Research, Vol. Formalin-fixed brain tissues were desiccated at 90°C for 4–6 hours, weighed, digested with a concentrated nitric acid (Fisher Scientific, Hampton, NH) at 80°C for 20 minutes, and subsequently diluted with an aqueous 30 wt% hydrogen peroxide. In contradistinction, all patients exposed to multiple doses of a GBCA had elevated levels of elemental gadolinium in the four prescribed neuroanatomic regions, ranging from 0.1 to 58.8 μg gadolinium per gram of tissue (Table 2). 1, 4 December 2017 | Magnetic Resonance in Medicine, Vol. 2, 22 January 2018 | Radiology, Vol. 9, The Egyptian Journal of Radiology and Nuclear Medicine, Vol. 35, No. 19, No. Technical aspects of MRI signal change quantification after gadolinium-based contrast agents' administration, Gadolinium based contrast agents (GBCA): Safety overview after 3 decades of clinical experience, Can gadolinium be re-chelated in vivo? 2, Magnetic Resonance Imaging Clinics of North America, Vol. All clinical and procedural data were extracted from our institutional electronic medical record system by using relational database software (Data Discovery and Query Building; IBM, Armonk, New York) as described in Appendix E1 (online). 83, No. 27, No. As free gadolinium is cytotoxic, the presence of the organic ligand serves as a physiologic chaperone, allowing an otherwise toxic metal to be safely administered intravenously and excreted (1,6–8). 40, No. 9, Frontiers in Molecular Neuroscience, Vol. 9, 13 March 2017 | European Radiology, Vol. Elemental gadolinium was detected in the four neuroanatomic regions of all five patients in the contrast group, with concentrations ranging from 0.1 to 19.4 μg gadolinium per gram of tissue (Table 2). 8, 13 March 2017 | The International Journal of Cardiovascular Imaging, Vol. 1, Magnetic Resonance in Medicine, Vol. 1, 28 July 2016 | Radiology, Vol. 114, No. 11, European Journal of Radiology Open, Vol. 26, No. 1, 6 December 2019 | RadioGraphics, Vol. 3, No. 3, 16 July 2015 | American Journal of Neuroradiology, Vol. 35, No. 7, 11 May 2017 | American Journal of Neuroradiology, Vol. 3, 8 November 2017 | Radiology, Vol. An additional syndrome, termed gadolinium deposition disease, has been proposed to describe patients with normal renal function who develop an array of symptoms following GBCA exposure. 62, No. Most patients in the contrast group underwent serial brain MR imaging for surveillance of known or resected CNS tumors. 3, 14 October 2018 | Journal of Magnetic Resonance Imaging, Vol. Transmission electron microscopy was performed in conjunction with electron probe microanalysis at our institutional microscopy core facility (R.J.M., with 12 years of experience) to characterize and quantify the distribution of gadolinium deposits in these formalin-fixed tissues. 48, No. The association between cumulative gadolinium dose and normalized T1-weighted signal intensity changes in the basal ganglia and posterior fossa are shown in Figure 2, A–D. Recently, indirect evidence has emerged that suggests gadolinium deposition may occur in patients with otherwise normal renal function. Kanda et al discovered high signal intensity of both the dentate nucleus and ... including the American College of Radiology, Health Canada, the Canadian Association of Radiologists, the Australian Department of Health, the European Medicines Agency, Within the contrast group, the lowest recorded eGFR within 24 hours of gadolinium administration for MR imaging was 49 mL/min/1.73 m2; most patients had eGFRs of at least 60 mL/min/1.73 m2. C = carbon, Cs = cesium, Cu = copper, Gd = gadolinium, O = oxygen, Os = osmium, Pb = lead, Ti = titanium, V = vanadium. 1, European Journal of Internal Medicine, Vol. 4, Journal of Neuroradiology, Vol. 121, No. The results of this single-center retrospective study demonstrate a significant dose-dependent relationship between intravenous GBCA administration and subsequent neuronal tissue deposition that was independent of patient age, sex, baseline renal function, or interval between gadolinium exposure and death. A study comparing dentate nucleus signal intensity after previous GBCA administration in patients who had received linear GBCAs compared with patients who had received macrocyclic GBCAs show no association between dentate signal hyperintensity and macrocyclic GBCA, but a highly significant association in patients who had received linear GBCAs. 5, 4 October 2018 | American Journal of Neuroradiology, Vol. 39, No. 4, Topics in Magnetic Resonance Imaging, Vol. 29, No. 311, No. 39, No. 46, No. 4, Physiological Measurement, Vol. 80, No. 3, Pratique Neurologique - FMC, Vol. 45, No. perfusion: A review of the evidence, Magnetic resonance index of activity (MaRIA) and Clermont score are highly and equally effective MRI indices in detecting mucosal healing in Crohn’s disease, Signal Enhancement of the Dentate Nucleus at Unenhanced MR Imaging after Very High Cumulative Doses of the Macrocyclic Gadolinium-based Contrast Agent Gadobutrol: An Observational Study, Gadolinium Deposition in Human Brain Tissues after Contrast-enhanced MR Imaging in Adult Patients without Intracranial Abnormalities, Comparison of Gadolinium Concentrations within Multiple Rat Organs after Intravenous Administration of Linear versus Macrocyclic Gadolinium Chelates, Distribution and chemical forms of gadolinium in the brain: a review, Absence of clinical cerebellar syndrome after serial injections of more than 20 doses of gadoterate, a macrocyclic GBCA: a monocenter retrospective study, Retención de compuestos de gadolinio usados en resonancia magnética: revisión crítica y recomendaciones de las agencias regulatorias, Noninvasive and Invasive Imaging of the Liver and Biliary Tract, Follow-up assessment of coiled intracranial aneurysms using zTE MRA as compared with TOF MRA: a preliminary image quality study, Signal intensity change on unenhanced T1-weighted images in dentate nucleus and globus pallidus after multiple administrations of gadoxetate disodium: an intraindividual comparative study, Maximum intensity breast diffusion MRI for BI-RADS 4 lesions detected on X-ray mammography, Gadolinium Brain Deposition after Macrocyclic Gadolinium Administration: A Pediatric Case-Control Study, Coherent normalization for 51, No. Reports of similar MR signal intensity changes in the dentate and/or deep gray nuclei among patients with multiple sclerosis, neurofibromatosis, hypoparathyroidism, inherited metabolic disorders, and Fahr disease may suggest that these areas are uniquely susceptible to metal deposition (14,15,30). 81, No. 7, 23 May 2017 | Frontiers in Cardiovascular Medicine, Vol. 49, No. 41, No. 12, 27 February 2018 | Nature Communications, Vol. Deposition of gadolinium in the brain has been increasingly reported in recent years. 76, No. 6, Journal of Magnetic Resonance Imaging, Vol. 8, 16 June 2017 | Neuroradiology, Vol. 1, 24 August 2016 | Acta Neurologica Scandinavica, Vol. It flows into the vascular system after intravenous injection. Gadolinium-based contrast agents (GBCAs) have enjoyed wide use since their introduction some 30 years ago. With use of the periphery of peritumoral postradiation changes on MR images as a surrogate for the outer boundary of the low-dose conformal radiation field, all harvested samples from the supratentorial region (basal ganglia and thalamus) of radiation-exposed patients were at least 2 cm away from this boundary, with a median distance of 4 cm (range, 3–5 cm). 4, 8 September 2017 | NMR in Biomedicine, Vol. 2, 21 September 2015 | European Radiology, Vol. The dentate nucleus was associated with the greatest dose-dependent change in T1-weighted signal intensity, whereas the pons demonstrated the lowest overall absolute change in T1-weighted signal intensity with gadolinium (Fig 2, C and D). 40, No. 13, 15 November 2018 | Scientific Reports, Vol. Differences in the amounts of gadolinium detected with ICP-MS in the four sampled neuronal tissues were assessed with the Mood median test. 20, No. 1, No. 80, No. 163, Topics in Magnetic Resonance Imaging, Vol. 47, No. 6, Magnetic Resonance in Medicine, Vol. 283, No. Given the widespread use of GBCAs, our confirmation of gadolinium within neuronal tissues, even in the setting of normal renal and hepatobiliary function, merits additional investigation. Your email address will not be published. 49, No. 285, No. 286, No. T1 45, Radiologic Clinics of North America, Vol. 79, No. 7, The British Journal of Radiology, Vol. 9, No. 86, No. 9, Journal of Magnetic Resonance Imaging, Vol. 69, No. ), College of Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905. ■ Elemental gadolinium accumulates in neuronal tissues after intravenous administration of gadolinium-based contrast agents (GBCAs), even in patients with normal renal and hepatobiliary function. 3, 13 February 2017 | Proceedings of the National Academy of Sciences, Vol. 5, European Journal of Endocrinology, Vol. 9, Contrast Media & Molecular Imaging, Vol. 1, Magnetic Resonance in Medical Sciences, Vol. 57, No. 20, No. 11, No. 3, 20 August 2019 | Radiology, Vol. Since then, more than 70 studies have examined persistent gadolinium deposition in the brain, bone, kidneys, liver, and spleen. The signal intensity of an MR image is affected by T1 and T2 relaxation times, which are characteristic physical properties of … Ten of the 11 cases of intracranial malignancy in the contrast group were limited to the supratentorial region without posterior fossa involvement; patient 7 had multifocal glioblastoma multiforme with a small untreated lesion in the brachium pontis. 3, Progress in Pediatric Cardiology, Vol. 39, No. enhancement with immediate gadoteridol enhancement in high grade gliomas, Interpretation and Reporting of Coronary Arteries in Transposition of the Great Arteries. Patients within the contrast group underwent four to 29 contrast-enhanced MR examinations, whereas those in the control group underwent one to six unenhanced MR examinations. 6, 19 June 2018 | Radiology, Vol. In the current study, we sought to confirm these initial reports of CNS gadolinium deposition with direct assessment of gadolinium accumulation in neuronal tissues among deceased patients previously exposed to multiple doses of intravenous gadolinium. 1, 23 February 2016 | European Radiology, Vol. 3, 14 February 2018 | PLOS ONE, Vol. 25, No. 10, 9 July 2018 | Pediatric Radiology, Vol. 27, No. 6, Regional Anesthesia & Pain Medicine, Vol. 29, No. Wednesday, November 18th8:00-9:00pm EST. The deposition of gadolinium within the body following exposure to these agents has been proven [4,5,6], and appears to be dependent on factors such as agent stability and patient renal function. FDA evaluating the risk of brain deposits with repeated use of gadolinium-based contrast agents for magnetic resonance imaging (MRI). 295, No. 21, No. 2019, European Journal of Inorganic Chemistry, Vol. 2, American Journal of Roentgenology, Vol. Similarly, the median age at the time of first MR examination was significantly lower for patients in the contrast group when compared with the control group (51 years [range, 42–61 years] vs 78.5 years [range, 58–87.5 years], respectively; P < .0001). 123, No. Nine of the 13 patients in the contrast group and eight of the 10 in the control group lived within Olmsted county, Minnesota, and received all of their adult health care at our medical center; the remaining four patients in the contrast group and two patients in the control group were regional patients within our extended health care network, permitting access to their outside medical records and prior radiologic examinations. 1, 27 September 2017 | La radiologia medica, Vol. 26, No. 2, 2 February 2017 | Journal of Magnetic Resonance Imaging, Vol. 49, No. 276, No. 34, 19 September 2018 | Pediatric Radiology, Vol. 29, No. 3, International Journal of Nanomedicine, Vol. 2, 20 January 2016 | Acta Radiologica, Vol. Despite relatively uncomplicated initial clinical trials in the early 1990s, a 2006 study causally associated the administration of gadolinium with the development of nephrogenic systemic fibrosis in patients with pre-existing renal dysfunction (9). For patients who underwent at least two MR examinations, changes in T1 signal intensities between the last and first examination in each of the four prescribed neuroanatomic locations were quantified as the percentage change in normalized T1 signal intensity. According to institutional policy, gadolinium contrast material is administered only when appropriate for the imaging study and is withheld from any patient with stage 4 or 5 chronic kidney disease (eGFR < 30 mL/min/1.73 m 2) or in the setting of ongoing acute kidney injury on the basis of American College of Radiology guidelines for the prevention of nephrogenic systemic fibrosis (12). 264, No. 17, No. 33, No. 1, 13 December 2019 | RadioGraphics, Vol. 17, No. 15, No. 2, 20 December 2017 | NMR in Biomedicine, Vol. 2, Journal of Magnetic Resonance Imaging, Vol. 3, Magnetic Resonance in Medicine, Vol. 2, 26 April 2018 | Andrologia, Vol. 3, 27 September 2016 | Radiology, Vol. Enter your email address below and we will send you the reset instructions. 9, 12 July 2018 | Pharmaceutical Research, Vol. 3, 3 December 2015 | DNP - Der Neurologe und Psychiater, Vol. 6, 25 February 2016 | American Journal of Neuroradiology, Vol. 9, No. Gadolinium accumulation after contrast-enhanced magnetic resonance imaging: Which implications in patients with Crohn’s disease? 5, 30 March 2017 | Environmental Science and Pollution Research, Vol. Neuronal tissues from the dentate nuclei, pons, globus pallidus, and thalamus of these 23 deceased patients were harvested and analyzed with inductively coupled plasma mass spectrometry (ICP-MS), transmission electron microscopy, and light microscopy to quantify, localize, and assess the effects of gadolinium deposition. 2, 26 December 2015 | La radiologia medica, Vol. 9, No. 35, No. When should we use contrast material in cardiac MRI? Patients who have undergone MRI, experience the side effects and may not be aware of the symptoms that are … Gadolinium Deposition in the Brain: Do We Know Enough to Change Practice? 92, 19 January 2018 | The British Journal of Radiology, Vol. 1, 29 August 2018 | Pediatric Radiology, Vol. 1, 30 May 2017 | Journal of Translational Medicine, Vol. 26, No. Cited Here | PubMed | CrossRef; 19. 1, CONTINUUM: Lifelong Learning in Neurology, Vol. 43, No. 69, No. 3, 8 October 2019 | Radiology, Vol. 31, No. However, the safety profile and attendant medicolegal liability associated with GBCAs changed in 2016 with the description of … 20, No. 2, 19 June 2017 | Radiology, Vol. 36, 8 June 2018 | American Journal of Physiology-Heart and Circulatory Physiology, Vol. Many clinical imaging studies provide indirect evidence of gadolinium deposition from T1 shortening, which varies substantially across different agents. 3, American Journal of Otolaryngology, Vol. 48, No. 28, No. 20, No. Also, it might be unrecognised in the clinical setting when lacking specific investigations that allow lanthanide detection and when co-occurrence of primary diseases might mask the role of gadolinium in triggering or contributing to the symptoms. 1, 12 June 2018 | Canadian Journal of Kidney Health and Disease, Vol. Self-gated 4D multiphase, steady-state imaging with contrast enhancement (MUSIC) using rotating cartesian K-space (ROCK): Validation in children with congenital heart disease, A BMI-adjusted ultra-low-dose CT angiography protocol for the peripheral arteries—Image quality, diagnostic accuracy and radiation exposure, Cumulative Dose of Macrocyclic Gadolinium-Based Contrast Agent Improves Detection of Enhancing Lesions in Patients with Multiple Sclerosis, Dentate Update: Imaging Features of Entities That Affect the Dentate Nucleus, Normal appearing white matter permeability: a marker of inflammation and information processing speed deficit among relapsing remitting multiple sclerosis patients, Tumor-Targeted and Clearable Human Protein-Based MRI Nanoprobes, Contrast Agent–Induced High Signal Intensity in Dentate Nucleus on Unenhanced T1-Weighted Images, Quantification and Assessment of the Chemical Form of Residual Gadolinium in the Brain After Repeated Administration of Gadolinium-Based Contrast Agents, Penetration and distribution of gadolinium-based contrast agents into the cerebrospinal fluid in healthy rats: a potential pathway of entry into the brain tissue. 33, No. 5, 28 January 2017 | Neurosurgery, Vol. 6, 29 April 2018 | Neuroradiology, Vol. 3, 1 February 2018 | American Journal of Neuroradiology, Vol. 3, American Journal of Veterinary Research, Vol. 1, 25 January 2016 | Advances in Therapy, Vol. 83, No. 3, American Journal of Neuroradiology, Vol. 2, Current Opinion in Nephrology & Hypertension, Vol. 37, No. 46, No. 6, Journal of Neurosurgery: Pediatrics, Vol. 9, 6 April 2015 | Radiology, Vol. 1, 1 March 2016 | Japanese Journal of Radiology, Vol. 5, American Journal of Roentgenology, Vol. Deceased patients who underwent autopsy following antemortem consent and received at least one unenhanced (control group) or at least four GBCA-enhanced (contrast group) MR examinations of the brain between 2000 and 2014 were included in this study. This was the week of the Gena and Chuck Norris interview with CBS about gadolinium agents. Rochester, Minn. - Mayo Clinic research finds direct evidence of gadolinium deposition in neuronal tissues following intravenous administration of gadolinium-based contrast agents used in MRI exams. Tissue gadolinium quantification of stable gadolinium isotopes 157Ga and 160Ga was performed by using an inductively coupled plasma mass spectrometer (ELAN DRC II; Perkin Elmer, Shelton, Conn). 8, European Journal of Inorganic Chemistry, Vol. 10, 19 September 2016 | Journal of Pharmacokinetics and Pharmacodynamics, Vol. 20, No. 19, No. Gadolinium Retention in the Body and Brain: Is It Time for an International Joint Research Effort? Moderate to strong dose-dependent correlations were observed between T1-weighted signal intensity changes and tissue concentrations of gadolinium in all four neuroanatomic regions, ranging from ρ = 0.49 (P = .08) in the globus pallidus to ρ = 0.89 (P < .0001) in the dentate nucleus (Fig 2). 29, No. 33, No. Preclinical studies provide evidence of the pattern and degree of gadolinium deposition across various agents, as well as some evidence regarding potential clinical and behavioral impact. 4, 13 December 2017 | Radiology, Vol. 80, No. Gadolinium deposition: is it chelated or dissociated gadolinium? The retrospective study revealed a dose relationship between high signal intensity … 207, No. 50, No. 9, JACC: Cardiovascular Imaging, Vol. Continuous variables were presented as medians and interquartile ranges owing to nonnormal data distributions unless otherwise noted. 3, Chemistry – A European Journal, Vol. Dense Breasts: What Do Our Patients Need to Be Told and Why? Median hepatobiliary function (alkaline phosphatase, aspartate aminotransferase, total bilirubin levels) was normal in most patients in the contrast group near the time of gadolinium administration (Table 1). 3, Journal of the American College of Cardiology, Vol. Some neurological and pain syndromes have been reported by patients and the concept of gadolinium-deposition disease … 46, No. ■ Transmission electron microscopy revealed the presence of a majority of gadolinium deposits in the endothelial walls, whereas a smaller fraction crossed an otherwise intact blood-brain barrier, with deposits in the neural interstitium. 8, No. 11, 28 November 2018 | Physiological Measurement, Vol. 2, Journal of the Korean Society of Radiology, Vol. 11, No. 9, Operative Techniques in Otolaryngology-Head and Neck Surgery, Vol. 48, No. Newer studies provide early, indirect evidence of washout. Noninvasive Imaging in Adult Congenital Heart Disease, Is There Long-term Signal Intensity Increase in the Central Nervous System on T1-weighted Images after MR Imaging with the Hepatospecific Contrast Agent Gadoxetic Acid? 285, No. Weekly enhanced T1-weighted MRI with Gadobutrol injections in MS patients: Is there a signal intensity increase in the dentate nucleus and the globus pallidus? Fourth, although we were unable to identify an association between renal function and gadolinium accumulation, the small sample size of this study could mask weaker correlations. The Effects of Acetazolamide on the Evaluation of Cerebral Hemodynamics and Functional Connectivity Using Blood Oxygen Level–Dependent MR Imaging in Patients with Chronic Steno-Occlusive Disease of the Anterior Circulation, Gadolinium accumulation in organs of Sprague–Dawley® rats after implantation of a biodegradable magnesium-gadolinium alloy, Guidelines for the use of magnetic resonance imaging in diagnosing and monitoring the treatment of multiple sclerosis: recommendations of the Swedish Multiple Sclerosis Association and the Swedish Neuroradiological Society, Commentary on “A Microfluidic Platform to Design Crosslinked Hyaluronic Acid Nanoparticles (cHANPs) for Enhanced MRI”, Diagnostic Imaging Principles and Applications in Head and Neck Pathology, Keeping Abreast of Developments in the Cancer Wars: A View From the Front, Nonenhanced hybridized arterial spin labeled magnetic resonance angiography of the extracranial carotid arteries using a fast low angle shot readout at 3 Tesla, A Review of Supplemental Screening Ultrasound for Breast Cancer, In vivo dentate nucleus MRI relaxometry correlates with previous administration of Gadolinium-based contrast agents, Combined blood pool and extracellular contrast agents for pediatric and young adult cardiovascular magnetic resonance imaging, Gadolinium deposition in the brain: Lessons learned from other metals known to cross the blood–brain barrier. 1069, 22 December 2016 | Radiology, Vol. Distances between the tumor or postradiation change margin relative to the harvested tissue were measured from MR imaging data. 282, No. 84, No. © 2020 Rector and Visitors of the University of Virginia.All rights reserved. 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