Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;52(5):1525-1530.
doi: 10.1002/jmri.27198. Epub 2020 Jun 1.

Effect of Exposure to Gadodiamide and Brain Irradiation on T1 -Weighted Images and ADC Maps of the Dentate Nucleus

Carlo A Mallio  1 , Marco Parillo  1 , Bruno Beomonte Zobel  1 , Paul M Parizel  2 , Carlo C Quattrocchi  1
Affiliations

Effect of Exposure to Gadodiamide and Brain Irradiation on T1 -Weighted Images and ADC Maps of the Dentate Nucleus

Carlo A Mallio et al. J Magn Reson Imaging. 2020 Nov.

Abstract

Background: Brain irradiation is considered a cofactor influencing the dentate nucleus (DN) signal intensity (SI) on unenhanced T1 -weighted images in patients exposed to gadolinium-based contrast agents (GBCAs).

Purpose: To assess the effect of gadodiamide and whole-brain radiation therapy (WBRT) on T1 -weighted images and on apparent diffusion coefficient (ADC) maps of DN.

Study type: Single-center retrospective.

Population: In all, 125 patients who underwent brain MRIs were classified into four groups: 1) patients who did neither receive intravenous GBCAs injections nor irradiation (controls); 2) patients having ≥3 GBCAs-enhanced scans and no WBRT; 3) patients having WBRT and < 3 GBCAs-enhanced scans; and 4) patients having WBRT and ≥ 3 GBCAs-enhanced scans.

Field strength/sequence: 1.5T magnet, echo-planar diffusion weighted imaging (DWI) and unenhanced T1 -weighted sequences.

Assessment: The DN-to-pons SI ratio on unenhanced T1 -weighted images and ADC values of the DN were calculated. Values were compared between groups and relative to the cumulative gadolinium dose and to the time delay after WBRT.

Statistical tests: Statistical analysis included the Mann-Whitney U-test and Spearman's rank-order correlation.

Results: DN ADC values were not significantly different (P = 0.34) between patients exposed to gadodiamide (0.81 ± 0.06) and controls (0.83 ± 0.07). There were no differences in DN ADC values (P = 0.28) and DN-to-pons SI ratios (P = 0.42) between patients exposed to WBRT (ADC values: 0.85 ± 0.09; SI ratio: 1.11 ± 0.10) and controls (ADC values: 0.83 ± 0.06; SI ratio: 1.09 ± 0.06). There was a significant negative correlation between DN ADC values and the time (days) since the end of WBRT (r = - 0.33; 95% confidence interval [CI]: -0.55, -0.06; P < 0.05).

Data conclusion: We did not find changes suggestive of gadolinium-related tissue microstructural damage of the DN. The ADC values of the DN are associated with the time from WBRT.

Level of evidence: 3 TECHNICAL EFFICACY STAGE: 5.

Keywords: DWI; MRI; brain irradiation; dentate nucleus; gadodiamide; whole brain radiation therapy.

PubMed Disclaimer

References

REFERENCES

    1. Parizel PM, Degryse HR, Gheuens J, et al. Gadolinium-DOTA enhanced MR imaging of intracranial lesions. J Comput Assist Tomogr 1989;13:378-385.
    1. Sherry AD, Caravan P, Lenkinski RE. Primer on gadolinium chemistry. J Magn Reson Imaging 2009;30:1240-1248.
    1. Rogosnitzky M, Branch S. Gadolinium-based contrast agent toxicity: A review of known and proposed mechanisms. Biometals 2016;29:365-376.
    1. Errante Y, Cirimele V, Mallio CA, di Lazzaro V, Zobel BB, Quattrocchi CC. Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered gadodiamide in patients with normal renal function, suggesting dechelation. Invest Radiol 2014;49:685-690.
    1. McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 2015;275:772-782.