Ten years of gadolinium retention and deposition: ESMRMB-GREC looks backward and forward

European Radiology, Год журнала: 2023, Номер 34(1), С. 600 - 611

Опубликована: Окт. 7, 2023

Язык: Английский

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Update on Gadolinium-Based Contrast Agent Safety, From the AJR Special Series on Contrast Media

American Journal of Roentgenology, Год журнала: 2023, Номер 223(3)

Опубликована: Окт. 18, 2023

Since its introduction more than 35 years ago, gadolinium-enhanced MRI has fundamentally changed medical practice. Although extraordinarily safe, gadolinium-based contrast agents (GBCAs) may have side effects. Four distinct safety considerations include acute allergiclike reactions, nephrogenic systemic fibrosis (NSF), gadolinium deposition, and symptoms associated with exposure. Acute reactions after GBCA administration are uncommon-far less iodinated agents-and, although rare, serious can occur. NSF is a rare but sclerodermalike condition occurring in patients kidney failure exposure to American College of Radiology (ACR) group I GBCAs. Group II III GBCAs considered lower risk, and, through their use, largely been eliminated. Unrelated NSF, retention trace amounts the brain other organs recognized for over decade. Deposition occurs all agents, linear appear deposit macrocyclic agents. Importantly, date, no data show any adverse biologic or clinical effects from even normal function. This article summarizes latest evidence commercially available focus on new discusses updates ACR classifications, describes approaches strengthening needed regulatory decisions.

Язык: Английский

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Clinical Safety of Gadobutrol: Review of Over 25 Years of Use Exceeding 100 Million Administrations

Investigative Radiology, Год журнала: 2024, Номер 59(9), С. 605 - 613

Опубликована: Март 1, 2024

Background The macrocyclic gadolinium-based contrast agent gadobutrol was introduced to the market in February 1998. Over last 25 years, has been administered more than 100 million times worldwide providing a wealth of data related safety. Objective aim this study perform thorough review and status update on gadobutrol's Materials Methods Safety from clinical phase II–IV program postmarketing surveillance were descriptively analyzed 1998 until December 31, 2022. Literature special at-risk populations specific safety aspects critically summarized. Results Forty-five studies recruited 7856 patients receiving gadobutrol. Drug-related adverse events (AEs) reported 3.4% serious AEs <0.1% patients. Nausea (0.7%) dysgeusia (0.4%) most AEs. All other drug-related occurred ≤0.3%. After administrations, overall drug reactions (ADRs) (including trials) rare with an reporting rate 0.0356%, hypersensitivity (0.0147%), nausea (0.0032%), vomiting (0.0025%), dyspnea (0.0010%). ADRs <0.001%. No trend for higher rates found reduced renal or liver function. Seven findings 7292 children ≤18 thereof 112 newborns/toddlers younger 2 years. Overall, 61 (0.84%) reported, including 3 ones. Adverse ≥65 years age (“elderly”) significantly less frequent A total 4 reports diagnostic consistent nephrogenic systemic fibrosis have received. causal relationship established between signs symptoms presence small amounts gadolinium body normal function after use Conclusions More administrations shown well-established benefit-risk profile any approved indication populations.

Язык: Английский

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Assessing the Association Between Gadolinium-Based Contrast Agents and Parkinson Disease: Insights From the Korean National Health Insurance Service Database

Investigative Radiology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 22, 2025

Objectives This study aimed to investigate the association between use of linear and macrocyclic gadolinium-based contrast agents (GBCAs) subsequent development Parkinson disease (PD). Methods In this retrospective cohort study, data were extracted from Korean National Health Insurance Service database, comprising 1,038,439 individuals. From population, 175,125 adults aged 40 60 years with no history brain identified. All patients including 3835 who administered GBCA at least once monitored until 2022 for onset PD. Propensity score (PS) matching was employed compare incidence PD those exposed GBCAs (either or macrocyclic) not (no-GBCA group). Results The final consisted 1175 subjects GBCAs, 2334 171,616 unexposed any After PS matching, significantly higher in group compared no-GBCA (0.9% vs 0.0%, P = 0.002) also than (0.5% 0.04%, 0.003). No significant difference observed groups. Conclusions Exposure linked an increased risk developing large population-based study. did differ GBCAs.

Язык: Английский

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Exposure to gadolinium and neurotoxicity: current status of preclinical and clinical studies

Neuroradiology, Год журнала: 2020, Номер 62(8), С. 925 - 934

Опубликована: Апрель 21, 2020

Язык: Английский

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Macrocyclic MR contrast agents: evaluation of multiple-organ gadolinium retention in healthy rats

Insights into Imaging, Год журнала: 2020, Номер 11(1)

Опубликована: Фев. 4, 2020

The purpose of this study was to compare Gd levels in rat tissues after cumulative exposure four commercially available macrocyclic gadolinium-based contrast agents (GBCAs).Sixty-five male Sprague-Dawley rats were randomized groups (n = 15 per group) and one control group 5). Animals each received 20 GBCA administrations (four week ProHance®, Dotarem®, Clariscan™, or Gadovist® for 5 consecutive weeks) at a dose 0.6 mmol/kg bodyweight. After 28-days' recovery, animals sacrificed harvested determination by inductively coupled plasma-mass spectroscopy (ICP-MS). Histologic assessment the kidney tissue performed all animals.Significantly (p ≤ 0.005; evaluations) lower noted with ProHance® than soft organs: 0.144 ± 0.015 nmol/g vs. 0.342 0.045, 0.377 0.042, 0.292 0.047 nmol/g, respectively, cerebrum; 0.151 0.039 0.315 0.04, 0.345 0.053, 0.316 0.040 cerebellum; 0.361 0.106 0.685 0.330, 0.823 0.495, 1.224 0.664 liver; 38.6 25.0 172 134, 212 121, 294 127 kidney; 0.400 0.112 0.660 0.202, 0.688 0.215, 0.999 0.442 skin. No GBCA-induced macroscopic microscopic findings kidneys.Less is retained brain body 28 days last compared other GBCAs, likely due unique physico-chemical features that facilitate more rapid efficient clearance.

Язык: Английский

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Unraveling Deep Gray Matter Atrophy and Iron and Myelin Changes in Multiple Sclerosis

American Journal of Neuroradiology, Год журнала: 2021, Номер 42(7), С. 1223 - 1230

Опубликована: Апрель 22, 2021

Modifications of magnetic susceptibility have been consistently demonstrated in the subcortical gray matter MS patients, but some uncertainties remain concerning underlying neurobiological processes and their clinical relevance. We applied quantitative mapping longitudinal relaxation rate relaxometry to clarify relative contribution atrophy iron myelin changes deep damage disability MS.Quantitative maps were computed for 91 patients 55 healthy controls from MR images acquired at 3T. Applying an external model, we estimated concentration all subjects. Subsequently, (atrophy-dependent) content (atrophy-independent) investigated globally (bulk analysis) regionally (voxel-based atlas-based thalamic subnuclei analyses). The impact observed MRI modifications was evaluated via regression models.We identified reduced (P < .001) increased pallidal mean concentrations with versus controls. Global basal ganglia did not differ between two groups, while actual depletion present thalamus .001). Regionally, showed ≤ posterior-medial regions .004), particularly pulvinar Disability predicted by volume (B = -0.341, P .02), -0.379, .005) -0.406, .009), as well -0.415, .003) .02) content, independent atrophy.Quantitative suggests atrophy-related increase within MS, along atrophy-independent reduction correlating disability. Absolute depletions may represent sensitive markers GM damage, which add MS.

Язык: Английский

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Cumulative gadodiamide administration leads to brain gadolinium deposition in early MS

Neurology, Год журнала: 2019, Номер 93(6)

Опубликована: Июль 9, 2019

Objective

Frequent administration of gadolinium-based contrast agents in multiple sclerosis (MS) may increase signal intensity (SI) unenhanced T1-weighted imaging MRI throughout the brain. We evaluated association between lifetime cumulative doses gadodiamide and increased SI within dentate nucleus (DN), globus pallidus (GP), thalamus patients with early MS.

Methods

A total 203 MS (107 baseline follow-up assessments) 262 age- sex-matched controls were included this retrospective, longitudinal, 3T MRI-reader-blinded study. Patients had disease duration <2 years at received exclusively all time points. ratio (SIR) to pons CSF lateral ventricle volume (CSF-LVV) assessed. Analysis covariance correlation analyses, adjusted for age, sex, region interest volume, used.

Results

The mean was 55.4 months, number administrations 9.2. At follow-up, 49.3% no showed DN T1 hyperintensity (p < 0.001). SIR 0.001) GP = 0.005) DN, GP, CSF-LVV higher compared associated No associations clinical outcomes severity detected over follow-up.

Conclusions

gadolinium deposition is without or radiologic correlates more aggressive disease.

Язык: Английский

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Assessment of Motor Evoked Potentials in Multiple Sclerosis

Sensors, Год журнала: 2023, Номер 23(1), С. 497 - 497

Опубликована: Янв. 2, 2023

Transcranial magnetic stimulation (TMS) is a noninvasive technique mainly used for the assessment of corticospinal tract integrity and excitability primary motor cortices. Motor evoked potentials (MEPs) play pivotal role in TMS studies. clinical guidelines, concerning use interpretation MEPs diagnosing monitoring people with multiple sclerosis (pwMS), were established almost ten years ago refer to implementation; this comprises stimulator connected standard EMG unit, positioning coil performed by using external landmarks on head. The aim present work was conduct narrative literature review MEP outcome measures research settings, assessed Methodological characteristics different system implementations (TMS without navigation, line-navigated e-field-navigated TMS); these discussed context mapping MS. An two case reports, an TMS, presented; results correspondence between MRI, EDSS classifications presented. Practical technical guiding principles improvement studies MS are discussed, suggesting e-field sense that it can improve accuracy testing providing more objective neurophysiological (e-field-navigated TMS) (Expanded Disability Status Scale—EDSS) classifications.

Язык: Английский

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Safe and Informed Use of Gadolinium-Based Contrast Agent in Body Magnetic Resonance Imaging: Where We Were and Where We Are

Journal of Clinical Medicine, Год журнала: 2024, Номер 13(8), С. 2193 - 2193

Опубликована: Апрель 10, 2024

Gadolinium-based contrast agents (GBCAs) have helped to improve the role of magnetic resonance imaging (MRI) for diagnosis and treatment diseases. There are currently nine different commercially available gadolinium-based that can be used body MRI cases, which classifiable according their structures (cyclic or linear) biodistribution (extracellular-space agents, target/specific-agents, blood-pool agents). The aim this review is illustrate effect on imaging, adverse reaction body, with goal lead proper selection in clinical contexts. When we choose between GBCAs, consider several factors: (1) safety impact; (2) diagnostic application; (3) higher relaxivity better lesion detection; (4) stability lower tissue deposit; (5) gadolinium dose/concentration volume injection; (6) pulse sequences protocol optimization; (7) contrast-to-noise ratio at 3.0 T than 1.5 T. Knowing patient's information, relevant GBCAs properties key features perform efficient high-quality examination.

Язык: Английский

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