Gadolinium Toxicity: Mechanisms, Clinical Manifestations, and Nanoparticle Role

Опубликована: Апрель 29, 2025

Gadolinium-based contrast agents (GBCAs), essential for MRI, are facing renewed scrutiny due to gadolinium (Gd) retention and emerging toxicity profiles. While the link between less stable Nephrogenic Systemic Fibrosis (NSF) in renal impairment is established, deposition also observed brain, bone, skin across all GBCA classes, even patients with normal function. This finding has raised concerns led controversial concept of Gadolinium Deposition Disease (GDD). The present review synthesizes current evidence on clinical manifestations underlying mechanisms. It highlights pathways beyond traditional transmetallation, particularly endogenous nanoparticle formation as a key mechanism Gd release retention, potentially challenging stability assumptions macrocyclic agents. Structural factors (linear/macrocyclic; ionic/non-ionic) parameters (thermodynamic log K; kinetic kobs) influencing risk evaluated alongside regulatory responses. GBCAs should be viewed not inert diagnostics but complex, cumulative biological interactions. Future research focus developing non-gadolinium alternatives, validating biomarkers early detection conducting controlled trials chelation therapy efficacy. Clinicians must balance diagnostic benefits potential long-term risks, ensuring informed patient consent judicious use.

Язык: Английский

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Nano-imaging agents for brain diseases: Environmentally responsive imaging and therapy

Nano Research, Год журнала: 2023, Номер 16(12), С. 13134 - 13163

Опубликована: Ноя. 6, 2023

Язык: Английский

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Update on neuroimaging in brain tumours

Current Opinion in Neurology, Год журнала: 2021, Номер 34(4), С. 497 - 504

Опубликована: Май 11, 2021

Purpose of review To highlight some the recent advances in magnetic resonance imaging (MRI), terms acquisition, analysis, and interpretation for primary diagnosis, treatment planning, surveillance patients with a brain tumour. Recent findings The rapidly emerging field radiomics associates large numbers features clinical characteristics. In context glioma, attempts are made to correlate such tumour genotype, using so-called radiogenomics. T2-fluid attenuated inversion recovery (FLAIR) mismatch sign is an easy apply feature identifying isocitrate dehydrogenase-mutant 1p/19q intact glioma very high specificity. For resting state functional MRI (fMRI) may become as powerful task-based fMRI. Functional ultrasound has shown potential identify functionally active cortex during surgery. response assessment automated techniques have been developed. Multiple new guidelines available, including those adult paediatric leptomeningeal metastases, well on metastasis perfusion imaging. Summary Neuroimaging plays central role but still often falls short essential questions. Advanced acquisition analysis hold great promise answering questions, expected change neuroimaging patient management substantially near future.

Язык: Английский

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Iron-Based Magnetic Nanosystems for Diagnostic Imaging and Drug Delivery: Towards Transformative Biomedical Applications

Pharmaceutics, Год журнала: 2022, Номер 14(10), С. 2093 - 2093

Опубликована: Сен. 30, 2022

The advancement of biomedicine in a socioeconomically sustainable manner while achieving efficient patient-care is imperative to the health and well-being society. Magnetic systems consisting iron based nanosized components have gained prominence among researchers multitude biomedical applications. This review focuses on recent trends areas diagnostic imaging drug delivery that benefited from iron-incorporated nanosystems, especially cancer treatment, diagnosis wound care Discussion will emphasise developments MRI technology hyperthermia diagnosis, advanced material synthesis targeted, triggered transport be focus for delivery. Insights onto challenges transforming these technologies into day-to-day applications also explored with perceptions potential patient-centred healthcare.

Язык: Английский

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Headache associated with intracranial hypotension: diagnostic challenges and difficulties in everyday neurological practice

Neurologia i Neurochirurgia Polska, Год журнала: 2024, Номер 58(1), С. 21 - 30

Опубликована: Фев. 23, 2024

Low pressure of cerebrospinal fluid (CSF) is a rare cause headache, except when the patient undergoes lumbar puncture. Headache associated with low CSF i.e. intracranial hypotension causes diagnostic difficulties. Headaches related to spontaneous (SIH) pose significant challenge in everyday neurological practice. Patients headaches due SIH are usually diagnosed only after long delay. Diagnostic problems may result unnecessary invasive procedures, or even neurosurgical operations. Diagnosing attributed requires consideration several clinical scenarios, and disease's features causing primary secondary disturbances. In this review, we discuss differential diagnosis SIH-related reference accumulated knowledge, including meta-analyses, guidelines, casuistry, applicable criteria International Classification Disorders. addition, head spine magnetic resonance imaging abnormalities, which indicate hypotension.

Язык: Английский

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Diffuse glioma molecular profiling with arterial spin labeling and dynamic susceptibility contrast perfusion MRI: A comparative study

Neuro-Oncology Advances, Год журнала: 2024, Номер 6(1)

Опубликована: Янв. 1, 2024

Abstract Background Evaluation of molecular markers (IDH, pTERT, 1p/19q codeletion, and MGMT) in adult diffuse gliomas is crucial for accurate diagnosis optimal treatment planning. Dynamic Susceptibility Contrast (DSC) Arterial Spin Labeling (ASL) perfusion MRI techniques have both shown good performance classifying markers, however, their has not been compared side-by-side. Methods Pretreatment data from 90 patients diagnosed with glioma (54 men/36 female, 53.1 ± 15.5 years, grades 2–4) were retrospectively analyzed. DSC-derived normalized cerebral blood flow/volume (nCBF/nCBV) ASL-derived nCBF tumor perifocal edema analyzed available IDH-mutation (n = 67), pTERT-mutation 39), codeletion 33), MGMT promoter methylation 31) status. Cross-validated uni- multivariate logistic regression models assessed parameters’ marker detection. Results ASL DSC parameters distinguished IDH-wildtype (wt) pTERT-wt tumors mutated ones. Univariate classification was comparable ASL-nCBF DSC-nCBV IDH (maximum AUROCC 0.82 0.83, respectively) pTERT 0.70 0.81, status differentiation. The approach improved (DSC-nCBV 0.89) (ASL-nCBF 0.8 0.86) classification. However, could differentiate or Positive correlations found between DSC-nCBV/-nCBF edema. Conclusions a viable gadolinium-free replacement characterization gliomas.

Язык: Английский

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Assessing the triad of biocompatibility, medical device functionality and biological safety

Medical Devices & Sensors, Год журнала: 2020, Номер 4(1)

Опубликована: Ноя. 21, 2020

Abstract Implantable medical devices, including sensors and contrast agents, have crucial roles in diagnostic therapeutic procedures that are intended to improve quality of life. They usually very successful, but all too often they fail deliver optimal satisfaction. Device performance, which is at the heart patient safety, dependent on biocompatibility materials used, functionality devices overall biological safety system. The interdependence this triad critical properties rarely considered within testing regulatory regimes control access products clinical applications. This paper analyses details a series product types (intra‐ocular lenses, metal‐on‐metal hips, coronary artery stents, nanoparticle agents closed‐loop sensor‐drug delivery systems) identifies difficulties when connectivity between these characteristics overlooked. then addresses generic weaknesses preclinical programs changes could assist resolving problems, providing better assurance safety.

Язык: Английский

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The LEGATOS technique: A new tissue‐validated dynamic contrast‐enhanced MRI method for whole‐brain, high‐spatial resolution parametric mapping

Magnetic Resonance in Medicine, Год журнала: 2021, Номер 86(4), С. 2122 - 2136

Опубликована: Май 15, 2021

Purpose A DCE‐MRI technique that can provide both high spatiotemporal resolution and whole‐brain coverage for quantitative microvascular analysis is highly desirable but currently challenging to achieve. In this study, we sought develop validate a novel dual‐temporal (DTR) DCE‐MRI‐based methodology deriving accurate, high‐spatial parameters. Methods Dual injection DTR was performed composite high‐temporal tissue gadolinium‐based‐contrast agent (GBCA) concentration curves were constructed. The low‐spatial first‐pass GBCA then reconstructed pixel‐by‐pixel higher spatial using process call LEGATOS. accuracy of kinetic parameters (K trans , v p e ) derived LEGATOS evaluated through simulations in vivo studies 17 patients with vestibular schwannoma (VS) 13 glioblastoma (GBM). Tissue from 15 tumors examined markers microvessels (CD31) cell density (hematoxylin eosin [H&E]). Results parameter maps offered superior improved compared the use data alone, provided discrimination plasma volume vascular leakage effects other approaches, correlated vascularity ( P ≤ 0.003) 0.006). Conclusion method be used generate estimates DCE‐MRI.

Язык: Английский

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Best practices for interventional pain procedures in the setting of an iodinated contrast media shortage: A multisociety practice advisory

Interventional Pain Medicine, Год журнала: 2022, Номер 1(3), С. 100122 - 100122

Опубликована: Июль 11, 2022

Representatives from the Spine Intervention Society (SIS) and American Academy of Pain Medicine (AAPM) have developed following best practice recommendations for performance interventional pain procedures in setting an iodinated contrast media shortage. The advisory has been endorsed by SIS, AAPM, Physical Rehabilitation (AAPMR), Neuroradiology (ASNR), Radiology (ASSR), North Neuromodulation (NANS), (NASS), Interventional (SIR).

Язык: Английский

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Interference of gadolinium dechelated from MR contrast agents by calcium signaling in neuronal cells of GnRH

Journal of Cellular Physiology, Год журнала: 2020, Номер 236(3), С. 2139 - 2143

Опубликована: Авг. 1, 2020

Abstract Contrast agents (CAs) used in magnetic resonance imaging (MRI) are produced by chelating the metal gadolinium (Gd) with organic ligand molecules to form stable complexes. But, Gd 3+ may dissociate from CAs and subsequently might become toxic its environment. Besides toxicity, it inhibit calcium channels on cell membranes this action could be detrimental cells governing biological development. The aim of study was investigate interference Gd3+ dechelated signaling neuronal gonadotropin‐releasing hormone (GnRH), regulating puberty, sexual mouse GT1‐7 line as a model system, Fura‐2 based for detecting interruption intracellular transport extracellular presence released CAs; gadodiamide gadoterate meglumine, when were stimulated vitro culture exposure melatonin.The CA meglumine interfered minimally signaling, thus use is preferable standard MRI exams. release significant becomes great concern impact neurophysiology general, gonadotropin production particular, even normal patients without nephrogenic systemic fibrosis. toxicity induced influx neurons GnRH would have implications puberty reproductive functions.

Язык: Английский

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