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Gadolinium Brain

Julian A Rees, Gauthier J-P Deblonde, Dahlia D An, Camille Ansoborlo, Stacey S Gauny, Rebecca J Abergel
Several MRI contrast agent clinical formulations are now known to leave deposits of the heavy metal gadolinium in the brain, bones, and other organs of patients. This persistent biological accumulation of gadolinium has been recently recognized as a deleterious outcome in patients administered Gd-based contrast agents (GBCAs) for MRI, prompting the European Medicines Agency to recommend discontinuing the use of over half of the GBCAs currently approved for clinical applications. To address this problem, we find that the orally-available metal decorporation agent 3,4,3-LI(1,2-HOPO) demonstrates superior efficacy at chelating and removing Gd from the body compared to diethylenetriaminepentaacetic acid, a ligand commonly used in the United States in the GBCA Gadopentetate (Magnevist)...
March 13, 2018: Scientific Reports
João Ferreira, Ana Franco, Tiago Teodoro, Miguel Coelho, Luísa Albuquerque
Vernet syndrome is a unilateral palsy of glossopharyngeal, vagus, and accessory nerves. Varicella zoster virus (VZV) infection has rarely been described as a possible cause. A 76-year-old man presented with 1-week-long symptoms of dysphonia, dysphagia, and weakness of the right shoulder elevation, accompanied by a mild right temporal parietal headache with radiation to the ipsilateral ear. Physical examination showed signs compatible with a right XI, X, and XI cranial nerves involvement and also several vesicular lesions in the right ear's concha...
March 12, 2018: Journal of Neurovirology
Fabian Aus dem Siepen, Christian Baumgärtner, Matthias Müller-Henessen, Florian André, Daniel Messroghli, Marco Ochs, Johannes Riffel, Evangelos Giannitsis, Hugo A Katus, Matthias G Friedrich, Sebastian J Buss
Background: Myocardial T1 and extracellular volume (ECV) derived from cardiovascular MRIs are more and more widely accepted as important markers for diagnosis, risk prediction and monitoring of cardiac disease. Yet data regarding long-term stability of myocardial T1 mapping are lacking. The aim of this study was to investigate the long-term stability of native and postcontrast T1 mapping values in healthy volunteers. Methods: 18 strictly selected healthy volunteers (52±10 years, 12 men) were studied on a Philips Achieva 1...
2018: Open Heart
Ryan T Fitzgerald, Vikas Agarwal, Jenny K Hoang, Frank Gaillard, Andrew Dixon, Emanuel Kanal
RATIONALE AND OBJECTIVES: Brain deposition of gadolinium following the administration of gadolinium-based contrast agents (GBCAs) was initially reported in 2014. Gadolinium deposition is now recognized as a dose-dependent consequence of exposure. The potential clinical implications are not yet understood. The purpose of this study was to determine radiologists' reporting practices in response to gadolinium deposition. MATERIALS AND METHODS: An electronic survey querying radiologists' practices regarding gadolinium deposition was distributed by Radiopaedia...
February 7, 2018: Current Problems in Diagnostic Radiology
Richard Pullicino, Mark Radon, Shubhabrata Biswas, Maneesh Bhojak, Kumar Das
Over the past 3 years, gadolinium-based contrast agents have been linked to MRI signal changes in the brain, which have been found to be secondary to gadolinium deposition in the brain, particularly in the dentate nuclei and globus pallidus even in patients having an intact blood-brain barrier and a normal renal function. This tends to occur more in linear agents than with macrocyclic agents. Nonetheless, there has been no significant evidence that this has any clinical consequence. We reviewed the current evidence related to this new phenomenon and the precautionary approach taken by regulatory agencies...
March 9, 2018: Clinical Neuroradiology
Nghi C Nguyen, Melissa K Yee, Abuzar M Tuchayi, John M Kirkwood, Hussein Tawbi, James M Mountz
Introduction: This pilot study aimed at exploring the utility of the proliferation tracer F-18 fluorothymidine (FLT) and positron-emission tomography (PET)/magnetic resonance imaging (MRI) (FLT-PET/MRI) for early treatment monitoring in patients with melanoma brain metastasis (MBM) who undergo targeted therapy or immunotherapy. Material and Methods: Patients with newly diagnosed MBM underwent baseline and follow-up FLT-PET/MRI scans at 3-4 weeks of targeted therapy or immunotherapy...
2018: Frontiers in Oncology
Luca Pasquini, Antonio Napolitano, Emiliano Visconti, Daniela Longo, Andrea Romano, Paolo Tomà, Maria Camilla Rossi Espagnet
In recent years, gadolinium-based contrast agents have been associated with different types of toxicity. In particular, nephrogenic systemic fibrosis, a progressive sclerotic-myxedematous systemic disease of unknown etiology, is related to gadolinium-based contrast agent administration in patients with kidney dysfunction. More recently, evidence of magnetic resonance signal intensity changes on pre-contrast T1-weighted images after multiple gadolinium-based contrast agent administrations resulted in the hypothesis of gadolinium brain accumulation in patients with normal renal function, subsequently confirmed in pathological samples...
March 5, 2018: CNS Drugs
Satoshi Namitome, Seigo Shindo, Kuniyasu Wada, Tadashi Terasaki, Makoto Nakajima, Yukio Ando
A 14-year-old girl developed transient disturbance of consciousness, dysarthria, and clumsiness of the right upper limb 4 months after herpes zoster ophthalmicus. Brain MRI showed acute cerebral infarction in the left middle cerebral artery (MCA) territory. CT angiography demonstrated mild stenosis in the top of the left internal carotid artery and the proximal side of the MCA. Cerebrospinal fluid (CSF) examination showed slightly mononuclear pleocytosis (6/μl). Titer of the anti-varicella zoster virus (VZV) IgG antibodies in CSF was increased, and gadolinium-enhanced brain MRI (T1 -weighted imaging) revealed enhancement of the vessel walls at the stenotic lesions...
February 28, 2018: Rinshō Shinkeigaku, Clinical Neurology
Lei Pei, Jingjing Xu, Minming Zhang
OBJECTIVE: To explore the correlation between the number of previous gadolinium-based contrast agent administrations and high signal intensity (SI) in the cerebrum nucleus on unenhanced T1 -weighted magnetic resonance images. METHODS: Thirty-nine patients who previously underwent at least three contrast-enhanced brain MRI examinations were enrolled in the study. The right globus pallidus, right thalamus, right dentate nucleus, pons and white matter of right frontal lobe were selected as region of interests (ROI)...
May 25, 2017: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
Rongtao Zhu, Weizhi Guo, Hongbo Fang, Shengli Cao, Bing Yan, Sanyang Chen, Kaiming Zhang, Shuijun Zhang
Brain death (BD) impairs liver function in potential donors, and is associated with hormonal and metabolic changes or molecular effects with pro‑inflammatory activation. Resident macrophages in the liver named Kupffer cells (KCs) undergo pro‑ or anti‑inflammatory pathway activation, which affects liver function. However, the role of the KCs in liver dysfunction following BD has not been fully elucidated. The aim of the present study was to investigate the role of KCs in liver dysfunction in the context of BD and the effects of their inhibition by gadolinium chloride (GdCl3)...
February 27, 2018: Molecular Medicine Reports
Hannah Aucott, Johan Lundberg, Henna Salo, Lena Klevenvall, Peter Damberg, Lars Ottosson, Ulf Andersson, Staffan Holmin, Helena Erlandsson Harris
BACKGROUND: Neuroinflammation triggered by infection or trauma is the cause of central nervous system dysfunction. High-mobility group box 1 protein (HMGB1), released from stressed and dying brain cells, is a potent neuroinflammatory mediator. The proinflammatory functions of HMGB1 are tightly regulated by post-translational redox modifications, and we here investigated detailed neuroinflammatory responses induced by the individual redox isoforms. METHODS: Male Dark Agouti rats received a stereotactic injection of saline, lipopolysaccharide, disulfide HMGB1, or fully reduced HMGB1, and were accessed for blood-brain barrier modifications using magnetic resonance imaging (MRI) and inflammatory responses by immunohistochemistry...
February 23, 2018: Journal of Innate Immunity
Justyna Rogowska, Ewa Olkowska, Wojciech Ratajczyk, Lidia Wolska
Since the 1980 s, gadolinium based contrast agents (GBCA) are routinely used in magnetic resonance imaging (MRI) as stable chelates of the Gd3+ ion, without toxic effects. Generally, GBCAs are considered as some of the safest contrast agents. However, it has been observed that they can accumulate in patients tissue, bone and probably in brain (causing nephrogenic systemic fibrosis in patients with kidney failure, insufficiency and disturbance of calcium homeostasis in the organism). The GBCAs are predominantly removed renally without metabolization...
February 23, 2018: Environmental Toxicology and Chemistry
Muhammad Atif Naveed, Pradeep Goyal, Ajay Malhotra, Xiang Liu, Sonali Gupta, Manisha Mangla, Rajiv Mangla
Purpose We explored whether advanced magnetic resonance (MR) imaging techniques could grade oligodendrogliomas. Methods Forty patients (age 9-61 years) with oligodendroglial tumors were selected. There were 23 patients with World Health Organization grade II (group 1) and 17 patients with grade III (group 2) tumors. Apparent diffusion coefficient (ADC) maps were calculated by b values of 0 and 1000 s/mm2 . Dynamic susceptibility contrast (DSC) images were obtained during the first pass of a bolus of gadolinium-based contrast...
January 1, 2018: Neuroradiology Journal
Caroline Bund, Benoît Lhermitte, Jérôme De Seze, Stéphane Kremer, Izzie-Jacques Namer
A 64-year-old man was admitted for expressive aphasia with lack of words. He had been diagnosed with Waldenström 4 years before. At that time, he received 6 cycles of single-agent fludarabine, and remission was obtained. Because of acute expressive aphasia, he underwent brain MRI, which showed frontoparietal and insular subcortical gadolinium enhancement; Bing-Neel syndrome was suspected. Fronto-temporo-insular hypometabolism and left parietal hypometabolism were highlighted on FDG PET/CT. Structural and functional brain imaging revealed impairment of brain areas due to white matter changes and reinforced the diagnosis...
February 21, 2018: Clinical Nuclear Medicine
R Pullicino, K Das
Gadolinium-based contrast agents have greatly expanded the capability of magnetic resonance imaging and have been used extensively in neuroradiology over the past 30 years. When initially developed they were thought to be relatively harmless; it was later discovered they are associated with nephrogenic systemic fibrosis and should be used with caution in certain patient groups, especially those with renal failure. Lately it has been found that the use of these contrast agents may result in deposition of gadolinium in the brain even in patients with an intact blood-brain barrier...
September 2017: Journal of the Royal College of Physicians of Edinburgh
Val M Runge, Johannes T Heverhagen
The question of improved relaxivity, and potential efficacy therein, for a next-generation of magnetic resonance gadolinium chelates with extracellular distribution and renal excretion, which could also be viewed from the perspective of dose, is addressed on the basis of historical development, animal experimentation, and human trials. There was no systematic evaluation that preceded the choice of 0.1 mmol/kg as the standard dose for human imaging with the gadolinium chelates. In part, this dose was chosen owing to bloodwork abnormalities seen in phase I and phase II studies...
February 17, 2018: Investigative Radiology
Michael Karsy, Daxa M Patel, Robert J Bollo
Magnetic resonance imaging-guided stereotactic laser ablation of intracranial targets, including brain tumors, has expanded dramatically over the past decade, but there have been few reports of complications, especially those occurring in a delayed fashion. Laser ablation of subependymal giant cell astrocytomas (SEGAs) is an attractive alternative to maintenance immunotherapy in some children with tuberous sclerosis complex (TSC); however, the effect of treatment on disease progression and the nature and frequency of potential complications remains largely unknown...
February 16, 2018: Journal of Neurosurgery. Pediatrics
Etsuko Hattori, Akinori Miyakoshi, Kohichi Go, Toshiharu Aotake, Yoshiyuki Kawakami, Masato Sakamoto, Takeshi Kawauchi, Yuuki Oichi, Noritaka Sano, Makoto Hayase, Makoto Ohta, Yuki Hirose, Hiroki Toda
OBJECTIVE: Molecularly targeted therapy has been adopted to treat a number of cancers. Bevacizumab, a recombinant humanized monoclonal antibody against vascular endothelial growth factor, is a representative agent used in molecularly targeted therapeutic regimens. However, the therapeutic effect of bevacizumab for the treatment of brain metastases remains unknown. We report the clinical effects of low dose bevacizumab(≤2.5mg/kg/week)to treat recurrent brain metastases. METHODS: We retrospectively analyzed patients with brain metastases who had been treated with bevacizumab between 2012 and 2016 at our institution...
February 2018: No Shinkei Geka. Neurological Surgery
Woo Hyeon Lim, Seung Hong Choi, Roh-Eul Yoo, Koung Mi Kang, Tae Jin Yun, Ji-Hoon Kim, Chul-Ho Sohn
OBJECTIVE: This study evaluated the possibility of accelerated gadolinium accumulation in irradiated brain parenchyma where the blood-brain barrier was weakened. METHODS: From January 2010 to June 2015, 44 patients with supratentorial glioblastoma were retrospectively identified who underwent pre- and post-radiation brain MR imaging, including R1 mapping. The mean dose of administered gadobutrol (Gadovist, Bayer, Germany) was 5.1 vials. Regions of interest (ROIs) were drawn around tumors that were located within 50-100% iso-dose lines of maximum radiation dose...
2018: PloS One
Enhao Gong, John M Pauly, Max Wintermark, Greg Zaharchuk
BACKGROUND: There are concerns over gadolinium deposition from gadolinium-based contrast agents (GBCA) administration. PURPOSE: To reduce gadolinium dose in contrast-enhanced brain MRI using a deep learning method. STUDY TYPE: Retrospective, crossover. POPULATION: Sixty patients receiving clinically indicated contrast-enhanced brain MRI. SEQUENCE: 3D T 1 -weighted inversion-recovery prepped fast-spoiled-gradient-echo (IR-FSPGR) imaging was acquired at both 1...
February 13, 2018: Journal of Magnetic Resonance Imaging: JMRI
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