HHS Public Access Author manuscript Author Manuscript

AJNR Am J Neuroradiol. Author manuscript; available in PMC 2017 June 01. Published in final edited form as: AJNR Am J Neuroradiol. 2016 December ; 37(12): 2340–2347. doi:10.3174/ajnr.A4891.

Pediatric patients demonstrate progressive T1-weighted hyperintensity in the dentate nucleus following multiple doses of gadolinium-based contrast agent

Author Manuscript

Donna R. Roberts1,2, Rano Chatterjee, M.D.1, Milad Yazdani, M.D.1, Barbara Marebwa1, Truman Brown, Ph.D.1, Heather Collins, Ph.D.1, Genevieve Bolles, M.D.1, Joseph M. Jenrette, M.D., Paul J. Nietert, Ph.D.4,5, and Xun Zhu, Ph.D.6 1Department

of Radiology and Radiological Sciences, Medical University of South Carolina

2Department

of Neurosciences and Neuroscience Research, Medical University of South Carolina

3Department

of Radiation Oncology, Medical University of South Carolina

4Department

of Biostatistics, Medical University of South Carolina

5Department

of Public Health Sciences, Medical University of South Carolina

6Department

of Psychology, Normal College, Shihezi University, Xinjiang, China

Abstract Author Manuscript

Background and Purpose—While there have been recent reports of brain retention of gadolinium following gadolinium-based contrast agent (GBCA) administration in adults, a retrospective series of pediatric patients has not previously been reported. We investigated the relationship between the number of prior GBCA doses and increasing T1 signal in the dentate nucleus on unenhanced T1-weighted MR imaging. We hypothesized that, despite differences in pediatric physiology and the smaller GBCA doses pediatric patients are typically administered based on weighted-adjusted dosing, the pediatric brain would also demonstrate dose dependent increasing T1 signal in the dentate nucleus.

Author Manuscript

Materials and methods—We included children with multiple GBCA administrations at our institution. A blinded-reader placed regions of interest (ROIs) within the dentate nucleus and adjacent cerebellar white matter. To eliminate reader bias, automated ROI delineation of the dentate nucleus, cerebellar white matter, and pons was also performed. Dentate to cerebellar white matter (DN/C) and dentate to pons (DN/P) ratios were compared to the number of GBCA administrations. Results—Over 20 years at our institution, 280 patients received at least 5 GBCA doses with one patient receiving 38 doses. Sixteen patients met inclusion/exclusion criteria for ROI analysis. Blinded-reader DN/C ratios were significantly associated with GBCA doses (rs=0.77, p=0.001).

Corresponding Author: Donna R. Roberts, Department of Radiology and Radiological Sciences, 96 Jonathan Lucas Street, MSC 323, Medical University of South Carolina, Charleston, SC 29425-3230, Phone: 843-792-9343, Fax: 843-792-1705, [email protected]. Presented at: ASNR 54th Annual Meeting, May 23 – 26, 2016, Washington, D.C.

Roberts et al.

Page 2

Author Manuscript

DN/P and DN/C ratios based on automated ROI placement were also significantly correlated with GBCA doses (t=4.98, p

Pediatric Patients Demonstrate Progressive T1-Weighted Hyperintensity in the Dentate Nucleus following Multiple Doses of Gadolinium-Based Contrast Agent.

While there have been recent reports of brain retention of gadolinium following gadolinium-based contrast agent administration in adults, a retrospect...
2MB Sizes 1 Downloads 3 Views