Gadolinium Deposition within the Pediatric Brain: No Increased Intrinsic T1-Weighted Signal Intensity within the Dentate Nucleus following the Administration of a Minimum of 4 Doses of the Macrocyclic Agent Gadoteridol

AJNR Am J Neuroradiol. 2018 Sep;39(9):1604-1608. doi: 10.3174/ajnr.A5748. Epub 2018 Aug 9.

Abstract

Background and purpose: Our aim was to evaluate whether serial administration of the macrocyclic gadolinium-based contrast agent gadoteridol in children is associated with T1-weighted hyperintensity within the dentate nucleus, an imaging surrogate for gadolinium deposition.

Materials and methods: We identified a retrospective cohort of 10 patients younger than 18 years of age who underwent between 4 and 8 gadoteridol-enhanced MR imaging examinations of the brain from 2016 to 2017. For comparison, we identified a retrospective cohort of 9 pediatric patients who each underwent 6 gadodiamide-enhanced MR imaging examinations. For each examination, both dentate nuclei were contoured on unenhanced images and the mean dentate-to-pons signal intensity ratio was calculated. Dentate-to-pons signal intensity ratios from the first and last scans were compared using paired t tests.

Results: In the gadoteridol group, there was no significant change in the mean dentate-to-pons signal intensity ratio from the first to the last scan (0.99 versus 0.99, P = .59). In the gadodiamide group, there was a significant increase in the mean dentate-to-pons signal intensity ratio from the first to the last scan (0.99 versus 1.10, P = .001).

Conclusions: Repeat administration of the macrocyclic gadolinium-based contrast agent gadoteridol in children was not associated with T1-weighted dentate hyperintensity, while the repeat administration of the linear gadolinium-based contrast agent gadodiamide was associated with T1-weighted dentate hyperintensity, presumably due to gadolinium deposition.

MeSH terms

  • Adolescent
  • Cerebellar Nuclei / diagnostic imaging*
  • Child
  • Contrast Media / adverse effects
  • Contrast Media / pharmacokinetics*
  • Female
  • Gadolinium / adverse effects
  • Gadolinium / pharmacokinetics
  • Heterocyclic Compounds / adverse effects
  • Heterocyclic Compounds / pharmacokinetics*
  • Humans
  • Magnetic Resonance Imaging / adverse effects
  • Magnetic Resonance Imaging / methods*
  • Male
  • Neuroimaging / adverse effects
  • Neuroimaging / methods*
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / pharmacokinetics*
  • Retrospective Studies

Substances

  • Contrast Media
  • Heterocyclic Compounds
  • Organometallic Compounds
  • gadoteridol
  • Gadolinium