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- Title
Switching from linear to macrocyclic gadolinium-based contrast agents halts the relative T<sub>1</sub> -Weighted signal increase in deep gray matter of children with brain tumors: A retrospective study.
- Authors
Rowe, Selene K.; Rodriguez, Daniel; Cohen, Ellie; Grundy, Richard; Morgan, Paul S.; Jaspan, Tim; Dineen, Robert A.
- Abstract
<bold>Background: </bold>Studies have shown signal intensity (SI) changes in the brains of children exposed to repeated doses of a gadolinium-based contrast agent (GBCA).<bold>Hypothesis: </bold>The trajectory of changes in relative dentate nucleus (DN) and globus pallidus (GP) SI in children receiving multiple doses of GBCA will alter when switched from linear to macrocyclic agents.<bold>Study Type: </bold>Retrospective longitudinal.<bold>Population: </bold>Thirty-five children, age range 0.5-17.0 years, undergoing brain tumor follow-up between 2006 and 2017.<bold>Field Strength/sequence: </bold>Unenhanced T1 WI, serial scans at both 1.5T and 3T.<bold>Assessment: </bold>Regions of interest were drawn on DN, GP, and SIs normalized to middle cerebellar peduncle (DN/MCP) and cerebral white matter (GP/CWM), respectively. A change in SI ratios as a function of dose (slope gradient) calculated according to the type of contrast agent received: linear only, macrocyclic only, or switchover from linear to macrocyclic. For the latter, gradients were compared before and after switchover. The effect of anticancer treatment on slope gradient was tested.<bold>Statistical Tests: </bold>One-sample t-test or Mann-Whitney U-test for slope gradients differing from zero. Independent samples t-tests to compare slope gradient groups. Paired sample t-tests to compare slope gradients before and after switchover.<bold>Results: </bold>A significant (P < 0.05) increase in SI ratio was observed following multiple doses of linear but not macrocyclic agents: mean percentage increase per dose in SI was 0.063% vs. -0.034% for DN/MCP, and 0.078% vs. 0.004% for GP/CWM ratios. A significant (P < 0.05) change of SI trajectory in the DN/MCP ratio was demonstrated when switching from a linear to macrocyclic agent. There was no difference in SI trajectory between patients who had anticancer therapies and those who did not, DN/MCP P = 0.740; GP/BWM P = 0.694.<bold>Data Conclusion: </bold>Switching from linear to macrocyclic gadolinium-based contrast agents seems to halt the relative T1 signal increase in deep gray matter in children. Anticancer treatments appeared to have no impact on the trajectory of T1 SI.<bold>Level Of Evidence: </bold>4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2020;51:288-295.
- Subjects
BRAIN tumors; TUMORS in children; GLOBUS pallidus; RETROSPECTIVE studies; DENTATE nucleus; GRAY matter (Nerve tissue); CONTRAST media; MAGNETIC resonance imaging; CHEMICAL elements; LONGITUDINAL method
- Publication
Journal of Magnetic Resonance Imaging, 2020, Vol 51, Issue 1, p288
- ISSN
1053-1807
- Publication type
journal article
- DOI
10.1002/jmri.26831