Effects of gadopentetate dimeglumine administration after osmotic blood-brain barrier disruption: toxicity and MR imaging findings.
Osmotic blood-brain barrier disruption with intraarterial chemotherapy has been shown to be beneficial in the treatment of malignant brain tumors. Imaging blood-brain barrier disruption is necessary to document the extent and degree of disruption and to correlate disruption with drug delivery. The present study evaluated blood-brain barrier disruption with gadopentetate dimeglumine-enhanced MR imaging and the associated toxicity of gadopentetate dimeglumine administration. Blood-brain barrier disruption was performed in seven dogs for imaging analysis and 17 dogs for toxicity evaluation. In the absence of gadopentetate dimeglumine administration, blood-brain barrier disruption could not be imaged. Enhanced MR imaging with a gadopentetate dimeglumine dose of 0.1 mmol/kg provided good images of disruption at an imaging time of 3 hr after disruption. However, when gadopentetate dimeglumine was given intravenously in conjunction with osmotic blood-brain barrier disruption, there was a statistically significant (p = .02) dose-dependent increase in the frequency of seizures, with 50% of the animals who received 0.1 mmol/kg and 75% who received 0.2 mmol/kg developing delayed seizures. Our findings show that, as with ionized iodinated CT contrast agents, gadopentetate dimeglumine is associated with toxicity when used in conjunction with osmotic blood-brain barrier disruption in dogs. Such toxicity may be a contraindication to the use of gadopentetate dimeglumine for monitoring patients with osmotically induced disruption of the blood-brain barrier.
Roman-Goldstein
S M
SM
Department of Diagnostic Radiology, Oregon Health Sciences University, Portland 97201.
Barnett
P A
PA
McCormick
C I
CI
Ball
M J
MJ
Ramsey
F
F
Neuwelt
E A
EA
D000818:Animals; D001812:Blood-Brain Barrier; D001921:Brain / Q000187:drug effects / Q000473:pathology; D003287:Contrast Media; D004285:Dogs; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D019786:Gadolinium DTPA; D008279:Magnetic Resonance Imaging; D008536:Meglumine / Q000008:administration & dosage* / Q000506:poisoning; D009942:Organometallic Compounds / Q000008:administration & dosage* / Q000506:poisoning; D009995:Osmosis; D004369:Pentetic Acid / Q000008:administration & dosage* / Q000506:poisoning
D003287:Contrast Media; D004338:Drug Combinations; D009942:Organometallic Compounds; D008536:Meglumine; D004369:Pentetic Acid; D019786:Gadolinium DTPA