Gadolinium-based Contrast Agent Accumulates in the Brain Even in Subjects without Severe Renal Dysfunction: Evaluation of Autopsy Brain Specimens with Inductively Coupled Plasma Mass Spectroscopy.
OBJECTIVE
To use inductively coupled plasma mass spectroscopy (ICP-MS) to evaluate gadolinium accumulation in brain tissues, including the dentate nucleus (DN) and globus pallidus (GP), in subjects who received a gadolinium-based contrast agent (GBCA).


METHODS
Institutional review board approval was obtained for this study. Written informed consent for postmortem investigation was obtained either from the subject prior to his or her death or afterward from the subject's relatives. Brain tissues obtained at autopsy in five subjects who received a linear GBCA (GBCA group) and five subjects with no history of GBCA administration (non-GBCA group) were examined with ICP-MS. Formalin-fixed DN tissue, the inner segment of the GP, cerebellar white matter, the frontal lobe cortex, and frontal lobe white matter were obtained, and their gadolinium concentrations were measured. None of the subjects had received a diagnosis of severely compromised renal function (estimated glomerular filtration rate <45 mL/min/1.73 m(2)) or acute renal failure. Fisher permutation test was used to compare gadolinium concentrations between the two groups and among brain regions.


RESULTS
Gadolinium was detected in all specimens in the GBCA agent group (mean, 0.25 µg per gram of brain tissue ± 0.44 [standard deviation]), with significantly higher concentrations in each region (P = .004 vs the non-GBCA group for all regions). In the GBCA group, the DN and GP showed significantly higher gadolinium concentrations (mean, 0.44 µg/g ± 0.63) than other regions (0.12 µg/g ± 0.16) (P = .029).


CONCLUSIONS
Even in subjects without severe renal dysfunction, GBCA administration causes gadolinium accumulation in the brain, especially in the DN and GP.
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Tomonori
T
Kanda
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Toshio
T
Fukusato
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Megumi
M
Matsuda
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Keiko
K
Toyoda
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Hiroshi
H
Oba
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Jun'ichi
J
Kotoku
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Takahiro
T
Haruyama
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Kazuhiro
K
Kitajima
From the Departments of Radiology (T.K., M.M., K.T., H.O., J.K., T.H., S.F.) and Pathology (T.F.), Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan; and Department of Radiology, Kobe University School of Medicine, Kobe, Japan (K.K.).
Shigeru
S
Furui
D001344:Autopsy; D001921:Brain / Q000378:metabolism* / Q000473:pathology*; D003287:Contrast Media / Q000493:pharmacokinetics*; D005682:Gadolinium / Q000493:pharmacokinetics*; D006801:Humans; D007674:Kidney Diseases; D012720:Severity of Illness Index; D013054:Spectrophotometry, Atomic; D014018:Tissue Distribution
D003287:Contrast Media; D005682:Gadolinium