Gadopentetate but not gadobutrol accumulates in the dentate nucleus of multiple sclerosis patients.
BACKGROUND
Previous studies have postulated an association between dentate nucleus T1 hyperintensity and multiple sclerosis (MS)-related progressive neurodegeneration. Therefore, MS patients have been excluded from most studies investigating brain deposition of gadolinium-based contrast agents (GBCAs).


OBJECTIVE
To study the hypothesis that dentate nucleus T1 hyperintensity in MS patients is associated with GBCA administration.


METHODS
In a cohort of 97 MS patients, the dentate-to-pons signal intensity ratio (DPSIR) was calculated for 265 consecutive T1-weighted magnetic resonance (MR) scans (including sessions with and without the administration of GBCA). Patients exclusively received either gadopentetate dimeglumine (Gd-DTPA, linear) or gadobutrol (Gd-BT-DO3A, macrocyclic).


RESULTS
In patients receiving Gd-DTPA, DPSIR increased significantly between the first and the last scan (+0.009, p < 0.001), and following magnetic resonance imaging (MRI) with Gd-DTPA administration as compared to following an MRI without Gd-DTPA administration (+0.005 vs -0.001; p = 0.022). Additionally, there was a positive linear relationship between the number of Gd-DTPA administrations and the increase in DPSIR ( p = 0.017). No DPSIR increase was observed after Gd-BT-DO3A administration.


CONCLUSIONS
Dentate nucleus T1 hyperintensity in MS patients is associated with Gd-DTPA (but not Gd-BT-DO3A) administration, suggesting an alternative explanation for the association of T1 hyperintensity with disease duration and severity.
Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Ludwig
L
Schlemm
NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Claudia
C
Chien
NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany/Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.
Judith
J
Bellmann-Strobl
NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Jan
J
Dörr
NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany/Medical Image Analysis Center (MIAC AG), Basel, Switzerland.
Jens
J
Wuerfel
NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Alexander U
AU
Brandt
Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany/NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany/Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany.
Friedemann
F
Paul
NeuroCure Clinical Research Center, NeuroCure Cluster of Excellence, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Michael
M
Scheel
D000328:Adult; D002529:Cerebellar Nuclei / Q000000981:diagnostic imaging* / Q000378:metabolism; D003287:Contrast Media / Q000008:administration & dosage / Q000378:metabolism*; D016208:Databases, Factual; D005260:Female; D019786:Gadolinium DTPA / Q000008:administration & dosage / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000000981:diagnostic imaging* / Q000378:metabolism; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging* / Q000378:metabolism; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000378:metabolism*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014018:Tissue Distribution
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol; D019786:Gadolinium DTPA
Multiple sclerosis; gadolinium; magnetic resonance imaging