Do Gadolinium-Based Contrast Agents Affect18F-FDG PET/CT Uptake in the Dentate Nucleus and the Globus Pallidus? A Pilot Study.
Gadolinium is toxic and to avoid its deposition in tissues, it must be chemically bonded with nonmetal ions to facilitate its excretion by the kidneys. High signal intensity in the dentate nucleus (DN) and globus pallidus (GP) on unenhanced T1-weighted MR images has been both morphologically and pathologically linked to gadolinium-based contrast agent (GBCA) retention in the brain. The purpose of this study was to determine whether repeated administrations of GBCA would affect the uptake of18F-FDG in the DN and GP on PET/CT.Methods:Three hundred seventy-six patients who underwent both contrast-enhanced MR (CE MR) of the brain and PET/CT from January 2004 to October 2015 were identified. Patients with a history of brain irradiation or hepatic or renal disease were excluded. The SUVmaxwas measured in the DN and GP on the PET/CT scan in patients who had 3-6 successive CE MR brain studies. The SUVmaxof the corresponding areas in the control group of patients who had not undergone previous CE MR and who had a normal, unenhanced MR finding of the brain was also measured. A Wilcoxon 2-sample test was used for statistical analysis.Results:Fifteen of 376 (4%) patients (mean age ± SD, 54 ± 18 y; 10 men and 5 women) were included in the subject group, and 15 patients (mean age ± SD, 36 ± 9 y; 11 men and 4 women) were included in the control group. The median DN SUVmaxwas significantly lower in the subject group than in the control group (5.4 vs. 6.4, respectively;P= 0.021). Similarly, the median GP SUVmaxwas significantly lower in the subject group than in the control group (8.8 vs. 12.1, respectively;P= 0.003).Conclusion:The median SUVmaxin the DN and GP was 16% and 27% lower, respectively, in patients who received GBCAs than in those who had not received GBCAs, possibly related to gadolinium deposition in these areas.
Medical Imaging and Radiation Therapeutics, Saint Louis University, St. Louis, Missouri.
Kyle
K
Bauer
Medical Imaging and Radiation Therapeutics, Saint Louis University, St. Louis, Missouri.
Alaina
A
Lathrum
Division of Nuclear Medicine, Saint Louis University, St. Louis, Missouri.
Osama
O
Raslan
Doisy College of Health Sciences, Saint Louis University, St. Louis, Missouri; and.
Patrick V
PV
Kelly
Neuroradiology Division, Department of Radiology, Saint Louis University, St. Louis, Missouri.
Yihua
Y
Zhou
Medical Imaging and Radiation Therapeutics, Saint Louis University, St. Louis, Missouri.
Debra
D
Hewing
Medical Imaging and Radiation Therapeutics, Saint Louis University, St. Louis, Missouri.
Crystal
C
Botkin
Medical Imaging and Radiation Therapeutics, Saint Louis University, St. Louis, Missouri.
James A
JA
Turner
Division of Nuclear Medicine, Saint Louis University, St. Louis, Missouri mosman@slu.edu.
Medhat
M
Osman
D000328:Adult; D001692:Biological Transport / Q000187:drug effects; D002529:Cerebellar Nuclei / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism*; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D005682:Gadolinium / Q000494:pharmacology*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D000072078:Positron Emission Tomography Computed Tomography; D012189:Retrospective Studies
D003287:Contrast Media; D019788:Fluorodeoxyglucose F18; D005682:Gadolinium
dentate nucleus; gadolinium; globus pallidus