title: Pediatric Brain: No Increased Signal Intensity in the Dentate Nucleus on Unenhanced T1-weighted MR Images after Consecutive Exposure to a Macrocyclic Gadolinium-based Contrast Agent.
abstract: Purpose To determine the effect of at least five serial injections of the macrocyclic gadolinium-based contrast agent (GBCA) gadoterate meglumine on the signal intensity (SI) of the dentate nucleus (DN) of the pediatric brain on nonenhanced T1-weighted magnetic resonance (MR) images. Materials and Methods In this retrospective, institutional review board-approved study, 41 pediatric patients (age range, 3-17 years) who were imaged in at least five consecutive 1.5-T MR examinations with the exclusive use of gadoterate meglumine (plus a final additional nonenhanced MR imaging examination) were evaluated. SI ratio differences between the first and last MR examination were calculated for DN-to-pons and DN-to-middle cerebellar peduncle (MCP) ratios in a region-of-interest-based analysis, and one-sample t tests were used to examine if the SI ratio differences differed from 0. Bayes factors were calculated to quantify the strength of evidence for each test. Results Patients underwent a mean of 8.6 ± 3.9 GBCA administrations (mean accumulated dose, 32.07 mmol ± 17.62, with an average of 16.7 weeks ± 7.9 between every administration). Both ratio differences did not differ significantly from 0 (DN-to-pons ratio: -0.0012 ± 0.0101, P = .436; DN-to-MCP ratio: 0.0007 ± 0.0088, P = .604), and one-sided Bayes factors provided substantial evidence against an SI ratio increase (0.10 for DN-to-pons ratio; 0.27 for DN-to-MCP ratio). Conclusion No increase of the SI in the DN was found after a mean of 8.6 serial injections of the macrocyclic GBCA gadoterate meglumine in pediatric patients, confirming previous studies that did not find this effect after serial injections of macrocyclic GBCAs in adults.©RSNA, 2017.
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Alexander
authors.initials: A
authors.lastname: Radbruch
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Robert
authors.initials: R
authors.lastname: Haase
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Philipp
authors.initials: P
authors.lastname: Kickingereder
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Philipp
authors.initials: P
authors.lastname: Bäumer
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bickelhaupt
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Daniel
authors.initials: D
authors.lastname: Paech
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wick
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Angelika
authors.initials: A
authors.lastname: Seitz
authors.affiliation: From the Department of Neuroradiology (A.R., R.H., P.K., P.B., A.S., M.B.) and Neurology Clinic (W.W.), University of Heidelberg Medical Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany (A.R., R.H., P.B., S.B., D.P., H.P.S.); Department of Radiology, German Cancer Consortium (DKTK), Heidelberg, Germany (A.R., R.H.); and Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany (A.R.).
authors.forename: Martin
authors.initials: M
authors.lastname: Bendszus
mesh_terms: D000293:Adolescent; D001927:Brain Diseases / Q000000981:diagnostic imaging*; D002529:Cerebellar Nuclei / Q000000981:diagnostic imaging*; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000008:administration & dosage*; D059906:Neuroimaging; D009942:Organometallic Compounds / Q000008:administration & dosage*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine