Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up
Background/Aim. Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, the...
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| Format: | Article |
| Language: | English |
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Military Health Department, Ministry of Defance, Serbia
2023-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502300018K.pdf |
| _version_ | 1797393699903111168 |
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| author | Kostić Dejan Mišović Miroslav Vučković Filip Crevar Đuro Sekulić Igor Georgievski-Brkić Biljana Kostić Smiljana Dinčić Evica |
| author_facet | Kostić Dejan Mišović Miroslav Vučković Filip Crevar Đuro Sekulić Igor Georgievski-Brkić Biljana Kostić Smiljana Dinčić Evica |
| author_sort | Kostić Dejan |
| collection | DOAJ |
| description | Background/Aim. Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, there is still no strong clinical evidence of the adverse effects of GBCAs on the brain parenchyma. The aim of the study was to determine the existence of gadolinium deposits in the brain of patients with relapsing-remitting multiple sclerosis after a ten-year follow-up period. During this period, the patients have regularly, each year, undergone magnetic resonance imaging (MRI) with the administration of gadolinium contrast (gadopentetate dimeglumine – Magnevist®) in order to follow the course of the disease. Methods. A cohort of 20 patients was formed for the purpose of this study. The ratio of the values of the signal intensity (SI) of different regions of the brain-to-cerebrospinal fluid (CSF) was com-pared for each patient on the initial MRI examination and the MRI examination ten years later. Results. Frontal cortex-to-CSF (p < 0.01), occipital cortex-to-CSF (p < 0.01), the white matter of the corona radiata-to-CSF (p < 0.01), parietal cortex-to-CSF (p < 0.05), thalamus-to-CSF (p = 0.051), putamen-to-CSF (p = 0.06), and anterior and posterior limb of the capsula interna-to-CSF (p = 0.062) SI ratios increased after multiple gadopentetate administrations. An increase in the absolute values of the T1- weighted (T1W) signal in three-quarters of patients was registered in the frontal and occipital cortex and cerebellar hemispheres. A slightly smaller increase in SI, but still greater than 55–65%, was registered in structures of the parietal cortex, putamen, cornu anterior and posterior of the capsula interna, corpus callosum (CC) splenium, pons, thalamus, nucleus caudatus, substantia nigra, CC genu, and temporal cortex. Conclusion. In the cohort of 20 patients, there was a statistically significant increase in SI in the pre-contrast T1W sequence in the following structures: frontal, parietal, and occipital cortex, as well as supratentorial white matter. This result speaks in favor of the existence of chronic accumulation of gadolinium contrast agent gadopentetate dimeglumine in brain structures. |
| first_indexed | 2024-03-09T00:07:35Z |
| format | Article |
| id | doaj.art-dc2c30016c75493795068c83e04bef6b |
| institution | Directory Open Access Journal |
| issn | 0042-8450 2406-0720 |
| language | English |
| last_indexed | 2024-03-09T00:07:35Z |
| publishDate | 2023-01-01 |
| publisher | Military Health Department, Ministry of Defance, Serbia |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj.art-dc2c30016c75493795068c83e04bef6b2023-12-12T13:09:30ZengMilitary Health Department, Ministry of Defance, SerbiaVojnosanitetski Pregled0042-84502406-07202023-01-0180973674210.2298/VSP220314018K0042-84502300018KGadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-upKostić Dejan0https://orcid.org/0000-0002-4420-6348Mišović Miroslav1https://orcid.org/0000-0002-4803-3341Vučković Filip2Crevar Đuro3Sekulić Igor4https://orcid.org/0000-0002-8016-5184Georgievski-Brkić Biljana5Kostić Smiljana6Dinčić Evica7Military Medical Academy, Institute of Radiology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Institute of Radiology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaMilitary Medical Academy, Institute of Radiology, Belgrade, Serbia + University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, SerbiaSpecial Hospital for Cerebrovascular Diseases “Sveti Sava”, Department of Radiology Diagnostics, Belgrade, SerbiaUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic of Neurology, Belgrade, Serbia University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia + Military Medical Academy, Clinic of Neurology, Belgrade, Serbia Background/Aim. Since 2014 and the publication of the results of the first study on the accumulation of gadolinium contrast, we have witnessed a growing body of evidence on the deposition and retention of gadolinium in the brain after the use of gadolinium-based contrast agents (GBCAs). However, there is still no strong clinical evidence of the adverse effects of GBCAs on the brain parenchyma. The aim of the study was to determine the existence of gadolinium deposits in the brain of patients with relapsing-remitting multiple sclerosis after a ten-year follow-up period. During this period, the patients have regularly, each year, undergone magnetic resonance imaging (MRI) with the administration of gadolinium contrast (gadopentetate dimeglumine – Magnevist®) in order to follow the course of the disease. Methods. A cohort of 20 patients was formed for the purpose of this study. The ratio of the values of the signal intensity (SI) of different regions of the brain-to-cerebrospinal fluid (CSF) was com-pared for each patient on the initial MRI examination and the MRI examination ten years later. Results. Frontal cortex-to-CSF (p < 0.01), occipital cortex-to-CSF (p < 0.01), the white matter of the corona radiata-to-CSF (p < 0.01), parietal cortex-to-CSF (p < 0.05), thalamus-to-CSF (p = 0.051), putamen-to-CSF (p = 0.06), and anterior and posterior limb of the capsula interna-to-CSF (p = 0.062) SI ratios increased after multiple gadopentetate administrations. An increase in the absolute values of the T1- weighted (T1W) signal in three-quarters of patients was registered in the frontal and occipital cortex and cerebellar hemispheres. A slightly smaller increase in SI, but still greater than 55–65%, was registered in structures of the parietal cortex, putamen, cornu anterior and posterior of the capsula interna, corpus callosum (CC) splenium, pons, thalamus, nucleus caudatus, substantia nigra, CC genu, and temporal cortex. Conclusion. In the cohort of 20 patients, there was a statistically significant increase in SI in the pre-contrast T1W sequence in the following structures: frontal, parietal, and occipital cortex, as well as supratentorial white matter. This result speaks in favor of the existence of chronic accumulation of gadolinium contrast agent gadopentetate dimeglumine in brain structures.https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502300018K.pdfgadolinium dtpalong term adverse effectsmagnetic resonance imagingmultiple sclerosis, relapsing-remitting |
| spellingShingle | Kostić Dejan Mišović Miroslav Vučković Filip Crevar Đuro Sekulić Igor Georgievski-Brkić Biljana Kostić Smiljana Dinčić Evica Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up Vojnosanitetski Pregled gadolinium dtpa long term adverse effects magnetic resonance imaging multiple sclerosis, relapsing-remitting |
| title | Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up |
| title_full | Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up |
| title_fullStr | Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up |
| title_full_unstemmed | Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up |
| title_short | Gadolinium deposition in the brain of patients with relapsing-remitting multiple sclerosis after 10 years of follow-up |
| title_sort | gadolinium deposition in the brain of patients with relapsing remitting multiple sclerosis after 10 years of follow up |
| topic | gadolinium dtpa long term adverse effects magnetic resonance imaging multiple sclerosis, relapsing-remitting |
| url | https://doiserbia.nb.rs/img/doi/0042-8450/2023/0042-84502300018K.pdf |
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