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Re-post - >>> 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

https://pubs.rsna.org/doi/10.1148/radiol.2015142690

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Original Research
Neuroradiology

Tomonori Kanda , Toshio Fukusato, Megumi Matsuda, Keiko Toyoda, Hiroshi Oba, Jun’ichi Kotoku, Takahiro Haruyama, Kazuhiro Kitajima, Shigeru Furui

Author Affiliations
Published Online:May 5 2015https://doi.org/10.1148/radiol.2015142690

Abstract
Even in subjects without severe renal dysfunction, gadolinium-based contrast agent administration causes gadolinium accumulation in the brain, especially in the dentate nucleus and globus pallidus.

Purpose
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).

Materials and 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 m2) 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).

Conclusion
Even in subjects without severe renal dysfunction, GBCA administration causes gadolinium accumulation in the brain, especially in the DN and GP.

© RSNA, 2015

Article History
Received November 20, 2014; revision requested January 5, 2015; revision received February 8; accepted March 2; final version accepted March 24.
Published online: May 05 2015
Published in print: July 2015


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