T1 signal intensity changes in dentate nucleus and lentiform nucleus on unenhanced T1-weighted MR images after intravenous administration of linear and macrocyclic contrast gadolinium based agents

Spyridoula Gyftomitrou, Theodosios Passas, Leonidas Kougias, Konstantia Tziola, Christos Arvanitis, Pavlos Tsikouriadis, Triantafyllos Geroukis


Purpose: Our aim is to establish a connection between intravenous injections of gadolinium based contrast agents (GBCAs) and T1 signal intensity increase in dentate nucleus and lentiform nucleus.

Material and Methods: The population of the study consisted of 166 patients who underwent brain MRI (456 total MRI scans) after iv injection of a gadolinium based contrast agent (linear: Gadodiamide, Gadopentetic acid/Gadopentate dimeglumine and macrocyclic: Gadoteric acid, Gadobutrol), at least twice between September 2013 and April 2017, and a control group which consisted of 50 patients who had never received GBCAs intravenously. Signal intensity was measured in the lentiform nucleus and dentate nucleus bilaterally on unenhanced T1weighted images for all the groups. Statistical analysis of the acquired measurements was performed.

Results: Patients who received Gadodiamide presented a mean T1 signal increase of 46.5 units (to SD ± 74) of the initial dentate nucleus signal; compared the control group the difference was statistically significant (p=0.034). A statistically significant T1 signal increase in lentiform nucleus is associated to administration of Gadobutrol, with a mean signal intensity increase of 23.6 units (SD ± 47.9) and statistical significance (p=0.43). No increase in signal intensity was noted for Gadoteric acid and Gadopentetic acid.

Conclusions: Intravenous administration of Gadodiamide and Gadobutrol results in signal intensity increase in lentiform nucleus and dentate nucleus.


Magnetic Resonance Imaging; Gadolinium; Contrast Media; Dentate Nucleus; Lentiform Nucleus

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Ramalho J, Ramalho M. Gadolinium Deposition and Chronic Toxicity. Magn Reson Imaging Clin N Am 2017; 25(4): 765-778.

Gulani V, Calamante F, Shellock F, et al. Gadolinium deposition in the brain: summary of evidence and recommendations. Lancet Neurol 2017; 16: 564-570.

Kanda T, Osawa M, Oba H, et al. High signal intensity in dentate nucleus on unenhanced t1-weighted MR images: association with linear versus macrocyclic gadolinium chelate administration. Radiology 2015; 275: 803-809.

Errante Y, Cirimele V, Mallio CA, et al. Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered Gadodiamide in patients with normal renal function, suggesting dechelation. Invest Radiol 2014; 49(10): 685-690.

Frenzel T, Lengsfeld P, Schirmer H, et al. Stability of gadolinium-based magnetic resonance imaging contrast agents in human serum at 37 degrees C. Invest Radiol 2008; 43: 817-828.

Radbruch A, Weberling LD, Kieslich PJ, et al. Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent. Radiology 2015; 275: 783-791.

Radbruch A, Weberling LD, Kieslich PJ, et al. High-signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted images: evaluation of the macrocyclic gadolinium-based contrast agent Gadobutrol. Invest Radiol 2015; 50(12): 805-810.

Stojanov DA, Aracki-Trenkic A, Vojinovic S, et al. Increasing signal intensity within the dentate nucleus and globus pallidus on unenhanced T1W magnetic resonance images in patients with relapsing-remitting multiple sclerosis: correlation with cumulative dose of a macrocyclic gadolinium-based contrast agent, Gadobutrol. Eur Radiol 2015; 26(3): 807-815.

Splendiani A, Perri M, Marsecano C, et al. Effects of serial macrocyclic-based contrast materials gadoterate meglumine and Gadobutrol administrations on gadolinium-related dentate nuclei signal increases in unenhanced T1-weighted brain: a retrospective study in 158 multiple sclerosis (MS) patients. Radiol Med 2018; 123(2): 125-134.

Bellin MF, Van Der Molen AJ. Extracellular gadolinium-based contrast media: an overview. Eur J Radiol 2008; 66: 160-167.

McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 2015; 275: 772-782.

Kanda T, Ishii K, Kawaguchi H, et al. High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology 2014; 270: 834-841.

Zhang Y, Cao Y, Shih GL, et al. Extent of signal hyperintensity on unenhanced T1-weighted brain MR images after more than 35 administrations of linear gadolinium-based contrast agents. Radiology 2017; 282: 516-525.

Radbruch A, Haase, R, Kieslich, PJ. No signal intensity increase in the dentate nucleus on unenhanced T1-weighted MR images after more than 20 serial injections of macrocyclic gadolinium-based contrast agents. Radiology 2017; 282: 699-707.

Radbruch A, Weberling LD, Kieslich PJ, et al. Intraindividual analysis of signal intensity changes in the dentate nucleus after consecutive serial applications of linear and macrocyclic gadolinium-based contrast agents. Invest Radiol 2016; 51: 683-690.

Runge V. critical questions regarding gadolinium deposition in the brain and body after injections of the gadolinium-based contrast agents, safety, and clinical recommendations in consideration of the EMA’s pharmacovigilance and risk assessment committee recommendation for suspension of the marketing authorizations for 4 linear agents. Invest Radiol 2017; 52: 317-323.

Smith TE, Steven A, Bagert BA. Gadolinium deposition in neurology clinical practice. Ochsner Journal 2019; 19 (1): 17-25.

DOI: http://dx.doi.org/10.36162/hjr.v4i2.267


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