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Letter

Macrocyclic Gadolinium-Based Contrast Agents Do Not Cause Hyperintensity in the Dentate Nucleus

T. Kanda, H. Oba, K. Toyoda and S. Furui
American Journal of Neuroradiology May 2016, 37 (5) E41; DOI: https://doi.org/10.3174/ajnr.A4710
T. Kanda
aDepartment of Radiology Teikyo University School of Medicine Itabashi-ku, Japan
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H. Oba
aDepartment of Radiology Teikyo University School of Medicine Itabashi-ku, Japan
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K. Toyoda
aDepartment of Radiology Teikyo University School of Medicine Itabashi-ku, Japan
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S. Furui
aDepartment of Radiology Teikyo University School of Medicine Itabashi-ku, Japan
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We wish to comment on the December 2015 article of Ramalho et al1 entitled “Gadolinium-Based Contrast Agent Accumulation and Toxicity: An Update” in the American Journal of Neuroradiology.

First, the authors introduced the study of Stojanov et al,2 in which gadobutrol (Gadavist; Bayer Schering Pharma, Berlin, Germany) was purported to cause hyperintensity in the dentate nucleus. However, this report lacks evidence because no hyperintensity in the dentate nucleus on T1WI could be noted in their presented figure, despite being seen in all other previous reports.3 In addition, Radbruch et al4 performed a replication study in which gadobutrol showed no correlation with hyperintensity in the dentate nucleus on T1WI. An animal study5 also denied the association between gadobutrol and hyperintensity in the dentate nucleus on T1WI. These results demonstrated that macrocyclic gadolinium-based contrast agents do not cause hyperintensity in the dentate nucleus.

Second, our group6 evaluated gadolinium deposition in the dentate nucleus, internal segment of the globus pallidus, frontal cortical lobe, white matter of the frontal lobe, and cerebral white matter. McDonald et al7 evaluated gadolinium deposition in the dentate nucleus, globus pallidus, thalamus, and pons. In addition, they confirmed the presence of extensive gadolinium deposits prominently clustered within the endothelial wall by using x-ray microanalysis. In the article by Ramalho et al, our work is mistaken for the great work of McDonald et al.

These 2 articles6,7 were published at almost the same time. The submission of our article on November 20, 2014, was earlier than that of McDonald et al,7 submitted on January 5, 2015, but the acceptance was on March 24, 2015—namely, later than the acceptance of the work of McDonald et al on February 12, 2015. Our work and the work of McDonald et al progressed independently, and the work of McDonald et al was published a little earlier than our article.

References

  1. 1.↵
    1. Ramalho J,
    2. Semelka RC,
    3. Ramalho M, et al
    . Gadolinium-based contrast agent accumulation and toxicity: an update. AJNR Am J Neuroradiol 2015 Dec 10. [Epub ahead of print] doi:10.3174/ajnr.A4615 pmid:26659341
    Abstract/FREE Full Text
  2. 2.↵
    1. Stojanov DA,
    2. Aracki-Trenkic A,
    3. 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 2016;26:807–15 doi:10.1007/s00330-015-3879-9 pmid:26105022
    CrossRefPubMed
  3. 3.↵
    1. Kanda T,
    2. Oba H,
    3. Toyoda K, et al
    . Brain gadolinium deposition after administration of gadolinium-based contrast agents. Jpn J Radiol 2016;34:3–9 doi:10.1007/s11604-015-0503-5 pmid:26608061
    CrossRefPubMed
  4. 4.↵
    1. Radbruch A,
    2. Weberling LD,
    3. 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;50:805–10 doi:10.1097/RLI.0000000000000227 pmid:26523910
    CrossRefPubMed
  5. 5.↵
    1. Jost G,
    2. Lenhard DC,
    3. Sieber MA, et al
    . Signal increase on unenhanced T1-weighted images in the rat brain after repeated, extended doses of gadolinium-based contrast agents: comparison of linear and macrocyclic agents. Invest Radiol 2016;51:83–89 doi:10.1097/RLI.0000000000000242 pmid:26606548
    CrossRefPubMed
  6. 6.↵
    1. Kanda T,
    2. Fukusato T,
    3. Matsuda M, et al
    . 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. Radiology 2015;276:228–32 doi:10.1148/radiol.2015142690 pmid:25942417
    CrossRefPubMed
  7. 7.↵
    1. McDonald RJ,
    2. McDonald JS,
    3. Kallmes DF, et al
    . Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 2015;275:772–82 doi:10.1148/radiol.15150025 pmid:25742194
    CrossRefPubMed
  • © 2016 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 37 (5)
American Journal of Neuroradiology
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Cite this article
T. Kanda, H. Oba, K. Toyoda, S. Furui
Macrocyclic Gadolinium-Based Contrast Agents Do Not Cause Hyperintensity in the Dentate Nucleus
American Journal of Neuroradiology May 2016, 37 (5) E41; DOI: 10.3174/ajnr.A4710

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Macrocyclic Gadolinium-Based Contrast Agents Do Not Cause Hyperintensity in the Dentate Nucleus
T. Kanda, H. Oba, K. Toyoda, S. Furui
American Journal of Neuroradiology May 2016, 37 (5) E41; DOI: 10.3174/ajnr.A4710
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