Contributions
Abstract: P478
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: (2272/349) Gadolinium based contrast agents (GBCAs) are extensively used for MRI examinations. In order to eliminate the toxicity of free gadolinium the various agents have different chelate molecules. The structure of this ligand can be linear or macrocyclic. Macrocyclic agents are considered more stable. In the past few years there have been several reports observing T1 hyperintensity in specific brain structures in patients with multiple contrast enhanced MRI examinations. Recent animal and post mortem studies give evidence of gadolinium deposition in neural tissue. The physiological and clinical significance of such deposition is not known.
Objective: We aimed to provide supportive or contradictive evidence of hyperintensity in the dentate nuclei in patients with multiple sclerosis (MS) in relation to previous GBCA administration, and to study any differences for the various gadolinium chelates.
Material and method: This is a retrospective cross sectional study of 163 patients with MS (42 men and 121 women, aged 20-68 years). The ratio of T1 intensity in the dentate nuclei versus the pons (DNP ratio) was calculated. We noted the number of administrations, type and amount of GBCA.
Results: The patients received an average number of 5.37 GBCA administrations each over 0-17 years (mean 5.23). The accumulated dose of GBCA per patient ranged between 0-275 ml (mean 72.7 ml). Of the total number of administrations (N=873), 74 % were the macrocyclic agents. We found a significant correlation between the DNP ratio and the number of gadolinium administrations (r=0.22, p=0.006), as well as between the DNP ratio and the accumulated dose (r=0.23, p=0.004) and mean dose (r=0.17, p=0.035) per patient. There was not a significant correlation of the DNP ratio with number of administrations (r=0.14, p=0.28) or total doses (r=0.155, p=0.242) for the subgroup of patients who had received only macrocyclic agents (N= 59).
Conclusion: Our study supports observations by other research groups that the use of GBCAs can result in neural tissue deposition. We found a correlation of increased DNP ratio both with the total dose, and with the number of administered GBCA doses. Further and larger studies are needed to identify the clinical impact of this observation.
Disclosure:
Elisabeth G. Celius received funding for travel and speaker"s fees from Almirall, Biogen Idec, Genzyme, Novartis, Sanofi-Aventis and Teva, and received unrestricted research grants from Biogen Idec, Genzyme and Novartis outside the submitted work.
Dr. Hanne F Harbo received an unrestricted research grant from Novartis, and support for travelling and speaking honoraria from Biogen Idec, Novartis, Sanofi-Aventis and Teva outside the submitted work.
Dr.Mona K Beyer has nothing to disclose
Dr Elisabeth Lindland has nothing to disclose
Dr Donata Biernat has nothing to disclose
Dr Piotr Sowa received honoraria for lectures from Novartis, Genzyme and Biogen Idec.
Sehrish Nabi has nothing to disclose
Abstract: P478
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: (2272/349) Gadolinium based contrast agents (GBCAs) are extensively used for MRI examinations. In order to eliminate the toxicity of free gadolinium the various agents have different chelate molecules. The structure of this ligand can be linear or macrocyclic. Macrocyclic agents are considered more stable. In the past few years there have been several reports observing T1 hyperintensity in specific brain structures in patients with multiple contrast enhanced MRI examinations. Recent animal and post mortem studies give evidence of gadolinium deposition in neural tissue. The physiological and clinical significance of such deposition is not known.
Objective: We aimed to provide supportive or contradictive evidence of hyperintensity in the dentate nuclei in patients with multiple sclerosis (MS) in relation to previous GBCA administration, and to study any differences for the various gadolinium chelates.
Material and method: This is a retrospective cross sectional study of 163 patients with MS (42 men and 121 women, aged 20-68 years). The ratio of T1 intensity in the dentate nuclei versus the pons (DNP ratio) was calculated. We noted the number of administrations, type and amount of GBCA.
Results: The patients received an average number of 5.37 GBCA administrations each over 0-17 years (mean 5.23). The accumulated dose of GBCA per patient ranged between 0-275 ml (mean 72.7 ml). Of the total number of administrations (N=873), 74 % were the macrocyclic agents. We found a significant correlation between the DNP ratio and the number of gadolinium administrations (r=0.22, p=0.006), as well as between the DNP ratio and the accumulated dose (r=0.23, p=0.004) and mean dose (r=0.17, p=0.035) per patient. There was not a significant correlation of the DNP ratio with number of administrations (r=0.14, p=0.28) or total doses (r=0.155, p=0.242) for the subgroup of patients who had received only macrocyclic agents (N= 59).
Conclusion: Our study supports observations by other research groups that the use of GBCAs can result in neural tissue deposition. We found a correlation of increased DNP ratio both with the total dose, and with the number of administered GBCA doses. Further and larger studies are needed to identify the clinical impact of this observation.
Disclosure:
Elisabeth G. Celius received funding for travel and speaker"s fees from Almirall, Biogen Idec, Genzyme, Novartis, Sanofi-Aventis and Teva, and received unrestricted research grants from Biogen Idec, Genzyme and Novartis outside the submitted work.
Dr. Hanne F Harbo received an unrestricted research grant from Novartis, and support for travelling and speaking honoraria from Biogen Idec, Novartis, Sanofi-Aventis and Teva outside the submitted work.
Dr.Mona K Beyer has nothing to disclose
Dr Elisabeth Lindland has nothing to disclose
Dr Donata Biernat has nothing to disclose
Dr Piotr Sowa received honoraria for lectures from Novartis, Genzyme and Biogen Idec.
Sehrish Nabi has nothing to disclose