Contributions
Abstract: P826
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: Repeated gadolinium based contrast agents (GBCAs) administrations have been associated with increased signal intensity (SI) in the dentate nucleus (DN) and globus pallidus (GP) on T1-weighted unenhanced magnetic resonance images. Compared to linear GBCAs, macrocyclic GBCAs seemed to be less involved in this process. Aim of the study was to evaluate SI ratio changes in the DN and GP in MS patients with normal renal function, after repeated administrations of macrocyclic GBCAs, comparing patients who received gadobutrol-only with patients who received gadobutrol plus other macrocyclic GBCAs.
Patients and methods: Inclusion criteria were: diagnosis of MS, at least 3 administrations of macrocyclic GBCAs (gadobutrol, gadoteridol, and/or gadoterate meglumine), and eGFR>60 ml/min. Clinical and paraclinical data, and baseline and follow-up renal and liver function parameters were collected. Baseline and follow-up T1-weighted image series were analysed by two readers; operator defined region-of-interest (ROI) measurements of mean SI have been performed and SI ratios (DN-to-pons and GP-to-thalamus) differences were calculated for both groups. We also analysed the following SI ratios: DN-to-IV ventricle CSF and GP-to-eye. Paired samples T-test or Wilcoxon signed rank test was used to compare SI ratio of the first and
last MRI, as appropriate. Differences in SI ratios between only gadobutrol and gadobutrol plus other macrocyclic GBCAs groups were compared using independent samples T-test or Mann-Whitney test, as appropriate.
Results: 27 MS patients (22 F, 5 M; age 45,56±12,16 years) received gadobutrol only, 25 patients gadobutrol + other macrocyclic GBCAs (15 F, 10 M; age 47,56±10,00 years). The median number of GBCA administrations was 5 (range 3-10) and 6 (range 3-12), respectively. After repeated administrations of GBCAs, no changes in DN-to-pons, GP-to-thalamus, DN-to-IV ventricle CSF, and GP-to-eye SI ratios have been observed in both groups. Moreover, differences between baseline and follow-up SI ratios did not differ between groups. Renal and liver functions remained within normal range throughout the study.
Conclusions: Repeated administrations of macrocyclic GBCA were not associated to SI changes of DN and GP in MS patients with normal renal function (both in gadobutrol-only group and gadobutrol plus other macrocyclic GBCAs group). Furthermore, SI ratio difference between last and first examinations did not differ between the two groups.
Disclosure: A Sartori has received funding for travel and/or speaker honoraria from Novartis, Teva, Merk, Genzyme, Almirall, Roche.
AG Gennari: nothing to disclose.
I Zorzenon: nothing to disclose.
A Dinoto has received funding for travel from Novartis, Genzyme, Biogen.
ME Morelli has received funding for travel from Genzyme.
A Bratina: nothing to disclose.
M Ukmar: nothing to disclose.
A Bosco has received funding for travel and/or speaker honoraria from Genzyme and Merck.
MA Cova: nothing to disclose.
P Manganotti: nothing to disclose.
Abstract: P826
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Introduction: Repeated gadolinium based contrast agents (GBCAs) administrations have been associated with increased signal intensity (SI) in the dentate nucleus (DN) and globus pallidus (GP) on T1-weighted unenhanced magnetic resonance images. Compared to linear GBCAs, macrocyclic GBCAs seemed to be less involved in this process. Aim of the study was to evaluate SI ratio changes in the DN and GP in MS patients with normal renal function, after repeated administrations of macrocyclic GBCAs, comparing patients who received gadobutrol-only with patients who received gadobutrol plus other macrocyclic GBCAs.
Patients and methods: Inclusion criteria were: diagnosis of MS, at least 3 administrations of macrocyclic GBCAs (gadobutrol, gadoteridol, and/or gadoterate meglumine), and eGFR>60 ml/min. Clinical and paraclinical data, and baseline and follow-up renal and liver function parameters were collected. Baseline and follow-up T1-weighted image series were analysed by two readers; operator defined region-of-interest (ROI) measurements of mean SI have been performed and SI ratios (DN-to-pons and GP-to-thalamus) differences were calculated for both groups. We also analysed the following SI ratios: DN-to-IV ventricle CSF and GP-to-eye. Paired samples T-test or Wilcoxon signed rank test was used to compare SI ratio of the first and
last MRI, as appropriate. Differences in SI ratios between only gadobutrol and gadobutrol plus other macrocyclic GBCAs groups were compared using independent samples T-test or Mann-Whitney test, as appropriate.
Results: 27 MS patients (22 F, 5 M; age 45,56±12,16 years) received gadobutrol only, 25 patients gadobutrol + other macrocyclic GBCAs (15 F, 10 M; age 47,56±10,00 years). The median number of GBCA administrations was 5 (range 3-10) and 6 (range 3-12), respectively. After repeated administrations of GBCAs, no changes in DN-to-pons, GP-to-thalamus, DN-to-IV ventricle CSF, and GP-to-eye SI ratios have been observed in both groups. Moreover, differences between baseline and follow-up SI ratios did not differ between groups. Renal and liver functions remained within normal range throughout the study.
Conclusions: Repeated administrations of macrocyclic GBCA were not associated to SI changes of DN and GP in MS patients with normal renal function (both in gadobutrol-only group and gadobutrol plus other macrocyclic GBCAs group). Furthermore, SI ratio difference between last and first examinations did not differ between the two groups.
Disclosure: A Sartori has received funding for travel and/or speaker honoraria from Novartis, Teva, Merk, Genzyme, Almirall, Roche.
AG Gennari: nothing to disclose.
I Zorzenon: nothing to disclose.
A Dinoto has received funding for travel from Novartis, Genzyme, Biogen.
ME Morelli has received funding for travel from Genzyme.
A Bratina: nothing to disclose.
M Ukmar: nothing to disclose.
A Bosco has received funding for travel and/or speaker honoraria from Genzyme and Merck.
MA Cova: nothing to disclose.
P Manganotti: nothing to disclose.