MRI demonstration of gadolinium deposition in bone after monthly triple-dose gadopentetate dimeglumine and correlation with frequency of hypophosphatemia

Devin Bageac, John J. DeBevits, Reshma Munbodh, Joshua Kaplan, Rong Wu, Paul A. DiCamillo, Chaoran Hu, Yanlin Wang, David Karimeddini, Robert T. Naismith, Suhayl Dhib-Jalbut, Leo Wolansky

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We retrospectively analyzed data of the BECOME trial to investigate whether serial administration of triple-dose (3-dose) gadopentetate dimeglumine would result in the development of T1 signal-to-noise (S/N) changes in the cranial diploic space and whether S/N changes correlated with on-study hypophosphatemia. Methods: Signal intensity analysis was performed on the first year's data of the BECOME trial using 3-dose Gd (14 months, maximum number of doses, 39, mean: 36). Routine blood and urine tests were obtained each month for safety monitoring. Linear mixed regression modeling with random intercept was used to analyze monthly signal-to-noise ratio (S/N = Bone/Air) using an ROI of the diploic space created from T2W images and overlaid on T1FS (T1 fat-saturated) images. Incidence of phosphate abnormalities was analyzed using the general estimation equation; correlation of phosphate and S/N change was achieved with type 3 test of fixed effects. Results: Cranial diploic space T1FS S/N increased over 14 months: S/N = 0.039 mean monthly increase (S.E. 0.008; p < 0.0001). Subjects with consistently normal phosphate levels (n = 32) experienced more of a S/N increase than patients with at least one episode of hypophosphatemia (n = 35) (0.057 vs. 0.023, respectively, p = 0.037). Those with moderate hypophosphatemia demonstrated no significant S/N increase. Conclusion: Monthly administration of 3-dose gadopentetate dimeglumine is associated with development of increased S/N on T1FS imaging in the cranial diploic space, suggesting Gd retention in bone. Our data suggests MRI could be used as a noninvasive method of tracking Gd retention in bone, which was more pronounced in patients with normal phosphate levels.

Original languageEnglish
Pages (from-to)136-141
Number of pages6
JournalClinical Imaging
Volume70
DOIs
StatePublished - Feb 2021

Keywords

  • Blood
  • Bone
  • Contrast media
  • Gadolinium
  • Gadolinium deposition disease
  • Hypophosphatemia
  • Toxicity

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