A team of researchers identified gadolinium from MRI contrast in gliomas, adjacent normal brain tissue and necrosis, according to a study published in Neuroradiology.
The Finnish team also found gadolinium retention was higher in patients who received liner gadolinium-based contrast agents (GBCAs) compared to macrocyclic GBCAs.
“To our knowledge, this is the first study to provide quantitative data of gadolinium retention in gliomas and neighboring normal brain with respect to tumor enhancement and type of GBCA used,” wrote Aida Kiviniemi, MD, PhD, with Turku University Hospital in Finland, and colleagues. “Despite the fact that GBCAs have been used for decades in MRI of brain tumors to identify BBB breakdown and characterize tumor vasculature, only one previous study can be found where gadolinium deposits in brain tumor biopsies have been evaluated.”
Kiviniemi and colleagues studied data taken from 69 patients with newly diagnosed primary glioma who underwent contrast-enhanced MR imaging prior to surgery. Seven patients received a linear GBCA, and the remaining 62 were exposed to macrocyclic GBCAs.
Gadolinium was identified in 39 (57 percent) glioma tumor samples, eight (62 percent) normal brain samples and 12 (86 percent) necrotic samples. Retention was found in enhancing and non-enhancing tumors. Linear GBCAs exposure were associated with significantly higher gadolinium retention compared to macrocyclic GBCAs.
“While the clinical significance of gadolinium retention into the brain remains unsolved, the European Medicines Agency has taken a significant step and has given recommendations to suspend the usage of certain linear GBCAs related to gadolinium accumulation,” the authors wrote. “In (the) USA, the US Food and Drugs Administration requires warning labeling to all GBCAs.”