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Signal Intensity Evaluation in the Dentate Nucleus and Subcortical Gray Matter

Effect of Several Administrations of Gadoterate Meglumine in Multiple Sclerosis

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Abstract

Purpose

Several studies reported gadolinium deposition in the dentate nuclei (DN) and the globus pallidus (GP) that was associated to linear GBCA administrations rather than macrocyclic. It is therefore imperative to evaluate and assess the safety of cumulative administration of gadoterate meglumine (macrocyclic). Thus, T1-weighted images (T1WI) of multiple sclerosis (MS) patients longitudinally followed for 4 years were retrospectively analyzed.

Methods

In this study 44 patients, 10 with clinically isolated syndrome (CIS), 24 relapsing-remitting MS (RRMS) and 10 primary-progressive MS (PPMS) were examined every 6 months (first four scans) and then with a 1-year interval (last two scans). Image processing consisted in reorienting unenhanced T1WI to standard space, followed by B1 inhomogeneity correction. A patient-specific template was then generated to normalize T1WI signal intensity (SI) and segment the DN and subcortical GM structures. All structures were then transformed to each patient space in order to measure the SI in each region. The cerebellar peduncles (CP) and semi-oval (SO) white matter were then manually delineated and used as reference to calculate SI ratios in the DN and subcortical GM structures. A linear mixed-effect model was finally applied to longitudinally analyze SI variations.

Results

The SI measurements performed in all structures showed no significant increases with the cumulative GBCA administration.

Conclusion

This study showed no significant SI increases within the DN and subcortical GM structures of longitudinally followed MS patients even with the cumulative administration of the macrocyclic GBCA gadoterate meglumine.

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Abbreviations

CIS:

Clinically isolated syndrome

CP:

Cerebellar peduncle

DN:

Dentate Nuclei

GBCA:

Gadolinium-based contrast agent

GM:

Gray matter

GP:

Globus pallidus

MS:

Multiple sclerosis

PPMS:

Primary progressive multiple sclerosis

ROI:

Region of interest

RRMS:

Relapsing remitting multiple sclerosis

SI:

Signal intensity

SOWM:

Semi-oval white matter

WI:

Weighted images

WM:

White matter

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Acknowledgements

The authors would like to express their gratitude to the staff of “CERMEP-Imagerie du Vivant” for their assistance in the acquisition of the data. This work has been supported by a grant provided by the French State and handled by the “Agence Nationale de la Recherche”, within the framework of the “Investments for the Future” program, under the reference ANR-10-COHO-002 Observatoire Français de la Sclérose en Plaques (OFSEP).

Author information

Authors and Affiliations

  1. Medical Imaging Sciences Program, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon

    Salem Hannoun

  2. CREATIS—CNRS UMR5220 & INSERM U1206, INSA-Lyon, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France

    Gabriel Kocevar, François Cotton, Françoise Durand-Dubief & Dominique Sappey-Marinier

  3. Datascience pole, Seenovate, Lyon, France

    Gabriel Kocevar

  4. Service de Neurologie A, Hôpital Neurologique, Hospices Civils de Lyon, Bron, France

    Pekes Codjia, Sandra Vukusic & Françoise Durand-Dubief

  5. Service de Biostatistiques, Hospices Civils de Lyon, Lyon, France

    Delphine Maucort-Boulch

  6. Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France

    François Cotton

  7. CERMEP—Imagerie du Vivant, Université de Lyon, Bron, France

    Dominique Sappey-Marinier

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  1. Salem Hannoun
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Contributions

All authors 1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; 2) drafted the work or revised it critically for important intellectual content; 3) approved the version to be published; and 4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Dominique Sappey-Marinier.

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Conflict of interest

S. Hannoun, G. Kocevar, P. Codjia, D. Maucort-Boulch, F. Cotton, S. Vukusic, F. Durand-Dubief and D. Sappey-Marinier declare that they have no competing interests.

Ethical standards

The study was approved by the local ethics committee (CPP Sud-Est IV) and the French national agency for medicine and health products safety (ANSM). All patients gave written informed consent to participate in this study.

Additional information

The authors S. Hannoun and G. Kocevar contributed equally to this work.

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Hannoun, S., Kocevar, G., Codjia, P. et al. Signal Intensity Evaluation in the Dentate Nucleus and Subcortical Gray Matter. Clin Neuroradiol 32, 677–685 (2022). https://doi.org/10.1007/s00062-021-00995-6

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  • DOI: https://doi.org/10.1007/s00062-021-00995-6

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