Abstract：
OBJECTIVE: 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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
目的：一些研究报道了钆在齿状核（DN）和苍白球（GP）中的沉积，这与GBCA的线性给药而不是大环给药有关。因此，必须评估和评估累积给药gadoterate葡甲胺（大环）的安全性。因此，回顾性分析纵向随访4年的多发性硬化症（MS）患者的T1加权图像（T1WI）。
方法：在这项研究中，44名患者，10例临床孤立综合征（CIS），每6个月检查24例复发缓解型MS（RRMS）和10例原发性进展型MS（PPMS）（前四次扫描），然后间隔1年（后两次扫描）。图像处理包括将未增强的T1WI重新定向到标准空间，其次是B1不均匀性校正。然后生成患者特异性模板以归一化T1WI信号强度(SI)并分割DN和皮质下GM结构。然后将所有结构转换到每个患者空间以测量每个区域中的SI。然后手动描绘小脑柄（CP）和半椭圆形（SO）白质，并用作参考以计算DN和皮质下GM结构中的SI比率。最终将线性混合效应模型应用于纵向分析SI变化。
结果：在所有结构中进行的SI测量显示，随着GBCA的累积给药，没有显着增加。
结论：这项研究显示，即使累积使用大环GBCAgadoterate葡甲胺，纵向随访MS患者的DN和皮质下GM结构内的SI也没有显著增加。
方法：在这项研究中，44名患者，10例临床孤立综合征（CIS），每6个月检查24例复发缓解型MS（RRMS）和10例原发性进展型MS（PPMS）（前四次扫描），然后间隔1年（后两次扫描）。图像处理包括将未增强的T1WI重新定向到标准空间，其次是B1不均匀性校正。然后生成患者特异性模板以归一化T1WI信号强度(SI)并分割DN和皮质下GM结构。然后将所有结构转换到每个患者空间以测量每个区域中的SI。然后手动描绘小脑柄（CP）和半椭圆形（SO）白质，并用作参考以计算DN和皮质下GM结构中的SI比率。最终将线性混合效应模型应用于纵向分析SI变化。
结果：在所有结构中进行的SI测量显示，随着GBCA的累积给药，没有显着增加。
结论：这项研究显示，即使累积使用大环GBCAgadoterate葡甲胺，纵向随访MS患者的DN和皮质下GM结构内的SI也没有显著增加。
