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Research ArticlePediatric Neuroimaging

T1 Signal Measurements in Pediatric Brain: Findings after Multiple Exposures to Gadobenate Dimeglumine for Imaging of Nonneurologic Disease

G.K. Schneider, J. Stroeder, G. Roditi, C. Colosimo, P. Armstrong, M. Martucci, A. Buecker and P. Raczeck
American Journal of Neuroradiology September 2017, 38 (9) 1799-1806; DOI: https://doi.org/10.3174/ajnr.A5270
G.K. Schneider
aFrom the Department of Diagnostic and Interventional Radiology (G.K.S., J.S., A.B., P.R.), Saarland University Medical Center, Homburg/Saar, Germany
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J. Stroeder
aFrom the Department of Diagnostic and Interventional Radiology (G.K.S., J.S., A.B., P.R.), Saarland University Medical Center, Homburg/Saar, Germany
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G. Roditi
bDepartment of Radiology (G.R., P.A.), National Health Service Greater Glasgow and Clyde, Glasgow Royal Infirmary, Glasgow, Scotland, UK
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C. Colosimo
cInstitute of Radiology (C.C., M.M.), Radiodiagnostica e Neuroradiologia, Fondazione Policlinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Rome, Italy.
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P. Armstrong
bDepartment of Radiology (G.R., P.A.), National Health Service Greater Glasgow and Clyde, Glasgow Royal Infirmary, Glasgow, Scotland, UK
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M. Martucci
cInstitute of Radiology (C.C., M.M.), Radiodiagnostica e Neuroradiologia, Fondazione Policlinico Universitario 'A. Gemelli', Università Cattolica del Sacro Cuore, Rome, Italy.
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A. Buecker
aFrom the Department of Diagnostic and Interventional Radiology (G.K.S., J.S., A.B., P.R.), Saarland University Medical Center, Homburg/Saar, Germany
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P. Raczeck
aFrom the Department of Diagnostic and Interventional Radiology (G.K.S., J.S., A.B., P.R.), Saarland University Medical Center, Homburg/Saar, Germany
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    Fig 1.

    Oncologic male patient (1 year 9 months of age at his first visit) undergoing follow-up imaging for cervical neuroblastoma in remission. Unenhanced T1- and T2-weighted transverse images of the DN-pons (A and B) and GP-thalamus (C and D) after 8 injections of 0.05 mmol/kg of gadobenate reveal no evidence of SI changes.

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    Fig 2.

    Oncologic female patient (7 years 2 months of age at her first visit) undergoing follow-up imaging for non-Hodgkin lymphoma in remission. Unenhanced T1- and T2-weighted transverse images of the DN-pons (A and B) and GP-thalamus (C and D) after 14 injections of 0.05 mmol/kg of gadobenate reveal no evidence of SI changes.

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    Table 1:

    Summary of group characteristicsa

    CharacteristicGadobenate-Exposed (n = 34)GBCA-Naïve Control (n = 24)P Value
    Age7.18 ± 5.93 yr8.78 ± 5.78 yr.31
    9 mo to 17 yr7 mo to 17 yr
    Sex (M/F)17:1716:8.28
    Body weight (kg)30.55 ± 18.5726.71 ± 17.23.43
    7.8–688.1–64
    No. of administrations7.8 ± 2.9NANA
    5–15
    Interval between first and last administrations2.24 ± 1.97 yrNANA
    9 mo to 7 yr
    Accumulated volume of gadobenate administered (mL)29.35 ± 24.95NANA
    5–112
    Accumulated gadobenate dose (g)b9.8 ± 8.33NANA
    1.67–37.41
    • Note:—NA indicates not applicable.

    • ↵a Data are mean ± SD and range.

    • ↵b One milliliter of MultiHance solution for injection contains 334 mg of gadobenic acid as the meglumine salt.39

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    Table 2:

    Summary of patient diagnosesa

    Group 1 (Gadobenate-Exposed)Group 2 (GBCA-Naïve Controls)
    DiagnosisNo.DiagnosisNo.
    T-cell non-Hodgkin lymphoma1Chronic recurrent osteomyelitis3
    Hodgkin lymphoma3Pelvic trauma1
    Coccygeal teratoma1Cystic fibrosis2
    Nephroblastoma4DORV/VSD1
    Neuroblastoma3Polycystic kidney disease1
    Chronic recurrent osteomyelitis2Melanoma1
    Hepatoblastoma2Non-Hodgkin lymphoma2
    Mesoblastic nephroma1Skull base osteoid osteoma1
    ALL1Germ cell tumor1
    Paravertebral schwannoma1Polytrauma, knee distortion, ACL rupture1
    Angioma of the spleen1Myocarditis2
    Germ cell tumor2Hemophilia A1
    Renal clear cell sarcoma1Blunt head trauma2
    Ewing sarcoma3Osler disease1
    Osteosarcoma2Multiple osteochondroma, whole-body staging1
    Rhabdoid tumor of the kidney1Congenital aortic malformation, whole-body imaging1
    Dermatofibrosarcoma1Persistent left superior vena cava, thoracic and head/neck imaging1
    ARVD/ARVC1Hypertension work-up1
    Hemangioendothelioma1
    Renal leiomyosarcoma1
    Focal nodular hyperplasia1
    • Note:—ALL indicates acute lymphoblastic leukemia; DORV, double outlet right ventricle; VSD, ventricula septal defect; ACL, anterior cruciate ligament; ARVD, arrhythmogenic right ventricular dysplasia; ARVC, arrhythmogenic right ventricular cardiomyopathy.

    • ↵a Patients in group 1 underwent multiple gadobenate-enhanced MR imaging studies for therapy follow-up or remission control. Patients in group 2 underwent preliminary unenhanced imaging as part of the initial work-up at the first visit.

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    Table 3:

    Comparison of brain SI values and DN-pons and GP-thalamus SI ratios between gadobenate-exposed and GBCA-naïve control subjectsa

    Reader/Patient GroupDNPonsGPThalamusDN-Pons RatioGP-Thalamus Ratio
    Reader 1
        Exposed366.4 ± 8.62370.5 ± 8.59360.5 ± 10.2360.3 ± 9.990.989 ± 0.0041.0 ± 0.003
        Control374.3 ± 8.12377.0 ± 8.65364.4 ± 10.3363.2 ± 9.880.994 ± 0.0041.0 ± 0.002
        P value.526.6090.796.842.383.572
    Reader 2
        Exposed367.8 ± 9.33373.6 ± 8.84392.3 ± 11.17370.5 ± 10.660.984 ± 0.0061.06 ± 0.009
        Control370.9 ± 9.70381.9 ± 10.25380.5 ± 11.59373.3 ± 11.10.972 ± 0.0071.02 ± 0.009
        P value.826.547.476.859.217.185
    Reader 3
        Exposed389.2 ± 9.79374.5 ± 8.63383.6 ± 10.68356.9 ± 9.061.04 ± 0.0091.07 ± 0.012
        Control386.3 ± 10.14380.9 ± 10.73383.5 ± 12.98365.6 ± 11.671.02 ± 0.0091.05 ± 0.011
        P value.839.642.996.555.101.134
    Reader 4
        Exposed365.3 ± 8.40372.6 ± 8.71381.1 ± 9.95369.9 ± 9.540.98 ± 0.0061.03 ± 0.006
        Control368.3 ± 9.47378.5 ± 10.28381.8 ± 10.57376.3 ± 9.280.97 ± 0.0051.01 ± 0.007
        P value.816.661.959.644.388.083
    Reader 5
        Exposed386.5 ± 9.82374.9 ± 9.04392.9 ± 10.64371.0 ± 9.681.03 ± 0.0131.06 ± 0.006
        Control386.3 ± 10.85383.4 ± 10.71385.4 ± 12.47376.8 ± 11.171.01 ± 0.0071.02 ± 0.009
        P value.987.547.647.699.147.002
    • ↵a Values are mean ± standard error of the mean.

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American Journal of Neuroradiology: 38 (9)
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G.K. Schneider, J. Stroeder, G. Roditi, C. Colosimo, P. Armstrong, M. Martucci, A. Buecker, P. Raczeck
T1 Signal Measurements in Pediatric Brain: Findings after Multiple Exposures to Gadobenate Dimeglumine for Imaging of Nonneurologic Disease
American Journal of Neuroradiology Sep 2017, 38 (9) 1799-1806; DOI: 10.3174/ajnr.A5270

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T1 Signal Measurements in Pediatric Brain: Findings after Multiple Exposures to Gadobenate Dimeglumine for Imaging of Nonneurologic Disease
G.K. Schneider, J. Stroeder, G. Roditi, C. Colosimo, P. Armstrong, M. Martucci, A. Buecker, P. Raczeck
American Journal of Neuroradiology Sep 2017, 38 (9) 1799-1806; DOI: 10.3174/ajnr.A5270
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