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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatric Neuroimaging

Deep Brain Nuclei T1 Shortening after Gadobenate Dimeglumine in Children: Influence of Radiation and Chemotherapy

S. Kinner, T.B. Schubert, R.J. Bruce, S.L. Rebsamen, C.A. Diamond, S.B. Reeder and H.A. Rowley
American Journal of Neuroradiology January 2018, 39 (1) 24-30; DOI: https://doi.org/10.3174/ajnr.A5453
S. Kinner
aFrom the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
gDepartment of Diagnostic and Interventional Radiology and Neuroradiology (S.K.), University Hospital Essen, Essen, Germany
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T.B. Schubert
aFrom the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
hClinic of Radiology and Nuclear Medicine (T.B.S.), Basel University Hospital, Basel, Switzerland.
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R.J. Bruce
aFrom the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
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S.L. Rebsamen
aFrom the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
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C.A. Diamond
bPediatrics (C.A.D.)
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S.B. Reeder
aFrom the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
cMedical Physics (S.B.R.)
dEmergency Medicine (S.B.R.)
eBiomedical Engineering (S.B.R.)
fMedicine (S.B.R.), University of Wisconsin-Madison, Madison, Wisconsin
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H.A. Rowley
aFrom the Departments of Radiology (S.K., T.B.S., R.J.B., S.L.R., S.B.R., H.A.R.)
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    Fig 1.

    Flow chart showing the patient-selection criteria. PFT indicates posterior fossa tumor.

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    Fig 2.

    T1-weighted images acquired before (A and C) and after 20 gadobenate injections (B and D) in a patient with follow-up for optic glioma without radiation or chemotherapy (A and B) and a patient with medulloblastoma after an operation and radiochemotherapy (C and D). Subtle signal changes of the dentate (arrows) can be seen in the patient without any therapy, while the patient with RCTX shows distinct T1 signal changes of the dentate and perifocal edema.

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    Fig 3.

    T1-weighted images acquired before (A and C) and after 10 gadobenate injections (B and D) in a patient being followed for a mass at the craniocervical junction with only surgical therapy (A and B) and a patient with medulloblastoma after an operation and radiochemotherapy (C and D). No signal change can be seen in the dentate for the patient without RCTX, while the patient with RCTX already shows signal changes after 10 injections.

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    Fig 4.

    Distribution of the signal ratio change of the globus pallidus compared with the thalamus (globus pallidus to thalamus) in children with no treatment variables (gray bars) and children with radiochemotherapy (black bars) shows a shift/tendency to higher ratio changes in children with posterior fossa tumors under therapy.

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    Fig 5.

    Scatterplot showing the correlation between cumulative gadolinium doses and signal ratio change for patients with and without therapy.

Tables

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  • Patient characteristicsa

    Unconfounded CasesPosterior Fossa TumorsP Value
    Total No. of patients6016
    Age (yr)8.7 (6–14)7.8 (4–10).095
    Sex: female30 (50.0%)6 (37.5%).543
    Contrast-enhanced MRIs7 (5–9)14.5 (11.2–16)<.001
    First-to-last MRI with contrast (yr)3.1 (1.3–4.7)3.4 (1.4–4.7).794
    Accumulated dose of gadoterate dimeglumine (mL)48.5 (31.1–87.2)63.8 (49.8–130.5).161
    Mean ratio change of dentate to pons0.028 (0.007–0.049)0.090 (0.049–0.132)<.001
    Mean ratio change of globus pallidus to thalamus0.034 (0.013–0.055)0.130 (0.091–0.168)<.001
    • Note:—min indicates minimum; max, maximum.

    • ↵a Data are presented as means with 95% confidence intervals in parentheses.

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American Journal of Neuroradiology: 39 (1)
American Journal of Neuroradiology
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S. Kinner, T.B. Schubert, R.J. Bruce, S.L. Rebsamen, C.A. Diamond, S.B. Reeder, H.A. Rowley
Deep Brain Nuclei T1 Shortening after Gadobenate Dimeglumine in Children: Influence of Radiation and Chemotherapy
American Journal of Neuroradiology Jan 2018, 39 (1) 24-30; DOI: 10.3174/ajnr.A5453

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Deep Brain Nuclei T1 Shortening after Gadobenate Dimeglumine in Children: Influence of Radiation and Chemotherapy
S. Kinner, T.B. Schubert, R.J. Bruce, S.L. Rebsamen, C.A. Diamond, S.B. Reeder, H.A. Rowley
American Journal of Neuroradiology Jan 2018, 39 (1) 24-30; DOI: 10.3174/ajnr.A5453
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