Kiviniemi Aida, Gardberg Maria, Ek Paul, Frantzén Janek, Bobacka Johan, Minn Heikki
Department of Radiology, Division of Medical Imaging, Turku University Hospital, University of Turku, Kiinamyllynkatu 4-8, FI-20521, Turku, Finland.
Department of Pathology, University of Turku, Turku University Hospital, Turku, Finland.
Neuroradiology. 2019 May;61(5):535-544. doi: 10.1007/s00234-019-02172-6. Epub 2019 Feb 2.
To quantitate gadolinium deposits in gliomas and adjacent normal brain specimens, and to evaluate their association with tumor contrast enhancement and the type of gadolinium-based contrast agent (GBCA) used.
A total of 69 patients with primary glioma who underwent contrast-enhanced magnetic resonance imaging (MRI) prior to surgery were included in this retrospective study. Gadolinium was measured from histologically viable tumor, normal brain, and necrosis within the sample, when available, using inductively coupled plasma mass spectrometry (ICP-MS). Tumor contrast enhancement was categorized as none, minimal, or noticeable. Differences in gadolinium deposits by contrast enhancement and GBCA type were assessed.
Seven patients received linear GBCA and 62 macrocyclic, respectively. At the time of surgery, gadolinium deposits were detected in 39 out of 69 (57%) tumor samples, 8 out of 13 (62%) normal brain, and 12 out of 14 (86%) necrotic specimens. Gadolinium was detected in both enhancing and non-enhancing tumors, but was greatest in gliomas with noticeable enhancement (p = 0.02). Administration of linear agents gadodiamide and gadopentetate dimeglumine resulted in significantly higher tumor gadolinium relative to macrocyclic gadoterate meglumine (p < 0.01 and p < 0.05, respectively). Normal brain and necrosis also showed higher gadolinium after exposure to linear gadodiamide (both p < 0.05). In multivariate regression, GBCA type (linear/macrocyclic) was the most powerful predictor of tumor gadolinium retention (p < 0.001).
Gadolinium can be detected in both enhancing and non-enhancing gliomas, neighboring normal brain, and necrosis. Gadolinium retention is higher after exposure to linear GBCAs compared with the macrocyclic gadoterate meglumine.
定量分析神经胶质瘤及邻近正常脑标本中的钆沉积情况，并评估其与肿瘤对比增强及所用钆基造影剂（GBCA）类型之间的关联。
本回顾性研究纳入了69例术前接受对比增强磁共振成像（MRI）检查的原发性神经胶质瘤患者。使用电感耦合等离子体质谱法（ICP-MS），在组织学上有活性的肿瘤、正常脑以及样本中的坏死区域（若有）测量钆含量。肿瘤对比增强分为无、轻度或明显增强。评估对比增强和GBCA类型导致的钆沉积差异。
分别有7例患者接受线性GBCA，62例接受大环类GBCA。手术时，69个肿瘤样本中有39个（57%）检测到钆沉积，13个正常脑样本中有8个（62%）检测到，14个坏死标本中有12个（86%）检测到。钆在增强和未增强的肿瘤中均有检测到，但在明显增强的神经胶质瘤中含量最高（p = 0.02）。与大环类钆喷酸葡胺相比，线性制剂钆双胺和钆喷替酸葡甲胺导致肿瘤钆含量显著更高（分别为p < 0.01和p < 0.05）。暴露于线性钆双胺后，正常脑和坏死区域的钆含量也更高（均为p < 0.05）。在多变量回归分析中，GBCA类型（线性/大环类）是肿瘤钆潴留的最强预测因素（p < 0.001）。
在增强和未增强的神经胶质瘤、邻近正常脑及坏死区域均可检测到钆。与大环类钆喷酸葡胺相比，暴露于线性GBCA后钆潴留更高。
