Gadoxetate disodium, a modern hepatospecific MRI contrast agent: Indirect signs for gadolinium deposition in the brain structures with signal intensity increase after intravenous application.

Background: Gadolinium brain deposits after intravenous application of gadolinium-based contrast agents (GBCA) have been recently reported.

Aim: We focused selectively on gadoxetate disodium, a hepatospecific linear GBCA. There are currently only a few studies in peer-reviewed literature focused selectively on gadoxetate disodium with conflicting results.

Materials And Methods: Twenty patients (mean age 55.5 ± 14.0 years) after previous repeated administrations of gadoxetate disodium (mean 2.6 ± 1.5) for liver diagnostic process were included. All patients had normal renal and liver functions, an intact blood-brain barrier, and did not receive any other GBCA. They underwent 26 brain magnetic resonance imaging (MRI) with T1WI axial scans for signal intensity (SI) evaluation. The SI changes were measured in globus pallidus (GP), dentate nucleus (DN), pons (Po), and thalamus (Th) and SI ratios (DN/Po, GP/Po, GP/Th, Th/Po) were calculated. The control group consisted of 10 healthy volunteers (mean age 54.8 ± 12.1 years) with no prior GBCA applications.

Statistical Analysis: Robust linear regression was used to test the effect of number of applications on the SI ratios.

Results: The significant effect of number of gadoxetate previous applications on DN/Po SI ratio was found. On an average, the DN/Po ratio increased by 0.36 percentage points [P = 0.042, 95% CI (0.03, 0.69)]. Other SI ratios were not significantly affected.

Conclusions: Repeated administrations of hepatospecific gadoxetate disodium leads to a statistically significant increase in the SI values in DN in patients with normal renal and liver functions, and with an intact blood-brain barrier, probably due to gadolinium deposition.