Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging-a comprehensive overview
Falk Delgado, Anna ; Van Westen, Danielle LU
; Nilsson, Markus
LU
; Knutsson, Linda
LU
; Sundgren, Pia C
LU
; Larsson, Elna-Marie
LU
and Falk Delgado, Alberto
(2019)
In Insights into Imaging
10(1).
- Abstract
Gadolinium-based contrast agents (GBCAs) increase lesion detection and improve disease characterization for many cerebral pathologies investigated with MRI. These agents, introduced in the late 1980s, are in wide use today. However, some non-ionic linear GBCAs have been associated with the development of nephrogenic systemic fibrosis in patients with kidney failure. Gadolinium deposition has also been found in deep brain structures, although it is of unclear clinical relevance. Hence, new guidelines from the International Society for Magnetic Resonance in Medicine advocate cautious use of GBCA in clinical and research practice. Some linear GBCAs were restricted from use by the European Medicines Agency (EMA) in 2017.This review focuses... (More)
Gadolinium-based contrast agents (GBCAs) increase lesion detection and improve disease characterization for many cerebral pathologies investigated with MRI. These agents, introduced in the late 1980s, are in wide use today. However, some non-ionic linear GBCAs have been associated with the development of nephrogenic systemic fibrosis in patients with kidney failure. Gadolinium deposition has also been found in deep brain structures, although it is of unclear clinical relevance. Hence, new guidelines from the International Society for Magnetic Resonance in Medicine advocate cautious use of GBCA in clinical and research practice. Some linear GBCAs were restricted from use by the European Medicines Agency (EMA) in 2017.This review focuses on non-contrast-enhanced MRI techniques that can serve as alternatives for the use of GBCAs. Clinical studies on the diagnostic performance of non-contrast-enhanced as well as contrast-enhanced MRI methods, both well established and newly proposed, were included. Advantages and disadvantages together with the diagnostic performance of each method are detailed. Non-contrast-enhanced MRIs discussed in this review are arterial spin labeling (ASL), time of flight (TOF), phase contrast (PC), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), susceptibility weighted imaging (SWI), and amide proton transfer (APT) imaging.Ten common diseases were identified for which studies reported comparisons of non-contrast-enhanced and contrast-enhanced MRI. These specific diseases include primary brain tumors, metastases, abscess, multiple sclerosis, and vascular conditions such as aneurysm, arteriovenous malformation, arteriovenous fistula, intracranial carotid artery occlusive disease, hemorrhagic, and ischemic stroke.In general, non-contrast-enhanced techniques showed comparable diagnostic performance to contrast-enhanced MRI for specific diagnostic questions. However, some diagnoses still require contrast-enhanced imaging for a complete examination.
(Less)
- author
- Falk Delgado, Anna
; Van Westen, Danielle
LU
; Nilsson, Markus
LU
; Knutsson, Linda
LU
; Sundgren, Pia C
LU
; Larsson, Elna-Marie
LU
and Falk Delgado, Alberto
- organization
- publishing date
- 2019-08-23
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Insights into Imaging
- volume
- 10
- issue
- 1
- article number
- 84
- publisher
- Springer
- external identifiers
-
- pmid:31444580
- scopus:85071515802
- ISSN
- 1869-4101
- DOI
- 10.1186/s13244-019-0771-1
- project
- Natural sugar as an MRI contrast agent for cancer diagnosis
- language
- English
- LU publication?
- yes
- id
- df479365-da84-42ee-85ab-36ef09b65b1b
- date added to LUP
- 2019-08-25 12:08:36
- date last changed
- 2024-04-16 17:50:23
@article{df479365-da84-42ee-85ab-36ef09b65b1b,
abstract = {{<p>Gadolinium-based contrast agents (GBCAs) increase lesion detection and improve disease characterization for many cerebral pathologies investigated with MRI. These agents, introduced in the late 1980s, are in wide use today. However, some non-ionic linear GBCAs have been associated with the development of nephrogenic systemic fibrosis in patients with kidney failure. Gadolinium deposition has also been found in deep brain structures, although it is of unclear clinical relevance. Hence, new guidelines from the International Society for Magnetic Resonance in Medicine advocate cautious use of GBCA in clinical and research practice. Some linear GBCAs were restricted from use by the European Medicines Agency (EMA) in 2017.This review focuses on non-contrast-enhanced MRI techniques that can serve as alternatives for the use of GBCAs. Clinical studies on the diagnostic performance of non-contrast-enhanced as well as contrast-enhanced MRI methods, both well established and newly proposed, were included. Advantages and disadvantages together with the diagnostic performance of each method are detailed. Non-contrast-enhanced MRIs discussed in this review are arterial spin labeling (ASL), time of flight (TOF), phase contrast (PC), diffusion-weighted imaging (DWI), magnetic resonance spectroscopy (MRS), susceptibility weighted imaging (SWI), and amide proton transfer (APT) imaging.Ten common diseases were identified for which studies reported comparisons of non-contrast-enhanced and contrast-enhanced MRI. These specific diseases include primary brain tumors, metastases, abscess, multiple sclerosis, and vascular conditions such as aneurysm, arteriovenous malformation, arteriovenous fistula, intracranial carotid artery occlusive disease, hemorrhagic, and ischemic stroke.In general, non-contrast-enhanced techniques showed comparable diagnostic performance to contrast-enhanced MRI for specific diagnostic questions. However, some diagnoses still require contrast-enhanced imaging for a complete examination.</p>}},
author = {{Falk Delgado, Anna and Van Westen, Danielle and Nilsson, Markus and Knutsson, Linda and Sundgren, Pia C and Larsson, Elna-Marie and Falk Delgado, Alberto}},
issn = {{1869-4101}},
language = {{eng}},
month = {{08}},
number = {{1}},
publisher = {{Springer}},
series = {{Insights into Imaging}},
title = {{Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging-a comprehensive overview}},
url = {{http://dx.doi.org/10.1186/s13244-019-0771-1}},
doi = {{10.1186/s13244-019-0771-1}},
volume = {{10}},
year = {{2019}},
}