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Original Research

Evaluation of 3.0-T MRI Brain Signal after Exposure to Gadoterate Meglumine in Women with High Breast Cancer Risk and Screening Breast MRI

Published Online:Oct 22 2019https://doi.org/10.1148/radiol.2019190847

Abstract

Women at high risk for breast cancer undergoing annual breast MRI screening with relatively large cumulative doses of gadoterate dimeglumine did not exhibit T1 signal increase in either globus pallidus or dentate nucleus at unenhanced 3.0-T brain MRI.

Background

Otherwise healthy women at high risk for breast cancer undergo annual contrast agent–enhanced breast MRI screening examinations, resulting in high cumulative doses of gadolinium-based contrast agents (GBCAs). Whereas the majority of studies showed no T1 signal ratio increase in deep brain nuclei after more than six doses of macrocyclic GBCA, this has not been explored in a healthy study population.

Purpose

To assess whether women who are administered large cumulative doses of macrocyclic GBCA with breast MRI at high-risk breast cancer screening exhibit T1 alterations in deep brain nuclei.

Materials and Methods

In this prospective study from November 2017 to March 2018, healthy women who were either exposed (because of high-risk breast cancer screening) or unexposed to only gadoterate meglumine underwent 3.0-T brain MRI with a dedicated head coil, including T1 mapping and magnetization-prepared rapid gradient-echo sequences. T1 times and T1 signal intensities were measured in the dentate nucleus (DN), globus pallidus (GP), crus anterior of capsula interna (CA), and pons. Ratios of DN to pons and GP to CA were calculated, and univariable Pearson correlation coefficients were calculated. Multivariable analysis included partial regression analysis.

Results

This study evaluated 25 women (mean age, 51 years ± 11 [standard deviation]) who were exposed to a mean GBCA dose of 129 mL (median 112 mL; range, 70–302 mL) and 16 women (mean age, 37 years ± 10) who were never exposed to any GBCA. Infratentorially, no correlation between cumulative GBCA dose and T1 times or signal intensity ratios was detected (P = .66 and .55, respectively). In partial correlation analysis by considering age as a confounder, there was a moderate negative correlation between GP-to-CA ratio and GBCA dose (r = −0.40; P = .01) but not for GP T1 times (r = 0.19; P = .24).

Conclusion

After administration of relatively large cumulative doses of gadoterate dimeglumine, healthy women at high risk for breast cancer who underwent annual contrast-enhanced breast MRI screening did not exhibit T1 signal increase in deep brain nuclei at 3.0-T MRI.

© RSNA, 2019

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Article History

Received: Apr 12 2019
Revision requested: May 23 2019
Revision received: Aug 25 2019
Accepted: Aug 29 2019
Published online: Oct 22 2019
Published in print: Dec 2019