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Linda Knutsson

Professor

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Diagnostic value of alternative techniques to gadolinium-based contrast agents in MR neuroimaging-a comprehensive overview

Författare

  • Anna Falk Delgado
  • Danielle Van Westen
  • Markus Nilsson
  • Linda Knutsson
  • Pia C Sundgren
  • Elna-Marie Larsson
  • Alberto Falk Delgado

Summary, in English

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.

Avdelning/ar

  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • Neuroradiologi
  • MultiPark: Multidisciplinary research focused on Parkinson´s disease
  • Diagnostisk radiologi, Lund
  • MR Physics
  • Medicinsk strålningsfysik, Lund

Publiceringsår

2019-08-23

Språk

Engelska

Publikation/Tidskrift/Serie

Insights into Imaging

Volym

10

Issue

1

Dokumenttyp

Artikel i tidskrift

Förlag

Springer

Ämne

  • Radiology, Nuclear Medicine and Medical Imaging
  • Other Physics Topics

Status

Published

Projekt

  • Natural sugar as an MRI contrast agent for cancer diagnosis

Forskningsgrupp

  • Neuroradiology
  • MR Physics

ISBN/ISSN/Övrigt

  • ISSN: 1869-4101