Influence of Artifact Corrections on MRI Signal Intensity Ratios for Assessment of Gadolinium Brain Retention.

Differences in brain signal intensity ratios (SIRs) of deep brain nuclei in T1-weighted (T1w) magnetic resonance images were reported as an indicator of gadolinium brain retention. Variable methods of image reconstruction and inhomogeneity correction for T1w images exist, which might affect the accuracy of SIRs. The aim of our prospective study was to investigate the effect of flow artifact compensation (FAC) and intensity inhomogeneity correction (IIC) on the dentate nucleus-to-pons and globus pallidus-to-thalamus SIRs in study participants who had previously received multiple doses of gadobutrol. This study included 76 participants who received five or more gadobutrol-enhanced scans between 2007 and 2017. A control group of 25 participants without gadolinium-based contrast agent application in their patient history was included for comparison. Unenhanced brain magnetic resonance imaging including two T1w spin-echo sequences with and without FAC was performed in all participants. Both sequences were reconstructed with and without IIC. Images were assessed for flow artifacts and SIRs were calculated. Using FAC, a lower proportion of participants had to be excluded from the final analysis of dentate nucleus-to-pons SIR due to flow artifacts (15% versus 46%, p < 0.001). Without IIC, a difference was found between the study and the control group for the dentate nucleus-to-pons ratio (p = 0.004), but not for the same sequence reconstructed with IIC (p = 0.29). For the globus pallidus-to-thalamus ratio, no difference was found between the study and control group. The application of an IIC algorithm has significant impact on brain nuclei SIRs for the assessment of gadolinium brain retention.

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