Lack of T1 hyperintensity in the dentate nucleus after 15 administrations of a macrocyclic contrast agent in multiple sclerosis

Introduction

In multiple sclerosis (MS), MRI has emerged as the most useful paraclinical biomarker. 'No evidence of disease activity' is a desired outcome in therapeutic clinical trials and therapy monitoring in individual patients, which includes the absence of new or enhancing lesions on MRI. Therefore, frequent follow-up contrast-enhanced MRI examinations play an important role in disease monitoring.

In 2013, Kanda et al1 described an increased signal intensity (SI) of the dentate nucleus (DN) on unenhanced T1-weighted MRI after multiple applications of gadolinium-based contrast agents (GBCAs) suggesting a deposition of gadolinium. Since then, numerous studies evaluated the effects of gadolinium deposition in the brain after serial application of GBCAs, and recent studies provide evidence that T1 hyperintensity of the DN is associated with the prior administrations of linear GBCAs, but not with macrocyclic GBCAs.2 3 However, the experience of an abnormal SI in the DN after...

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