Effective Meningioma Images Despite Reduced Gadolinium - EMJ

Effective Meningioma Images Despite Reduced Gadolinium

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A NEW study has found that the gadolinium dose for MRI imaging can be reduced by over half the standard amount without compromising the ability to distinguish meningiomas from surrounding brain tissues. This research highlighted a significant step forward in improving patient care and mitigating concerns associated with gadolinium-based contrast agents.

Tshea Dowers, University of Toronto, Canada, and team discovered that reducing the gadolinium dose by 62% still provided sufficient visual clarity to delineate brain tumours from healthy tissue. “At the standard gadolinium dose, most meningiomas show avid contrast enhancement, suggesting that administering a smaller dose may be feasible,” the authors noted.

The study included 108 patients with suspected or confirmed meningiomas who underwent brain MRI with varying gadolinium doses, categorized into three groups: micro (25% of the standard dose, typically 0.1 mmol), low (62% of the standard dose), and standard. The researchers assessed signal differences for each dose both quantitatively and qualitatively, comparing the performance of low and microdoses to the standard dose.

Results indicated that reducing the gadolinium dose to 62% of the standard level still allowed for effective visual delineation of meningiomas. There was a statistically significant decrease in signal difference between the tumour and adjacent brain tissues with reduced doses (p < 0.02). However, the low dose’s performance remained comparable to the standard dose on visual assessment.

Conversely, using a microdose resulted in a significantly higher proportion of cases with less-than-optimal differentiation between the tumour and healthy tissue, affecting the clarity between the tumour and the cortex (p = 0.041) and the tumour and sinus (p < 0.001).

The researchers concluded that while a 62% gadolinium dose is effective for imaging, further reduction to 25% compromises the ability to distinguish tumours from adjacent structures, rendering it inadvisable. This discovery paves the way for safer and more cost-effective MRI procedures in the diagnosis of meningiomas.



Dowers T et al. Comparative evaluation of lower gadolinium doses for MR imaging of meningiomas: how low can we go? Am J Reuroradiol. 2024;A8375.

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