Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance
Intravenously (IV) administered Gadolinium-based-contrast-agents (GBCAs) can enter the intracranial cerebrospinal-fluid (CSF) space via weak barriers between blood and CSF at multiple locations in the brain. This enables IV-GBCAs to be used as a tracer to study CSF circulation and clearance in the b...
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Elsevier
2025-05-01
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| Series: | NeuroImage |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1053811925002423 |
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| author | Jun Hua Yuanqi Sun Yinghao Li Xinyi Zhou Yuhan Bian Adrian Paez Briana Meyer Swati Rane Levendovszky |
| author_facet | Jun Hua Yuanqi Sun Yinghao Li Xinyi Zhou Yuhan Bian Adrian Paez Briana Meyer Swati Rane Levendovszky |
| author_sort | Jun Hua |
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| description | Intravenously (IV) administered Gadolinium-based-contrast-agents (GBCAs) can enter the intracranial cerebrospinal-fluid (CSF) space via weak barriers between blood and CSF at multiple locations in the brain. This enables IV-GBCAs to be used as a tracer to study CSF circulation and clearance in the brain. With proper optimization, IV-GBCA induced signal changes can be robustly detected in various brain regions associated with CSF circulation. Nevertheless, whether these signal changes can be attributed to GBCA concentration changes in the CSF space should be interpreted with caution. This review attempts to discuss several technical challenges for using IV-GBCA MRI to study CSF circulation in the brain. First, it is critical to minimize the partial volume effects from the blood compartment as IV-GBCAs can present in both the blood and CSF compartments for a long time. Second, MRI approaches that can provide a quantitative measure of GBCA concentration in the CSF are preferred as raw MR signal intensities can often have a complicated relationship with GBCA concentration. Third, regions with intracranial and extracranial blood supply should be analyzed separately because GBCA distribution in regions with extracranial blood supply may not be a proper indicator for CSF clearance from the brain. Fourth, differences in the cerebrovasculature should be considered when comparing IV-GBCA concentration changes in the CSF in brain diseases. Finally, a proper reference signal needs to be established to calibrate longitudinal post-GBCA signals across sessions. Some of these issues may also apply to intrathecal GBCA MRI studies. |
| format | Article |
| id | doaj-art-a7e7cba47e434abfb7b1e27054a72012 |
| institution | OA Journals |
| issn | 1095-9572 |
| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-a7e7cba47e434abfb7b1e27054a720122025-08-20T02:14:35ZengElsevierNeuroImage1095-95722025-05-0131212123910.1016/j.neuroimage.2025.121239Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearanceJun Hua0Yuanqi Sun1Yinghao Li2Xinyi Zhou3Yuhan Bian4Adrian Paez5Briana Meyer6Swati Rane Levendovszky7Neurosection, Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA; Corresponding author at: Johns Hopkins University School of Medicine, Department of Radiology, Kennedy Krieger Institute, F.M. Kirby Research Center for Functional Brain Imaging, 707N Broadway, Baltimore, MD 21205, USA.Neurosection, Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USANeurosection, Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USANeurosection, Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USANeurosection, Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USANeurosection, Division of MR Research, Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USADepartment of Radiology, University of Washington, Seattle, WA, USADepartment of Radiology, University of Kansas Medical Center, Kansas City, KS, USAIntravenously (IV) administered Gadolinium-based-contrast-agents (GBCAs) can enter the intracranial cerebrospinal-fluid (CSF) space via weak barriers between blood and CSF at multiple locations in the brain. This enables IV-GBCAs to be used as a tracer to study CSF circulation and clearance in the brain. With proper optimization, IV-GBCA induced signal changes can be robustly detected in various brain regions associated with CSF circulation. Nevertheless, whether these signal changes can be attributed to GBCA concentration changes in the CSF space should be interpreted with caution. This review attempts to discuss several technical challenges for using IV-GBCA MRI to study CSF circulation in the brain. First, it is critical to minimize the partial volume effects from the blood compartment as IV-GBCAs can present in both the blood and CSF compartments for a long time. Second, MRI approaches that can provide a quantitative measure of GBCA concentration in the CSF are preferred as raw MR signal intensities can often have a complicated relationship with GBCA concentration. Third, regions with intracranial and extracranial blood supply should be analyzed separately because GBCA distribution in regions with extracranial blood supply may not be a proper indicator for CSF clearance from the brain. Fourth, differences in the cerebrovasculature should be considered when comparing IV-GBCA concentration changes in the CSF in brain diseases. Finally, a proper reference signal needs to be established to calibrate longitudinal post-GBCA signals across sessions. Some of these issues may also apply to intrathecal GBCA MRI studies.http://www.sciencedirect.com/science/article/pii/S1053811925002423Partial volumeConcentrationExtracranialIntracranialCerebrovasculatureReference signal |
| spellingShingle | Jun Hua Yuanqi Sun Yinghao Li Xinyi Zhou Yuhan Bian Adrian Paez Briana Meyer Swati Rane Levendovszky Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance NeuroImage Partial volume Concentration Extracranial Intracranial Cerebrovasculature Reference signal |
| title | Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance |
| title_full | Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance |
| title_fullStr | Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance |
| title_full_unstemmed | Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance |
| title_short | Technical considerations for using intravenous gadolinium-based-contrast-agent (GBCA) based MRI approaches to study cerebrospinal fluid (CSF) circulation and clearance |
| title_sort | technical considerations for using intravenous gadolinium based contrast agent gbca based mri approaches to study cerebrospinal fluid csf circulation and clearance |
| topic | Partial volume Concentration Extracranial Intracranial Cerebrovasculature Reference signal |
| url | http://www.sciencedirect.com/science/article/pii/S1053811925002423 |
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