Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the last decade, i.v. contrast media use in magnetic resonance imaging (MRI) of the central nervous system has become well established. Three agents are currently available in the United States: gadopentetate dimeglumine (Magnevist), gadodiamide (Omniscan), and gadoteridol (ProHance). At a dose of 0.1 mmol/kg, for which all three agents are approved, the contrast effect is equivalent. The agents differ on the basis of stability in vivo, osmolality, and charge. A single agent (ProHance) is approved for high-dose administration (0.3 mmol/kg). The basis of this approval is due in part to the high stability of the agent and thus lower potential for toxicity from long-term heavy metal deposition. Clinical experience, combined with new developments in MR technology, continue to expand applications for these agents. Improved detection of metastatic disease to the brain has been demonstrated in multiple clinical trials with high-dose contrast administration. High dose may also play an important role in brain infection and infarction, providing improved recognition of blood-brain barrier disruption and thus disease activity. First-pass studies make possible the evaluation of regional cerebral blood volume with high intrinsic spatial resolution. The availability of new instrumentation, together with the use of high contrast dose, have improved the quality and clinical utility of these studies. Research is ongoing in the development of new agents, both with greater tissue selectivity and improved safety profile. Chelates of dysprosium, in addition to gadolinium, are receiving attention for potential clinical application in first-pass imaging.
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PMID:Update: safety, new applications, new MR agents. 765 96

This article reports the results of clinical testing in pediatric patients of a new contrast agent, gadoteridol injection (ProHance), developed by Squibb Diagnostic as a nonionic gadolinium agent for use in magnetic resonance imaging (MRI). Thirteen children (four girls and nine boys) ranging in age from 10 to 18 years were enrolled in the study. The children had MR studies of the brain and/or spine with T1-weighted, T2-weighted, and postgadoteridol injection T1-weighted sequences. Five children had primary brain or spine neoplasms, three children had metastatic disease to the central nervous system, one child had a recurrent brain neoplasm and spinal canal metastasis, one child had an arteriovenous malformation, and two children were normal on the MRI studies. No minor or major reactions to gadoteridol injection developed in the 13 patients. Gadoteridol injection provided excellent delineation and enhancement of the arteriovenous malformation and all of the primary and secondary neoplasms of the central nervous system except for one case of a grade 1 glioma of the midbrain. Gadoteridol injection is a safe and excellent contrast agent for use in MRI.
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PMID:Magnetic resonance imaging of the central nervous system in children with a new nonionic gadolinium contrast agent--gadoteridol injection (ProHance). 849 90

Compliance with an institution's dosage guidelines for gadoteridol was determined, and adverse reactions to gadoteridol and gadopentetate were compared. Departmental policy in March 1993 set the standard dose of gadoteridol at 0.1 mmol/kg. A dose of 0.05 mmol/kg was set for patients with suspected acoustic neurinomas or pituitary microadenomas. Guidelines allowing a high dose of 0.2 or 0.3 mmol/kg were also established for specific indications involving suspected metastatic disease or inadequate contrast enhancement at the standard dose. Data on gadoteridol use were collected concurrently from May 1993 to January 1994 and included the dose, the indication for the dose, and any adverse reactions. Safety data for patients who had received gadopentetate between June 1988 and March 1990 were also collected and reviewed. The subjects in this retrospective analysis represented the same broad population as those involved in the concurrent evaluation of gadoteridol use. The frequency and types of adverse events in the two groups were compared. During the gadoteridol-review period, 8377 patients underwent magnetic resonance imaging studies; 3558 (42.5%) of them received gadoteridol. Of the 3558 doses given, 3375 (94.9%) were 0.1 mmol/kg (the standard dose). Compliance with the guidelines for nonstandard doses was 90% for the 0.3-mmol/kg dose, 74% for the 0.2-mmol/kg dose, and 39% for the 0.05-mmol/kg dose. There were 101 adverse reactions to gadoteridol in 75 (2.1%) of the 3558 recipients. The reactions were mild to moderate and self-limiting. Records for 4892 gadopentetate recipients were analyzed. There were adverse reactions in 62 patients (1.3%). Again, most reactions were mild to moderate. The use of gadoteridol at a medical center generally complied with institutional guidelines. Gadoteridol was well tolerated whether given in standard or high doses. The frequencies and types of adverse reactions to gadoteridol and gadopentetate were similar.
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PMID:Dosage of gadoteridol and adverse reactions relative to gadopentetate. 859 Feb 39