1. Assessment of Gadobutrol Safety in Combination with Ionizing Radiation Using a Preclinical MRI-Guided Radiotherapy Model.
- Author
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Petronek MS, Steinbach EJ, Kalen AL, Builta ZJ, Callaghan CM, Hyer DE, Spitz DR, Flynn RT, Buatti JM, Magnotta VA, Zepeda-Orozco D, St-Aubin JJ, and Allen BG
- Subjects
- Acute Kidney Injury chemically induced, Acute Kidney Injury physiopathology, Animals, Brain diagnostic imaging, Brain drug effects, Brain pathology, Brain radiation effects, Contrast Media adverse effects, Disease Models, Animal, Gadolinium adverse effects, Gadolinium pharmacology, Humans, Kidney diagnostic imaging, Kidney drug effects, Kidney pathology, Kidney radiation effects, Magnetic Resonance Imaging, Mice, Organometallic Compounds adverse effects, Radiotherapy, Image-Guided adverse effects, Radiotherapy, Image-Guided methods, Acute Kidney Injury diagnostic imaging, Contrast Media pharmacology, Organometallic Compounds pharmacology, Radiation, Ionizing
- Abstract
MR-linac technology enhances the precision of therapeutic radiation by clarifying the tumor-normal tissue interface and provides the potential for adaptive treatment planning. Accurate delineation of tumors on diagnostic magnetic resonance imaging (MRI) frequently requires gadolinium-based contrast agents (GBCAs). Despite generally being considered safe, previous literature suggests that GBCAs are capable of contrast-induced acute kidney injury (AKI). It is unclear if the risk for AKI is enhanced when GBCAs are administered concurrently with ionizing radiotherapy. During irradiation, gadolinium may be liberated from its chelator which may induce AKI. The goal of this work was to determine if radiation combined with GBCAs increased the incidence of AKI. Using a preclinical MRI-guided irradiation system, where MRI acquisitions and radiation delivery are performed in rapid succession, tumor-bearing mice with normal kidney function were injected with GBCA and treated with 2, 8 or 18 Gy irradiation. Renal function was assessed on days three and seven postirradiation to assess for AKI. No clinically relevant changes in blood urea nitrogen and creatinine were observed in any combination of GBCA and radiation dose. From these data, we conclude that GBCA in combination with radiation does not increase the risk for AKI in mice. Additional investigation of multiple doses of GBCA administered concurrently with irradiation is warranted to evaluate the risk of chronic kidney injury., (©2021 by Radiation Research Society. All rights of reproduction in any form reserved.)
- Published
- 2021
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