Assessment of Gadobutrol Safety in Combination with Ionizing Radiation Using a Preclinical MRI-Guided Radiotherapy Model.
Assessment of Gadobutrol Safety in Combination with Ionizing Radiation Using a Preclinical MRI-Guided Radiotherapy Model.
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应用临床前mri引导放射治疗模型评价加多比特与电离辐射联合使用的安全性。
DOI：
10.1667/rade-20-00199.1
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发表时间：
2021-03-01
影响因子：
3.4
通讯作者：
Allen BG
中科院分区：
文献类型：
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作者：
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;Allen BG
磁共振直线加速器技术通过明确肿瘤-正常组织的界面来提高治疗放射的精确度，并提供了自适应治疗计划的潜力。在诊断磁共振成像(MRI)上准确描绘肿瘤通常需要使用基于Gd的造影剂(GBCA)。尽管通常被认为是安全的，但以前的文献表明，GBCA能够引起造影剂诱导的急性肾损伤(AKI)。目前尚不清楚当GBCA与电离放射治疗同时进行时，AKI的风险是否会增加。在辐射过程中，Gd可能从它的螯合剂中释放出来，从而可能导致AKI。这项工作的目标是确定放射与GBCA结合是否会增加AKI的发生率。使用临床前MRI引导的放射治疗系统，快速连续进行MRI采集和放射治疗，将肾功能正常的荷瘤小鼠注射GBCA，并接受2、8或18Gy射线治疗。在照射后第3天和第7天评估肾功能，以评估AKI。在GBCA和放射剂量的任何组合中，都没有观察到血尿素氮和肌酐的临床相关变化。从这些数据中，我们得出结论，GBCA与辐射联合使用不会增加小鼠AKI的风险。在放疗的同时给予多剂量GBCA的额外研究是有必要的，以评估慢性肾损伤的风险。
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.