Open this publication in new window or tab >>C. J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark.
Department of Neuroradiology, University Medical Center Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark; Center for Translational Neuromedicine, University of Rochester Medical Center, NY, Rochester, United States.
Center for Translational Neuromedicine, University of Copenhagen, Copenhagen, Denmark.
Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway; KG Jebsen Centre for Brain Fluid Research, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
Department of Neuroradiology, University Medical Center Bonn, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.
Department of Radiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway; Department of Geriatrics and Internal Medicine, Sorlandet Hospital, Arendal, Norway.
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2024 (English)In: NMR in Biomedicine, ISSN 0952-3480, E-ISSN 1099-1492, Vol. 37, no 9, article id e5159Article, review/survey (Refereed) Published
Abstract [en]
Over the last decade, it has become evident that cerebrospinal fluid (CSF) plays a pivotal role in brain solute clearance through perivascular pathways and interactions between the brain and meningeal lymphatic vessels. Whereas most of this fundamental knowledge was gained from rodent models, human brain clearance imaging has provided important insights into the human system and highlighted the existence of important interspecies differences. Current gold standard techniques for human brain clearance imaging involve the injection of gadolinium-based contrast agents and monitoring their distribution and clearance over a period from a few hours up to 2 days. With both intrathecal and intravenous injections being used, which each have their own specific routes of distribution and thus clearance of contrast agent, a clear understanding of the kinetics associated with both approaches, and especially the differences between them, is needed to properly interpret the results. Because it is known that intrathecally injected contrast agent reaches the blood, albeit in small concentrations, and that similarly some of the intravenously injected agent can be detected in CSF, both pathways are connected and will, in theory, reach the same compartments. However, because of clear differences in relative enhancement patterns, both injection approaches will result in varying sensitivities for assessment of different subparts of the brain clearance system. In this opinion review article, the "EU Joint Programme – Neurodegenerative Disease Research (JPND)" consortium on human brain clearance imaging provides an overview of contrast agent pharmacokinetics in vivo following intrathecal and intravenous injections and what typical concentrations and concentration–time curves should be expected. This can be the basis for optimizing and interpreting contrast-enhanced MRI for brain clearance imaging. Furthermore, this can shed light on how molecules may exchange between blood, brain, and CSF.
Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
brain clearance, cerebrospinal fluid, glymphatics, intrathecal injection, intravenous injection
National Category
Radiology, Nuclear Medicine and Medical Imaging Neurosciences
Identifiers
urn:nbn:se:umu:diva-224080 (URN)10.1002/nbm.5159 (DOI)001204639900001 ()38634301 (PubMedID)2-s2.0-85190949684 (Scopus ID)
Funder
EU, Horizon 2020, 825664Swedish Research Council, 2022-04263Swedish Foundation for Strategic ResearchThe Research Council of Norway, 333956
2024-05-132024-05-132024-08-20Bibliographically approved