ArticleJCI insight2021
Clinical application of intrathecal gadobutrol for assessment of cerebrospinal fluid tracer clearance to blood.
Article in JCI insight, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
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Who cites it
44 citing papers in PubMed, 59 citations in OpenAlex.
- A phase I/II study on intracerebroventricular tralesinidase alfa in patients with Sanfilippo syndrome type B.The Journal of clinical investigation · 2023Trial
- Brain Clearance of Contrast Agent in Intravenous DCE-MRI Is Measurable and Cannot Be Explained by Clearance Across the BBB Alone.Magnetic resonance in medicine · 2026Article
- In-silico solute transport via perivascular networks in the human intracranial space.Nature communications · 2026Article
- Simultaneous measurement of water transport across the blood-brain and blood-CSF barrier in the human brain with arterial spin labeling MRI.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Article
- Estimation of human brain fluid clearance using intrathecal imaging contrast agents.Fluids and barriers of the CNS · 2026Observational
- Glymphatic System Visualized With Intrathecal Gadoterate Meglumine Administered via External Ventricular Drain.Cureus · 2026Article
- The impact of human brain geometry on the transport of an intrathecal tracer.Fluids and barriers of the CNS · 2026Article
- Modeling glioma-induced impairments on the glymphatic system.Fluids and barriers of the CNS · 2026Article
- Human brain MRI data of intrathecally injected tracer evolution over 72 hours for data-integrated simulations.Scientific data · 2026Article
- The influence of intermittent hypercapnia on cerebrospinal fluid flow and clearance in Parkinson's disease and healthy older adults.NPJ Parkinson's disease · 2025Article
- The parasagittal dural space of the human brain.Brain : a journal of neurology · 2025Review
- The pathogenesis of cerebral small vessel disease and vascular cognitive impairment.Physiological reviews · 2025Review
- Altered brain fluid dynamics in spontaneous intracranial hypotension.Fluids and barriers of the CNS · 2025Observational
- Cholinergic basal forebrain neurons regulate vascular dynamics and cerebrospinal fluid flux.Nature communications · 2025Article
- U-Net-Based Prediction of Cerebrospinal Fluid Distribution and Ventricular Reflux Grading.NMR in biomedicine · 2025Article
- Vascular Contribution to Cerebral Waste Clearance Affected by Aging or Diabetes.Diagnostics (Basel, Switzerland) · 2025Article
- Imaging brain fluid dynamics and waste clearance involving perivascular spaces in cerebral small vessel disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Review
- A method for measuring first glymphatic influx of a cerebrospinal fluid tracer in the human brain.Frontiers in neuroscience · 2025Article
- Advances and controversies in meningeal biology.Nature neuroscience · 2024Review
- Neurosurgery and the glymphatic system.Acta neurochirurgica · 2024Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUNDMethodology for estimation of cerebrospinal fluid (CSF) tracer clearance could have wide clinical application in predicting excretion of intrathecal drugs and metabolic solutes from brain metabolism and for diagnostic workup of CSF disturbances.METHODSThe MRI contrast agent gadobutrol (Gadovist) was used as a CSF tracer and injected into the lumbar CSF. Gadobutrol is contained outside blood vessels of the CNS and is eliminated along extravascular pathways, analogous to many CNS metabolites and intrathecal drugs. Tracer enrichment was verified and assessed in CSF by MRI at the level of the cisterna magna in parallel with obtaining blood samples through 48 hours.RESULTSIn a reference patient cohort (n = 29), both enrichment within CSF and blood coincided in time. Blood concentration profiles of gadobutrol through 48 hours varied between patients diagnosed with CSF leakage (n = 4), idiopathic normal pressure hydrocephalus dementia (n = 7), pineal cysts (n = 8), and idiopathic intracranial hypertension (n = 4).CONCLUSIONAssessment of CSF tracer clearance is clinically feasible and may provide a way to predict extravascular clearance of intrathecal drugs and endogenous metabolites from the CNS. The peak concentration in blood (at about 10 hours) was preceded by far peak tracer enhancement at MRI in extracranial lymphatic structures (at about 24 hours), as shown in previous studies, indicating a major role of the spinal canal in CSF clearance capacity.FUNDINGThe work was supported by the Department of Neurosurgery, Oslo University Hospital; the Norwegian Institute for Air Research; and the University of Oslo.
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