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@ARTICLE{vanOsch:271079,
      author       = {van Osch, Matthias J P and Wåhlin, Anders and Scheyhing,
                      Paul and Mossige, Ingrid and Hirschler, Lydiane and Eklund,
                      Anders and Mogensen, Klara and Gomolka, Ryszard and
                      Radbruch, Alexander and Qvarlander, Sara and Decker, Andreas
                      and Nedergaard, Maiken and Mori, Yuki and Eide, Per Kristian
                      and Deike-Hofmann, Katerina and Ringstad, Geir},
      title        = {{H}uman brain clearance imaging: {P}athways taken by
                      magnetic resonance imaging contrast agents after
                      administration in cerebrospinal fluid and blood.},
      journal      = {NMR in biomedicine},
      volume       = {37},
      number       = {9},
      issn         = {0952-3480},
      address      = {New York, NY},
      publisher    = {Wiley},
      reportid     = {DZNE-2024-00951},
      pages        = {e5159},
      year         = {2024},
      abstract     = {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.},
      subtyp        = {Review Article},
      keywords     = {Humans / Contrast Media: pharmacokinetics / Magnetic
                      Resonance Imaging / Brain: diagnostic imaging / Brain:
                      metabolism / Metabolic Clearance Rate / Animals /
                      Cerebrospinal Fluid: metabolism / Cerebrospinal Fluid:
                      diagnostic imaging / brain clearance (Other) / cerebrospinal
                      fluid (Other) / glymphatics (Other) / intrathecal injection
                      (Other) / intravenous injection (Other) / Contrast Media
                      (NLM Chemicals)},
      cin          = {AG Radbruch},
      ddc          = {610},
      cid          = {I:(DE-2719)5000075},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:38634301},
      doi          = {10.1002/nbm.5159},
      url          = {https://pub.dzne.de/record/271079},
}