Analysis of Blood Gadolinium in an Isotope Geochemist Following Contrast MRI

Normal brain tissue does not have blood flowing throughout it; instead oxygen diffuses across a blood-brain barrier in order to oxygenate brain cells. Brain tumors, however, do grow blood supplies, so an abnormal distribution of blood in the brain is a key indicator of abnormal cell growth. But how is the distribution of blood in inside the brain observed? The lanthanide ion gadolinium(III) has unpaired 5f-shell electrons and is thus paramagnetic. As such, the presence of Gd causes the nuclei of nearby atoms to relax more quickly when excited to high-energy spin states by pulses of radio-frequency energy than they would without Gd nearby. The signal in magnetic resonance imaging correlates with this nuclear spin relaxation time, so gadolinium's presence in certain body tissues makes those tissues appear as bright areas on MRI images. Gadolinium is therefore commonly injected intravenously just prior to MRI imaging, so that the distribution of blood in and around the brain can be mapped. Gadolinium as a free ion is toxic, so it is injected in a relatively inert form, often as gadoversetamide, in which Gd is tightly bound in nine-fold coordination with N, C, and O. This compound is removed from the blood by the kidneys at a rate that is fast compared to the rate of breakdown of this compound in the blood, thus preventing release of toxic Gd in the bloodstream. But how quickly can the kidneys of an isotope geochemist remove Gd from blood? In this experiment, a single isotope geochemist's wristwatch was synchronized with that of the MRI technician and then left in a dressing room with all other magnetically susceptible objects until after the MRI. The time of intravenous injection of gadoversetamide into the isotopist was recorded by the technician and later transmitted verbally to the isotopist. Following the MRI session, blood samples were collected by self-fingerprick, in a Class 100 trace metal clean lab, from 47 to 281 minutes after intravenous injection. For each timepoint, approximately 300 microliters of blood were transferred by acid-washed pipette to an acid-washed, Teflon, screw-cap vial and weighed. Samples were digested with hot, concentrated nitric acid and 30% hydrogen peroxide, dried down, and redissolved in 0.32 M nitric acid. Gd concentrations were measured by quadrupole ICP-MS, at masses 152, 154, 155, 156, 157, 158, and 160, using yttrium (mass 89) and bismuth (mass 209) as internal standards to normalize plasma variations during the run. Results indicate decreasing blood Gd concentrations, from 35.8 parts per million by weight at 47 minutes after injection to 7.5 parts per million at 281 minutes. The data have a near-perfect fit to an exponential decay curve with half-life of 105 minutes, demonstrating that renal filtration of gadoversetamide is a first-order reaction in at least one isotope geochemist.