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Gadolinium-based contrast agents: A comprehensive risk assessment.

Tyler J Fraum1, Daniel R Ludwig1, Mustafa R Bashir2,3

  • 1Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA.

Journal of Magnetic Resonance Imaging : JMRI
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Summary

Gadolinium-based contrast agents (GBCAs) used in MRI carry risks, including nephrogenic systemic fibrosis (NSF). This review details GBCA health impacts and provides updated practice recommendations for clinicians and patients.

Keywords:
MRIgadolinium-based contrast agentreview

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Area of Science:

  • Radiology and Medical Imaging
  • Pharmacology and Toxicology

Background:

  • Gadolinium-based contrast agents (GBCAs) are widely used in MRI, administered in up to 35% of examinations.
  • Initial perceptions of minimal risk contrasted with later findings linking GBCAs to nephrogenic systemic fibrosis (NSF).
  • Growing concerns exist regarding the broader health implications of gadolinium exposure.

Purpose of the Study:

  • To provide an updated review of the risks associated with Gadolinium-based contrast agent administration.
  • To consolidate current data on adverse reactions, gadolinium deposition, and toxicity, with a focus on NSF.
  • To offer practice recommendations aligned with professional guidelines for GBCA use.

Main Methods:

  • Review of existing literature and data on Gadolinium-based contrast agents.
  • Analysis of immediate adverse reactions, effects during pregnancy and lactation.
  • Evaluation of gadolinium deposition and toxicity, specifically concerning NSF development.

Main Results:

  • Gadolinium-based contrast agents are linked to significant health risks, most notably nephrogenic systemic fibrosis (NSF).
  • Data covers immediate adverse events, risks in pregnant or lactating individuals, and long-term gadolinium deposition.
  • The review synthesizes current evidence to inform clinical practice.

Conclusions:

  • Clinicians, radiologists, and patients must be informed about the updated risks of Gadolinium-based contrast agents.
  • Practice recommendations are provided to guide safe administration and patient management.
  • Awareness of gadolinium deposition and toxicity is crucial for minimizing patient harm.