Gadolinium Deposition in Neurology Clinical Practice.

Area of Science:

• Neurology
• Radiology
• Toxicology

Background:

• Gadolinium-based contrast agents (GBCAs) are vital for neurologic MRI diagnostics.
• GBCAs exist in macrocyclic and linear forms.
• Since 2014, research indicates potential gadolinium deposition in the brain after repeated GBCA administration.

Purpose of the Study:

• To review literature on gadolinium deposition and associated health outcomes.
• To summarize updated medical society recommendations on GBCA use.

Main Methods:

• Literature review of animal and human studies on gadolinium deposition.
• Review of studies on GBCA-associated health outcomes.
• Summary of current medical society guidelines and perspectives on GBCA administration.

Main Results:

• Gadolinium deposition in the human brain was first reported in 2014.
• Linear GBCAs are associated with brain gadolinium deposition (dentate nucleus, globus pallidus) on MRI.
• Macrocyclic GBCAs have not been convincingly linked to MRI-detectable gadolinium deposition.
• No adverse health outcomes have been linked to gadolinium deposition to date.

Conclusions:

• GBCAs cause dose-dependent gadolinium deposition in the brain.
• Only linear GBCAs show deposition visualized on MRI.
• Current guidelines stress individualized risk-benefit assessments for GBCA use.