Acute Adverse Events Following Gadolinium-based Contrast Agent Administration: A Single-Center Retrospective Study of...

Area of Science:

• Radiology
• Pharmacovigilance
• Medical Imaging Safety

Background:

• Acute allergic-like and physiologic reactions are observed after gadolinium-based contrast agent (GBCA) administration during MRI.
• Comparing GBCA reaction rates and identifying risk factors is challenging due to the uncommon nature of these events.

Purpose of the Study:

• To compare the reaction rates among four GBCAs: gadodiamide, gadobutrol, gadobenate dimeglumine, and gadoterate meglumine.
• To identify potential risk factors associated with GBCA reactions.

Main Methods:

• Retrospective analysis of 281,945 GBCA injections across 158,100 patients from June 2009 to May 2017.
• Reactions were classified as allergic-like or physiologic (mild, moderate, severe) based on American College of Radiology criteria.
• Multivariable regression models with generalized estimating equations were used to analyze reaction rates and risk factors.

Main Results:

• Gadobenate and gadobutrol exhibited higher rates of allergic-like reactions compared to gadodiamide and gadoterate.
• Gadoterate, gadobenate, and gadobutrol were associated with increased rates of physiologic reactions versus gadodiamide.
• Severe allergic-like reactions (n=6) required hospitalization, occurring with gadobutrol and gadobenate.
• Patient age, sex, examination location, and MRI type were correlated with acute reaction rates.

Conclusions:

• Gadobenate and gadobutrol are linked to higher allergic-like reaction rates, while gadoterate, gadobenate, and gadobutrol show higher physiologic reaction rates compared to gadodiamide.
• Patient demographics and MRI specifics are significant factors influencing acute GBCA reaction incidence.