Gadolinium in Medical Imaging-Usefulness, Toxic Reactions and Possible Countermeasures-A Review

Area of Science:

• Radiology and Medical Imaging
• Toxicology
• Materials Science

Background:

• Gadolinium (Gd), a rare-earth element, is crucial for MRI contrast agents.
• Gd-chelates have been intravenously administered for over 30 years.
• Concerns regarding Gd-chelate toxicity have risen, particularly in patients with renal impairment.

Purpose of the Study:

• To review the chemical properties of Gd and its medically used chelates.
• To discuss the toxicity and potential side effects of Gd-chelate injections.
• To highlight the risks associated with Gd retention in patients.

Main Methods:

• Literature review on Gd chemistry, chelate formulations, and clinical use.
• Analysis of data on nephrogenic systemic fibrosis incidence.
• Examination of factors influencing Gd retention in the body.

Main Results:

• Gd-chelates are effective MRI contrast agents but carry risks.
• Nephrogenic systemic fibrosis is a severe risk in patients with severe renal dysfunction.
• Gd retention occurs even in patients without renal dysfunction, influenced by dose and chelate structure.

Conclusions:

• Restricting Gd-chelate use in patients with severe renal dysfunction has reduced nephrogenic systemic fibrosis.
• Awareness of Gd retention is increasing, necessitating careful consideration of chelate choice and cumulative dosage.
• Further research into Gd toxicity and safe usage protocols is warranted.