Brain gadolinium deposition after administration of gadolinium-based contrast agents

Kanda, Tomonori; Oba, Hiroshi; Toyoda, Keiko; Kitajima, Kazuhiro; Furui, Shigeru

doi:10.1007/s11604-015-0503-5

Cited by 147 publications

(117 citation statements)

References 59 publications

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“…Furthermore, small post-mortem studies showed the presence of miniscule amounts of gadolinium in brain tissue in patients who received GCCAs in the past [8][9][10]. The recent post-mortem study by Murata et al found that gadolinium deposition in normal brain and bone tissue occurs with both agents based on macrocyclic (only nonionic, i.e.…”

Section: Evidence For Gadolinium Retentionmentioning

confidence: 99%

Gadolinium retention after administration of contrast agents based on linear chelators and the recommendations of the European Medicines Agency

2017

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The Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicines Agency (EMA) earlier this year recommended to suspend some marketing authorisations for Gadolinium Containing Contrast Agents (GCCAs) based on linear chelators due to the potential risk of gadolinium retention in the human body. These recommendations have recently been re-evaluated by EMA's Committee for Medicinal Products for Human Use (CHMP), and confirmed the final opinion of the European Medicines Agency. This editorial provides an overview of the available GCCAs and summarises the recent evidence of gadolinium retention. Moreover, a critical appraisal of the strengths and limitations of the scientific evidence currently available on gadolinium retention is given. Key points • EMA recommended suspension of some EU marketing authorisations of four linear GCCAs. • Brain MRI findings indicating gadolinium retention have been confirmed by mass spectrometry.• Current scientific evidence for gadolinium retention has several methodological limitations.• No clear clinical evidence exists indicating that gadolinium retention causes neurotoxicity.• Long-term safety of GCCAs, however, remains unclear.

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Section: Evidence For Gadolinium Retentionmentioning

confidence: 99%

Gadolinium retention after administration of contrast agents based on linear chelators and the recommendations of the European Medicines Agency

2017

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“…Because gadolinium is toxic to humans, it is injected along with chelating compounds that can prevent its toxicity by promoting its quick excretion from the body [106]. However, increased signal intensity in the dentate nucleus, globus pallidus, and pulvinar of thalamus on T1WI in patients subjected to repeated GBCA administration was recently reported for the first time.…”

Section: Gadoliniummentioning

confidence: 99%

“…The administered gadolinium remains in the human body for a long time and causes abnormal signal intensity on T1WI (Fig. 4) [106][107][108]. Because of the toxicity of gadolinium, residual gadolinium has been attracting increasing attention [109][110][111][112][113][114][115][116].…”

Section: Gadoliniummentioning

confidence: 99%

“…In autopsy studies, gadolinium is detected in the brain tissue from patients with a history of GBCA administration using ICP-MS [119][120][121]. The signal intensity on T1WI and the residual gadolinium in these brain regions are both correlated with the total dose of GBCA administered, and the gadolinium deposition is clearly due to past GBCA administration [106]. Animal studies have also confirmed that the signal from the dentate nucleus on T1WI is affected by previous gadolinium administration, and that gadolinium is deposited [122,123], but none of these clinical phenomena have been reported in connection with gadolinium deposition in the brain in the presence of normal renal function [106].…”

Section: Gadoliniummentioning

confidence: 99%

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Contribution of metals to brain MR signal intensity: review articles

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“…We chose this journal because there are many new key concepts or innovative techniques that are suitable for clinical application Gadolinium deposition in brain. The deposition of gadolinium-based contrast agents (GBCAs) in the brains of patients without renal insufficiency is a hot topic in the field of neuroradiology [7,8]. It is still unclear how GBCA penetrates the blood-brain barrier and is deposited in the brain.…”

mentioning

confidence: 99%