Gadolinium-based MR Contrast Agents and Nephrogenic Systemic Fibrosis

Kuo, Phillip H.; Kanal, Emanuel; Abu‐Alfa, Ali K.; Cowper, Shawn E.

doi:10.1148/radiol.2423061640

Cited by 568 publications

(416 citation statements)

References 8 publications

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“…For instance, CA diffuses in cytoplasm after electroporation, and in perinuclear vesicles after pinocytosis. 24 Also, as recently pointed out, differential in vivo stability of commercial Gd chelates is another variable to be take into consideration for longer term studies, 40 but should have no role to play in the relative acute process we had been monitoring.…”

Section: Discussionmentioning

confidence: 99%

Discrepancies between the fate of myoblast xenograft in mouse leg muscle and NMR label persistency after loading with Gd-DTPA or SPIOs

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Discrepancies between the fate of myoblast xenograft in mouse leg muscle and NMR label persistency after loading with Gd-DTPA or SPIOs

et al. 2009

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“…Specifically, in this serum system there were differences in the release of Gd between Magnevist and Omniscan (Magnevist behavior appeared to be similar to the macrocyclic GBCA Dotarem and ProHance) but both Magnevist and Omniscan are associated with the greatest number of cases of NSF. The theory also does not take into account many other patient-associated factors thought to play a role-not least the fact that only a small minority of ESRD patients develop NSF (2,5). Other observations that demonstrate that other factors play a significant role in the development of NSF include:…”

Section: The Phagocytosis Of Gd Triggers Inflammatorymentioning

confidence: 99%

“…To date, it has only been reported in patients with severely impaired renal function (SIRF), endstage renal disease (ESRD), and those in acute renal failure (ARF) (2)(3)(4)(5). The many other risk factors thought to be associated with NSF include: edema (6), metabolic acidosis, thrombotic events, high-dose erythropoietin (EPO) (7,8), systemic inflammation (9), recent surgery, kidney disease (10), and gadolinium (Gd 3þ )-based contrast agent (GBCA) exposure (11,12), especially when used at relatively high dose GBCA (5,13).…”

mentioning

confidence: 99%

Mechanism of NSF: New evidence challenging the prevailing theory

Newton¹,

Jimenez

2009

Magnetic Resonance Imaging

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Nephrogenic systemic fibrosis (NSF) has been associated with the administration of gadolinium‐based contrast agents in patients with severely impaired renal function (SIRF), endstage renal disease (ESRD), or acute renal failure (ARF). Since the vast majority of these patients do not get NSF, it is highly likely that patient factors play a role in its development. Although “free” or dechelated gadolinium is thought by some to be the only trigger of NSF, recent evidence suggests that chelated gadolinium may be important. Chelated gadolinium such as Omniscan (gadodiamide) and Magnevist (gadopentetate) can directly stimulate macrophages and monocytes in vitro to release profibrotic cytokines and growth factors capable of initiating and supporting the tissue fibrosis that is characteristic of NSF. In addition, an effect of chelated gadolinium on fibroblasts has also been demonstrated. Chelated gadolinium in the form of Omniscan, Magnevist, MultiHance, and ProHance increased proliferation of human dermal fibroblasts. Indeed, increased numbers of macrophages, together with activated fibroblasts and fibrocytes, are essential cells in the fibrotic process and are present in NSF skin. Accordingly, it is important that chelated gadolinium, in combination with patient cofactors, is considered in the etiology of NSF associated with enhanced scans. J. Magn. Reson. Imaging 2009;30:1277–1283. © 2009 Wiley‐Liss, Inc.

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“…He originally stated that the contrast used was ''gadolinium DTPA''; however, after consultation with the radiologists involved this was retracted and a correction published as the agent implicated was gadolinium DTPA-BMA (gadodiamide) (7). Since then, other groups have confirmed this association, finding an NSF incidence of up to 5% in patients with severe renal failure administered gadolinium-based contrast agents (GBCAs) (13)(14)(15)(16)(17). Studies have also found positive association between the total cumulative dose of GBCA received and the development of NSF (16)-indicating a form of dose-response relationship, that is, those patients exposed to higher doses or repeat examinations were more likely to develop NSF.…”

Section: Nephrogenic Systemic Fibrosismentioning

confidence: 99%

Renovascular imaging in the NSF Era

Roditi

Maki

Oliveira

et al. 2009

Magnetic Resonance Imaging

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The detection of the association between nephrogenic systemic fibrosis (NSF), a rare but potentially life‐threatening disease only encountered in patients with severely impaired renal function, and the previous administration of some Gd‐chelates has cast a shadow on the administration of Gd‐chelates in patients with chronic renal failure. So far, contrast‐enhanced MR‐angiography (MRA) was considered the best diagnostic modality in patients with suspected renal disease. This review explores the most appropriate use of renal MRA with a focus on newly developed nonenhanced MRA techniques. Nonenhanced MRA techniques mainly based on SSFP with ECG‐gating allow for acceptable spatial resolution to visualize at least the proximal parts of the renal arteries. In addition functional renal imaging techniques and their current clinical role are critically appreciated. J. Magn. Reson. Imaging 2009;30:1323–1334. © 2009 Wiley‐Liss, Inc.

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Gadolinium-based MR Contrast Agents and Nephrogenic Systemic Fibrosis

Cited by 568 publications

References 8 publications

Discrepancies between the fate of myoblast xenograft in mouse leg muscle and NMR label persistency after loading with Gd-DTPA or SPIOs

Discrepancies between the fate of myoblast xenograft in mouse leg muscle and NMR label persistency after loading with Gd-DTPA or SPIOs

Mechanism of NSF: New evidence challenging the prevailing theory

Renovascular imaging in the NSF Era

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