Gadolinium retention in the body: what we know and what we can do

Abstract

Gadolinium-based contrast agents (GBCA), widely used in Magnetic Resonance Imaging (MRI) for almost 30 years, were recently shown to be deposited in the brain and to induce persistent T1 shortening in deep gray matter structures in subjects with normal renal function. The aim of the present study is to summarize the evidence derived from the rapidly growing scientific literature on Gadolinium retention in the brain and in the rest of the body. To this end, the original articles that described imaging and pathology findings in humans and animals exposed to GBCA were reviewed. The main aspects that emerged were the different effects of linear and macrocyclic GBCA on brain MRI appearance, the evidence of Gadolinium tissue retention in multiple organs, and the debated issue of the possible clinical consequences. Although no adverse health effects have been documented so far, updated information about GBCA build-up in the body is necessary for health professionals, also in view of the increasing concern in the general population. To date, our knowledge about the mechanisms of Gadolinium tissue deposition and, above all, its long-term consequences is still largely incomplete. However, while official guidelines are eagerly awaited, some advices may already be given, to help our radiological daily practice.

Absence of infratentorial lesions in Fabry disease contributes to differential diagnosis with multiple sclerosis

“…Nevertheless, a significant renal impairment is present in FD patients (Pisani et al, 2014). This clinical finding, coupled to the recent concerns raised about a possible gadolinium deposition in the brain of patients undergoing multiple contrast MRI exams (Tedeschi et al, 2017), indirectly support the use of feasible and easy-to-identify neuroradiological signs, such as the combined callosal-infratentorial evaluation, to differentiate FD from MS.…”

<p>Gadolinium-doped bioglass scaffolds promote osteogenic differentiation of hBMSC via the Akt/GSK3&beta; pathway and facilitate bone repair in vivo</p>

“…[10][11][12][13][14][15] In particular, Gd element is found in human bones and plays a key role in bone tissue growth and regeneration. [19][20][21][22] In this study, we successfully fabricated Gd-BG scaffolds with hierarchical pores and bioactive Gd element for effective bone defect healing.…”

“…18 Many studies have shown a considerably higher level of Gd deposition in bone tissue, indicating that bone might be a preferential site of Gd deposition. [19][20][21][22] Thus, Gd-containing biomaterials have attracted considerable interest worldwide. 23,24 The in vitro studies have shown that Gd could promote the proliferation of various kinds of cells.…”

Highly Accelerated Vessel-Selective Arterial Spin Labelling Angiography using Sparsity and Smoothness Constraints

“…Gaussian noise was added in k-space. k-Space SNR was defined as = ( ) [4] where rms(I) represents was the root-mean-square intensity of the noiseless k-space measurements and  is the standard deviation of the added noise signal. Three noise conditions were simulated, i) no noise, ii) moderate noise (SNRk = 185.7), and iii) high noise (SNRk = 92.8).…”

“…Gadolinium-based contrast agents are unsuitable for patients with renal dysfunction because they can trigger nephrogenic systemic fibrosis (2), and have also been shown to be retained in the brain (3). Although the long-term health implications of gadolinium retention are still unknown (4,5), minimizing the use of gadolinium based contrast agents is recommended for clinical applications and research use.…”