Incidence of Nephrogenic Systemic Fibrosis after Adoption of Restrictive Gadolinium-based Contrast Agent Guidelines

Abstract

After restrictive guidelines regarding GBCA administration were instituted, no new cases of NSF were identified among 52,954 contrast-enhanced MR examinations, including those performed in patients with an eGFR lower than 60 mL/min/m(2).

Editor's Choice – Management of Descending Thoracic Aorta Diseases

“…Using alternative imaging modalities or using the lowest possible amount of gadolinium may prevent NSF. 24 2.3.7. Positron emission tomography.…”

Development of the application of speciation in chemistry

“…The most frequently studied metal nuclei are 23 Na, 27 Al, 29 Si, and 51 V, but 195 Pt, 119 Sn, 113 Cd, 183 W, 199 Hg, and 205 Tl are also measured often. If the number of protons in the nuclei is an odd number, the natural abundance of the NMR active nuclei is usually much higher than that with an even number.…”

Gadolinium and nephrogenic systemic fibrosis: an update

“…Data on the type and dose of Gd used is not available in all studies. For those studies that do report dose-effect, an increased NSF risk with either increasing cumulative Gd dose over multiple examinations or with a high single dose during a single examination is recorded [30,33,36,[42][43][44]. One observational study reports an average 2.4 % risk of developing NSF for each radiological study using Gd in at-risk patients [32].…”

“…This reflects a culture shift highlighted by a recent report of widely adopted policy changes among nephrologists across the USA relating to Gd contrast use in renal impairment and awareness of the risk factors and morbidity associated with NSF [62]. Since 2007, there has been a dramatic drop in the number of NSF cases reported, with multiple large studies in Sweden and the USA identifying reduced incidence or no new cases of NSF following restrictive prescribing policies [42,44,59,63]. In particular, no new pediatric cases of NSF have been reported to the Yale Registry in the period 2007-2013 (personal communication, Yale NSF Registry).…”