Prospective Cohort Study of Nephrogenic Systemic Fibrosis in Patients With Stage 3–5 Chronic Kidney Disease Undergoing MRI With Injected Gadobenate Dimeglumine or Gadoteridol

Abstract

To our knowledge, and consistent with reports in the literature, no association of gadobenate dimeglumine or gadoteridol with unconfounded cases of NSF has yet been established. Study data confirm that both gadoteridol and gadobenate dimeglumine properly belong to the class of GBCAs considered to be associated with the lowest risk of NSF.

Differenzialdiagnostik der Pannikulitis

“…Die nephrogene systemische Fibrose (nephrogene fibrosierende Dermatopathie) tritt in erster Linie bei Patienten mit Niereninsuffizienz auf, die im Rahmen von Magnetresonanztomographie (MRT)-Untersuchungen Gadolinium-haltige Kontrastmittel erhalten haben [4,17]. Es kommt wenige Wochen bis Monate nach der Kontrastmittelgabe zu schmerzhaften erythematösen Indurationen mit orangenhautartiger Oberfläche und Kontrakturen.…”

“…Seit 2007 werden Gadolinium-haltige Kontrastmittel bei niereninsuffizienten Patienten und Kindern gemieden, jedoch sind Fälle bis zu 10 Jahre nach Exposition beschrieben worden. Inzwischen wurden neue Gadolinium-haltige Kontrastmittel entwickelt, die offensichtlich kein Risiko für die Entwicklung einer nephrogenen systemischen Fibrose mit sich bringen (Gadoteridol, Gadobenate dimeglumine) [17].…”

Clinical utility of gadobenate dimeglumine in contrast-enhanced MRI of the breast: a review

“…Available data do not reveal an increased risk of NSF for gadobenate dimeglumine (no unconfounded cases of NSF have been reported with this agent) and it is considered safer than other GBCAs, such as gadodiamide and gadopentetate dimeglumine, in patients with renal impairment. [41][42][43] Numerous studies reveal a robust safety profile for this agent.…”

The Benefits of High Relaxivity for Brain Tumor Imaging: Results of a Multicenter Intraindividual Crossover Comparison of Gadobenate Dimeglumine with Gadoterate Meglumine (The BENEFIT Study)

“…In this latter case, a clear understanding of the differences between GBCAs in terms of relaxivity and enhancement potential is fundamental to avoid misinterpretation of imaging findings (ie, to avoid interpretations of disease progression or therapy response, which, in reality, may be due solely to the different enhancement potential of various agents at equivalent doses). In regard to the risk of delayed adverse reactions, whereas gadoterate has a macrocyclic structure and is widely considered a safe GBCA based on in vitro stability data, 25 no cases of nephrogenic systemic fibrosis have yet been reported after the sole administration of gadobenate, [26][27][28] and gadobenate, like gadoterate, is considered a low-risk agent for nephrogenic systemic fibrosis by the American College of Radiology and other regulatory authorities, including the US Food and Drug Administration. 29,30 Moreover, unlike gadoterate, gadobenate has a dual route of elimination from the body, meaning that Gd 3ϩ is still eliminated via the hepatobiliary pathway in even greater amounts in patients with severely impaired renal function or end-stage renal disease.…”

“…29,30 Moreover, unlike gadoterate, gadobenate has a dual route of elimination from the body, meaning that Gd 3ϩ is still eliminated via the hepatobiliary pathway in even greater amounts in patients with severely impaired renal function or end-stage renal disease. 26,27,31 In regard to the possibility of intracranial Gd 3ϩ deposition, the GBCAs most closely associated with this phenomenon as yet have been gadodiamide and gadopentetate dimeglumine (ie, the same GBCAs most frequently associated with unconfounded cases of nephrogenic systemic fibrosis). [19][20][21][22][23][24] In terms of immediate-type adverse events, both gadobenate and gadoterate were safe and well-tolerated in patients with suspected or confirmed brain pathology, with no serious adverse events reported for either agent.…”