Residual or Retained Gadolinium: Practical Implications for Radiologists and Our Patients

Kanal, Emanuel; Tweedle, Michael F.

doi:10.1148/radiol.2015150805

Cited by 226 publications

(171 citation statements)

References 25 publications

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“…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]. These regions show increased signal with the administration of linear-type GBCAs but not macrocyclic-type GBCAs; because linear-type GBCAs are more unstable , and pulvinar of thalamus (yellow arrows) are hypointense compared with a normal agematched female (Fig.…”

Section: Gadoliniummentioning

confidence: 99%

Contribution of metals to brain MR signal intensity: review articles

et al. 2016

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Section: Gadoliniummentioning

confidence: 99%

Contribution of metals to brain MR signal intensity: review articles

et al. 2016

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“…The accumulated safety record is excellent, with serious adverse reactions occurring in roughly 0.03% of all administrations. 2,3 These adverse reactions are more common in patients with history of asthma, allergies, and renal insufficiency and in patients injected at faster rates. 1,4,5 GBCAs had an exceptional safety reputation from 1988 to 2006, to the point that in 2004 and 2005 GBCAs were recommended as a substitute for iodine-based contrast media in patients with renal failure for CT and in interventional studies.…”

mentioning

confidence: 99%

Gadolinium-Based Contrast Agent Accumulation and Toxicity: An Update

Ramalho

Semelka

Ramalho

et al. 2015

American Journal of Neuroradiology

374

244

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SUMMARY:In current practice, gadolinium-based contrast agents have been considered safe when used at clinically recommended doses in patients without severe renal insufficiency. The causal relationship between gadolinium-based contrast agents and nephrogenic systemic fibrosis in patients with renal insufficiency resulted in new policies regarding the administration of these agents. After an effective screening of patients with renal disease by performing either unenhanced or reduced-dose-enhanced studies in these patients and by using the most stable contrast agents, nephrogenic systemic fibrosis has been largely eliminated since 2009. Evidence of in vivo gadolinium deposition in bone tissue in patients with normal renal function is well-established, but recent literature showing that gadolinium might also deposit in the brain in patients with intact blood-brain barriers caught many individuals in the imaging community by surprise. The purpose of this review was to summarize the literature on gadolinium-based contrast agents, tying together information on agent stability and animal and human studies, and to emphasize that low-stability agents are the ones most often associated with brain deposition.ABBREVIATIONS: DN ϭ dentate nuclei; GBCA ϭ gadolinium-based contrast agent; NSFϭ nephrogenic systemic fibrosis

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“…It should be careful considered about mis-precipitation by Gd 3+ instead of Ca 2+ in many organs, because of an antagonistic effect due to the ion size similarity between Gd 3+ and Ca 2+ . (Kanal and Tweedle, 2015;Idée et al, 2009). In addition, there is also report that Ca 2+ found in a gadolinium precipitation.…”

Section: Discussionmentioning

confidence: 99%

Comparison of nephrotoxicity between two gadolinium-contrasts, gadodiamide and gadopentetate in patients with mildly diminished renal failure

et al. 2017

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-Although gadolinium (Gd)-based contrast media have been found to be nephrotoxic, their nephrotoxicity, and the dependence of nephrotoxicity on chelate types, have not been assessed in patients with normal or mildly diminished renal failure. This prospective, randomized study compared the nephrotoxicity of low doses of the nonionic Gd-based contrast medium gadodiamide (Omniscan®) and the ionic Gd-based contrast medium gadopentetate (Magnevist®) in patients with serum creatinine < 1.6 mg/dL. Patients aged 20 to 80 years, weighing 45 to 70 kg and with normal or < 1.6 mg/dL Serumcreatinine in the 3 months prior to undergoing magnetic resonance imaging (MRI) of brain, were enrolled. Patients were randomized to receive 0.1 mol/kg gadodiamide or gadopentetate. Serum-creatinine, serum cystatin-C, estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease (MDRD) formula, and estimated creatinine clearance rate (eCCr) using the Cockcroft-Gault formula were measured just before and 16-80 hr after MRI. Groups were compared statistically by Mann-Whitney U-tests and Wilcoxon signed-rank tests. There were no significant differences in clinical characteristics between the gadodiamide (n = 43) and gadopentetate (n = 59) groups. Serum-creatinine, eGFR and eCCr before and 16-80 hr after MRI did not differ significantly within either group or between the two groups. Serum cystatin-C was significantly higher 16-80 hr after than before MRI only in the gadodiamide group (0.79 ± 0.21 vs. 0.74 ± 0.14 mg/L, p = 0.028). The ionic contrast medium, gadopentetate, did not affect renal function during MRI, whereas the nonionic contrast medium, gadodiamide, affected renal function transiently.

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Residual or Retained Gadolinium: Practical Implications for Radiologists and Our Patients

Cited by 226 publications

References 25 publications

Contribution of metals to brain MR signal intensity: review articles

Contribution of metals to brain MR signal intensity: review articles

Gadolinium-Based Contrast Agent Accumulation and Toxicity: An Update

Comparison of nephrotoxicity between two gadolinium-contrasts, gadodiamide and gadopentetate in patients with mildly diminished renal failure

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