Toxicity associated with gadolinium-based contrast-enhanced examinations

Lattanzio, Silvia Maria

doi:10.3934/biophy.2021015

Cited by 8 publications

(9 citation statements)

References 155 publications

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“…The toxicity of Gd 3+ in biological systems is largely due to its ability to mimic cations, particularly calcium ions (Ca 2+ ), but also magnesium, zinc, and iron. These should not be overlooked, particularly because of the role of these ions as coenzymes in various biochemical processes [ 3 ]. Due to the toxic nature of Gd 3+ ions, they are chelated with organic ligands to form GBCA that have either a linear or a macrocyclic structure.…”

Section: Methodsmentioning

confidence: 99%

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Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents

Dekker,

Stroomberg,

Van der Molen

et al. 2024

Insights Imaging

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Gadolinium-based contrast agents (GBCA) are essential for diagnostic MRI examinations. GBCA are only used in small quantities on a per-patient basis; however, the acquisition of contrast-enhanced MRI examinations worldwide results in the use of many thousands of litres of GBCA per year. Data shows that these GBCA are present in sewage water, surface water, and drinking water in many regions of the world. Therefore, there is growing concern regarding the environmental impact of GBCA because of their ubiquitous presence in the aquatic environment. To address the problem of GBCA in the water system as a whole, collaboration is necessary between all stakeholders, including the producers of GBCA, medical professionals and importantly, the consumers of drinking water, i.e. the patients. This paper aims to make healthcare professionals aware of the opportunity to take the lead in making informed decisions about the use of GBCA and provides an overview of the different options for action.In this paper, we first provide a summary on the metabolism and clinical use of GBCA, then the environmental fate and observations of GBCA, followed by measures to reduce the use of GBCA. The environmental impact of GBCA can be reduced by (1) measures focusing on the application of GBCA by means of weight-based contrast volume reduction, GBCA with higher relaxivity per mmol of Gd, contrast-enhancing sequences, and post-processing; and (2) measures that reduce the waste of GBCA, including the use of bulk packaging and collecting residues of GBCA at the point of application.Critical relevance statement This review aims to make healthcare professionals aware of the environmental impact of GBCA and the opportunity for them to take the lead in making informed decisions about GBCA use and the different options to reduce its environmental burden.Key points• Gadolinium-based contrast agents are found in sources of drinking water and constitute an environmental risk.• Radiologists have a wide spectrum of options to reduce GBCA use without compromising diagnostic quality.• Radiology can become more sustainable by adopting such measures in clinical practice. Graphical Abstract

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Section: Methodsmentioning

confidence: 99%

“…cyclic ligand) and either ionic (i.e. dissociation into charged particles occurs in solution) or non-ionic [ 3 ]. The structure of GBCA determines their complex stability and in vivo stability.…”

Section: Methodsmentioning

confidence: 99%

Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents

Dekker,

Stroomberg,

Van der Molen

et al. 2024

Insights Imaging

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“…Em animais aquáticos provoca danos nas membranas celulares. (Lattanzio, 2021) Hoje no mercado existem diversos agentes de contraste para serem utilizados na RMN, que são: Gadopentetato de dimeglumina (Gd-DTPA), Gadoterato de meglumina (Gd-DOTA), Gadoteridol (Gd-HP-DO3A), Gadodiamida (Gd-DTPA-BMA), Gadoversetamida (Gd-DTPA-BMEA), Gadobutrol (Gd-BT-DO3A), Gadoxetato dissódico (Gd-EOB-DTPA) e Gadobenato de dimeglumina (Gd-BOPTA).…”

Section: O Que é O Gadolíneo?unclassified

“…Eles aumentam a sensibilidade e a especificidade de detectar e avaliar várias patologias, sendo muito relevante para discriminar células cancerígenas. (Lattanzio, 2021). Para que possa ser utilizado como meio de contraste para uso clínico, o Gd 3+ necessita estar fortemente ligado a um quelante, para que se evitem os efeitos tóxicos relacionados à sua forma livre.…”

Section: Introductionunclassified

Toxicidade do gadolínio por meio de contraste em exames de imagem

Silva

Fazenda

2022

RSD

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Objetivo: a finalidade deste artigo é descrever as propriedades e utilidades do Gadolínio (Gd), dando ênfase a sua toxicidade como meio de contraste em exames de Ressonância Magnética Nuclear (RMN). Essa pesquisa tem como base descrever as principais reações adversas, indicações, contraindicações e toxicidade pelo uso de GBCAs, um fármaco comumente usado como contraste não ionizante. Metodologia: foi realizada uma revisão de literatura, onde foram adquiridas informações em artigos científicos de sites renomados como Scientific Eletronic Library Online (SciELO) e US national Library of Medicine (PubMed). Resultados: o Gd é um metal utilizado de várias formas para diversas finalidades, e uma delas é em exames de RMN como meio de contraste. Entretanto, pode fornecer riscos à saúde de pacientes que apresentem doenças prévias, como renais crônicos, ou aqueles que sejam portadores de sensibilidades ou alergias, podendo causar reações agudas maiores ou menores, que vão de urticárias, cefaleias e vômitos, até choque anafilático e laringoespasmo. Todavia, uma das complicações que vêm sendo estudada com amplitude é a patologia denominada como Fibrose Sistêmica Nefrogênica (FSN). Há recentemente estudos nos quais foram relatados riscos até mesmo em pacientes com funções renais dentro da normalidade. Conclusão do estudo: esclarecimento das orientações e informações importantes para o paciente que realiza o exame de RMN contrastado, e também, deixar como alerta aos profissionais de saúde sobre um tema não muito abordado, porém de alta periculosidade.

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“…The authors hypothesized that changes in disease pathophysiology and gadolinium structure could influence gadolinium deposition 7 . There are certain potential biases in examining and evaluating the health/clinical consequences of gadolinium deposition 8 . The bulk of clinical investigations on GBCAs were unable to examine direct acute toxicity and diagnostic effectiveness of the agents, and hence the long-term health impacts, according to the research.…”

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confidence: 99%