Gadolinium Elimination in a Gadolinium Deposition Disease Population After a Single Exposure to Gadolinium-Based Contrast Agents

• Published in: Investigative radiology Vol. 60; no. 7; p. 429
• Main Authors: Ramalho, Joana, Ramalho, Miguel, Semelka, Richard C
• Format: Journal Article
• Language: English
• Published: United States 01.07.2025
• Subjects: Adult; Aged; Contrast Media - administration & dosage; Contrast Media - pharmacokinetics; Female; Gadolinium - administration & dosage; Gadolinium - pharmacokinetics; Gadolinium - urine; Humans; Magnetic Resonance Imaging - methods; Male; Middle Aged; Retrospective Studies; GBCA; gadolinium elimination; macrocyclic; linear; urine; gadolinium
• ISSN: 1536-0210
• DOI: 10.1097/RLI.0000000000001146

This study documents the gadolinium (Gd) content in urine over time after the administration of a single dose of Gd-based contrast agent (GBCA) in patients diagnosed with Gd deposition disease. In this retrospective observational study, 45 subjects with normal renal function who had performed 1 contrast-enhanced magnetic resonance imaging and had a nonprovoked (native) 24-hour urine test for Gd quantification after the examination were evaluated. The GBCA brand and the time interval in days between the GBCA administration and 24-hour urine Gd measurements were recorded. Log-log plot visualization of time points for urine Gd content was obtained. Time points collected for urine Gd content showed that Gd was above the reference levels for 3 months postinjection. The urinary concentration of Gd was similar for all agents, including linear and macrocyclic. The urinary content decreased in a dog-leg fashion. Gd urine content was substantially elevated at 1 month and decreased to remain above the accepted normal range by 3 months. Gd is retained in the body and shows demonstrable continued spontaneous elimination in urine for at least several months after administration, including the most stable macrocyclic agents. The Gd elimination pattern shows a logarithmic decrease pattern between 1 and 3 months for all agents, regardless of their structure.