Gadolinium‐based contrast agents: A comprehensive risk assessment

• Published in: Journal of magnetic resonance imaging Vol. 46; no. 2; pp. 338 - 353
• Main Authors: Fraum, Tyler J., Ludwig, Daniel R., Bashir, Mustafa R., Fowler, Kathryn J.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.08.2017
• Subjects: Animals; Contrast agents; Contrast Media - adverse effects; Contrast Media - toxicity; Etiology; Female; Fibrosis; Gadolinium; Gadolinium - adverse effects; Gadolinium - toxicity; gadolinium‐based contrast agent; Humans; Lactation; Lactation - drug effects; Magnetic resonance imaging; Magnetic Resonance Imaging - adverse effects; Maternal Exposure; MRI; Nephrogenic Fibrosing Dermopathy - chemically induced; NMR; Nuclear magnetic resonance; Pregnancy; review; Risk Assessment; Risk Factors; Side effects; Tissue Distribution; Toxicity; Treatment Outcome; gadolinium-based contrast agent; MRI; review
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.25625

Gadolinium‐based contrast agents (GBCAs) have been used in magnetic resonance imaging (MRI) since the 1980s and are now administered in up to 35% of all MRI examinations. While GBCAs were initially felt to carry minimal risk, the subsequent identification of GBCAs as the key etiologic factor in the development of nephrogenic systemic fibrosis (NSF) has raised concerns about the broader health impacts of gadolinium exposure. Clinicians, radiologists, and patients should be aware of the most up‐to‐date data pertaining to the risks of GBCA administration. Specific issues covered in this review article include immediate adverse reactions; pregnancy and lactation; and gadolinium deposition and toxicity, with a special focus on NSF. Practice recommendations based on the presented data, as well as current professional society guidelines, are provided for each section. Level of Evidence: 1 Technical Efficacy: Stage 5 J. MAGN. RESON. IMAGING 2017;46:338–353