Gadolinium in Medical Imaging-Usefulness, Toxic Reactions and Possible Countermeasures-A Review

• Published in: Biomolecules (Basel, Switzerland) Vol. 12; no. 6; p. 742
• Main Authors: Blomqvist, Lennart, Nordberg, Gunnar F, Nurchi, Valeria M, Aaseth, Jan O
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 2022; MDPI
• Subjects: Chelates; Chelating Agents - adverse effects; Contrast agents; contrast induced nephropathy; Contrast Media - adverse effects; Contrast Media - chemistry; Fibrosis; Gadolinium; Gadolinium - chemistry; Gadolinium - toxicity; gadolinium induced respiratory distress syndrome; gadolinium kinetics; Humans; Kidney Diseases - chemically induced; Kidneys; Magnetic resonance imaging; Magnetic Resonance Imaging - adverse effects; Magnetic Resonance Imaging - methods; Medical imaging; Medicin och hälsovetenskap; nephrogenic systemic fibrosis; Patients; Renal function; Review; side effects of gadolinium chelates; Toxicity; treatment of gadolinium toxicity; gadolinium induced respiratory distress syndrome; gadolinium toxicity; contrast induced nephropathy; nephrogenic systemic fibrosis; side effects of gadolinium chelates; treatment of gadolinium toxicity; chelates; gadolinium kinetics; gadolinium
• ISSN: 2218-273X; 2218-273X
• DOI: 10.3390/biom12060742

Gadolinium (Gd) is one of the rare-earth elements. The properties of its trivalent cation (Gd ) make it suitable to serve as the central ion in chelates administered intravenously to patients as a contrast agent in magnetic resonance imaging. Such Gd-chelates have been used for more than thirty years. During the past decades, knowledge has increased about potential harmful effects of Gd-chelates in patients with severe renal dysfunction. In such patients, there is a risk for a potentially disabling and lethal disease, nephrogenic systemic fibrosis. Restricting the use of Gd-chelates in persons with severely impaired renal function has decreased the occurrence of this toxic effect in the last decade. There has also been an increasing awareness of Gd-retention in the body, even in patients without renal dysfunction. The cumulative number of doses given, and the chemical structure of the chelate given, are factors of importance for retention in tissues. This review describes the chemical properties of Gd and its medically used chelates, as well as its toxicity and potential side effects related to injection of Gd-chelates.