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Research status of Gadolinium-based contrast on safety
YUAN Sishu  XIA Liming  YANG Zhaoxia  QIAO Jinhan 

Cite this article as: Yuan SS, Xia LM, Yang ZX, et al. Research status of Gadolinium-based contrast on safety. Chin J Magn Reson Imaging, 2020, 11(8): 717-720. DOI:10.12015/issn.1674-8034.2020.08.030.


[Abstract] Magnetic resonance imaging (MRI) has become a crucial radiologic method for clinical diagnosis, and enhanced MRI can improve image quality of tissue, organ and vessel. Since U.S. FDA approved the first Gadolinium-based contrast agent (GBCA) in 1988, it has been used more than 30 years, and over 300 million patients worldwide were benefited by its diagnosis and treatment guidance. GBCA was considered as a comparative safer contrast media for its overall low incidence rate of adverse drug reaction. With deep understanding and widespread application of GBCA, clinicians pay more attention to its safety. In 2006, nephrogenic systemic fibrosis (NSF) which drew a lot radiologists’ attention. NSF is a rare but serious systemic disease characterized by fibrosis throughout the body in renally impaired individuals. Consider the patients’ benefit, the management of GBCA was strengthened to ensure the NSF incidence ratio decreased. Recently, another issue, Gd retention in the brain, especially in dental nucleus and globus pallidus arouse widespread attention again. Drug authorities executed different regulatory measures in different countries and regions make radiologists overstressed in GBCA application and selection. Therefore, the paper will review the literatures on the application of GBCA, summarizing the background, possible mechanism and clinical significance, providing a powerful theory foundation for GBCA selection and correct understanding in clinic.
[Keywords] gadolinium-based contrast agent；magnetic resonance imaging；nephrogenic systemic fibrosis；acute adverse effect；Gadolinium retention

YUAN Sishu Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

XIA Liming* Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

YANG Zhaoxia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

QIAO Jinhan Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

*Corresponding to: Xia LM, E-mail: cjr.xialiming@vip.163.com

Conflicts of interest   None.

Received  2019-12-24
Accepted  2020-06-04
DOI: 10.12015/issn.1674-8034.2020.08.030
Cite this article as: Yuan SS, Xia LM, Yang ZX, et al. Research status of Gadolinium-based contrast on safety. Chin J Magn Reson Imaging, 2020, 11(8): 717-720. DOI:10.12015/issn.1674-8034.2020.08.030.

[1]
Davenport MS, McDonald RJ, Asch D, et al. ACR committee on drugs and contrast media, ACR Manual on Contrast Media Version2020. DOI: .
[2]
Thurnher SA. MR imaging of pelvic masses in women: contrast-enhanced vs unenhanced images. Am J Roentgenol, 1992, 159(6): 1243-1250.
[3]
Jha RC, Mitchell DG, Weinreb JC, et al. LI-RADS categorization of benign and likely benign findings in patients at risk of hepatocellular carcinoma: A pictorial atlas. AJR Am J Roentgenol, 2014, 203(1): W48-69.
[4]
Zhang Y, Zhao J, Guo D, et al. Evaluation of short-term response of high intensity focused ultrasound ablation for primary hepatic carcinoma: utility of contrast-enhanced MRI and diffusion-weighted imaging. Eur J Radiol, 2011, 79(3): 347-352.
[5]
Ramalho J, Semelka RC, Ramalho M, et al. Gadolinium-based contrast agent accumulation and toxicity: an update. Am J Neuroradiol, 2016, 37(7): 1192-1198.
[6]
Jeffrey C, Weinreb JC. MRI safety issue for implants, devices, and contrast: update 2018. (2019-06-21)[2019-10-22]. https://meeting.rsna.org/program/index.cfm.2018.11.26.
[7]
Cowper SE, Robin HS, Steinberg SM, et al. Scleromyxoedema-like cutaneous diseases in renal-dialysis patients. Lancet, 2000, 356(9234): 1000-1001.
[8]
Grobner T. Gadolinium-a specific trigger for the development of nephrogenic fibrosing dermopathy and nephrogenic systemic fibrosis. Nephrol Dial Transplant, 2006, 21(4): 1104-1108.
[9]
Aqarwal R, Brunelli SM, Williams K, et al. Gadolinium-based contrast agents and nephrogenic systemic fibrosis: a systematic review and meta-analysis. R Nephrol Dial Transplant, 2009, 24(3): 856-863.
[10]
Bennett CL, Qureshi ZP, Sartor AO, et al. Gadolinium-induced nephrogenic systemic fibrosis: the rise and fall of an iatrogenic disease. Clin Kidney J, 2012, 5(1): 82-88.
[11]
Fraum TJ, Ludwig DR, Bashir MR, et al. Gadolinium-based contrast agents: A comprehensive risk assessment. J Magn Reson Imaging, 2017, 46(2): 338-353.
[12]
Ramalho M, Ramalho J. Gadolinium-based contrast agents: Associated adverse reactions. Magn Reson Imaging Clin N Am, 2017, 25(4): 755-764.
[13]
Gauden AJ, Phal PM, Drummond KJ, et al. MRI safety: nephrogenic systemic fibrosis and other risks. J Clin Neurosci, 2010, 17(9): 1097-1104.
[14]
Heinz-Peer G, Neruda A, Watschinger B, et al. Prevalence of NSF following intravenous gadolinium-contrast media administration in dialysis patients with end stage renal disease. Eur J Radiol, 2010, 76(1): 129-134.
[15]
Joffe P, Thomsen HS, Meusel M, et al. Pharmacokinetics of gadodiamide injection in patients with severe renal insufficiency and patients undergoing hemodialysis or continuous ambulatory peritoneal dialysis. Acad Radiol, 1998, 5(7): 491-502.
[16]
Perriss R, Løkkegaard H, Løgager V, et al. Preliminary experience with contrast-enhanced MR angiography in patients with end-stage renal failure. Acad Radiol, 2005, 12(5): 652-657.
[17]
Spinosa DJ, Angle JF, Haqspiel KD, et al. Interventional uroradiologic procedures performed using gadodiamide as an alternative to iodinated contrast material. Cardiovasc Intervent Radiol, 2000, 23(1): 72-75.
[18]
张斌，梁龙，陈文波，等．含钆对比剂与肾源性系统性纤维化关联度变化趋势的Meta分析及因果解析．磁共振成像, 2015, 6(4): 304-312.
[19]
Bellin MF, Van der Molen AJ. Extracellular gadolinium-based contrast media: an overview. Eur J Radiol, 2008, 66(2): 160-167.
[20]
Edward M, Quinn JA, Mukherjee S, et al. Gadodiamide contrast agent "activates" fibroblasts: a possible cause of nephrogenic systemic fibrosis. J Pathol, 2008, 214(5): 584-593.
[21]
Davison R, Mead P. Nephrogenic systemic fibrosis (NSF): the role of tamoxifen. NDT Plus, 2010, 3(5): 505.
[22]
Elmholdt TR, Pedersen M, et al. Nephrogenic systemic fibrosis is found only among gadolinium-exposed patients with renal insufficiency: a case-control study from Denmark. Br J Dermatol, 2011, 165(4): 828-836.
[23]
Voth M, Rosenberq M, Breuer J, et al. Safety of gadobutrol, a new generation of contrast agents: experience from clinical trials and postmarketing surveillance. Invest Radiol, 2011, 46(11): 663-671.
[24]
Kanda T, Ishii K, Kawaguchi H, et al. High signal intensity in the dentate nucleus and globus pallidus on unenhanced T1-weighted MR images: relationship with increasing cumulative dose of a gadolinium-based contrast material. Radiology, 2014, 270(3): 834-841.
[25]
Errante Y, Cirimele V, Mallio CA, et al. Progressive increase of T1 signal intensity of the dentate nucleus on unenhanced magnetic resonance images is associated with cumulative doses of intravenously administered gadodiamide in patients with normal renal function, suggesting dechelation. Invest Radiol, 2014, 49(10): 685-690.
[26]
Adin ME, Kleinberq L, Vaidya D, et al. Hyperintense dentate nuclei on T1-weighted MRI: relation to repeat gadolinium administration. AJNR Am J Neuroradiol, 2015, 36(10): 1859-1865.
[27]
McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology, 2015, 275(3): 772-782.
[28]
Kanda T, Fukusato T, Matsuda M, et al. Gadolinium-based contrast agent accumulates in the brain even in subjects without severe renal dysfunction: evaluation of autopsy brain specimens with inductively coupled plasma mass spectroscopy. Radiology, 2015, 276(1): 228-232.
[29]
Murata N, Gonzales-Cuyar LF, Murata K, et al. Macrocyclic and other non-group 1 gadolinium contrast agents deposit low levels of gadolinium in brain and bone tissue: preliminary results from 9 patients with normal renal function. Invest Radiol, 2016, 51(7): 447-453.
[30]
Ramalho J, Castillo M, AIObaidy M, et al. High signal intensity in globus pallidus and dentate nucleus on unenhanced T1-weighted MR images: evaluation of two linear gadolinium-based contrast agents. Radiology, 2015, 276(3): 836-844.
[31]
Weberling LD, Kieslich PJ, Kickingereder P, et al. Increased signal intensity in the dentate nucleus on unenhanced T1-weighted images after gadobenate dimeglumine administration. Invest Radiol, 2015, 50(11): 743-748.
[32]
Radbruch A, Weberling LD, Kieslich PJ, et al. Gadolinium retention in the dentate nucleus and globus pallidus is dependent on the class of contrast agent. Radiology, 2015, 275(3): 783-791.
[33]
Kanda T, Osawa M, Oba H, et al. High signal intensity in dentate nucleus on unenhanced T1-weighted MR Images: association with linear versus macrocyclic gadolinium chelate administration. Radiology, 2015, 275(3): 803-809.
[34]
Smith AP, Marino M, Roberts J, et al. Clearance of gadolinium from the brain with no pathologic effect after repeated administration of gadodiamide in healthy rats: an analytical and histologic study. Radiology, 2017, 282(3): 743-751.
[35]
Pullicino R, Das K. Is it safe to use gadolinium-based contrast agents in MRI?. J R Coll Physicians Edinb, 2017, 47(3): 243-246.
[36]
Foley MJ, Ghahremani GG, Rogers LF. Reappraisal of contrast media used to detect upper gastrointestinal perforations: comparison of ionic water-soluble media with barium sulfate. Radiology, 1982, 144(2): 231-237.
[37]
Jung JW, Kang HR, Kim MH, et al. Immediate hypersensitivity reaction to gadolinium-based MR contrast media. Radiology, 2012, 264(2): 414-422.
[38]
Bruder O, Schneider S, Nothnagel D, et al. Acute adverse reactions to gadolinium-based contrast agents in CMR: multicenter experience with 17,767 patients from the EuroCMR registry. JACC Cardiovasc Imaging, 2011, 4(11): 1171-1176.
[39]
Bruder O, Schneider S, Pilz G, et al. 2015 update on acute adverse reaction to gadolinium-based contrast agents in cardiovascular MR. Large multi-national and multi-ethnical population experience with 37788 patients from the EuroCMR registry. J Cardiovasc Magn Reson, 2015, 17(58): 1-7.
[40]
Behzadi AH, Zhao Y, Farooq Z, et al. Immediate allergic reactions to gadolinium-based contrast agents: a systematic review and meta-analysis. Radiology, 2018, 282(2): 471-482.
[41]
严福华，王培军，陈敏，等.钆对比剂临床安全性应用中国专家建议.中华放射学杂志, 2019, 53(7): 539-544.

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