Gadolinium-Based Contrast Agent Accumulation and Toxicity: an Update

• Autor(a) principal: Ramalho, J
• Data de Publicação: 2016
• Outros Autores: Semelka, RC, Ramalho, M, Nunes, RH, Alobaidy, M, Castillo, M
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/3968
• topic: HSJ NRAD; Cerebellar Nuclei / diagnostic imaging; Animals; Humans; Contrast Media / adverse effects*; Contrast Media / pharmacokinetics*; Gadolinium / adverse effects*; Gadolinium / pharmacokinetics*; Magnetic Resonance Imaging / adverse effects; Nephrogenic Fibrosing Dermopathy / chemically induced*; Nephrogenic Fibrosing Dermopathy / epidemiology

In current practice, gadolinium-based contrast agents have been considered safe when used at clinically recommended doses in patients without severe renal insufficiency. The causal relationship between gadolinium-based contrast agents and nephrogenic systemic fibrosis in patients with renal insufficiency resulted in new policies regarding the administration of these agents. After an effective screening of patients with renal disease by performing either unenhanced or reduced-dose-enhanced studies in these patients and by using the most stable contrast agents, nephrogenic systemic fibrosis has been largely eliminated since 2009. Evidence of in vivo gadolinium deposition in bone tissue in patients with normal renal function is well-established, but recent literature showing that gadolinium might also deposit in the brain in patients with intact blood-brain barriers caught many individuals in the imaging community by surprise. The purpose of this review was to summarize the literature on gadolinium-based contrast agents, tying together information on agent stability and animal and human studies, and to emphasize that low-stability agents are the ones most often associated with brain deposition.