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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2017; 27(02): 141-147
DOI: 10.4103/0971-3026.209212
Genitourinary Radiology

Gadolinium based contrast agents in current practice: Risks of accumulation and toxicity in patients with normal renal function

Anju Ranga
Department of Radio-diagnosis, VMMC and Safdarjung Hospital, New Delhi, India
,
Yatish Agarwal
Department of Radio-diagnosis, VMMC and Safdarjung Hospital, New Delhi, India
,
Kanika Garg
Department of Radio-diagnosis, VMMC and Safdarjung Hospital, New Delhi, India
› Author Affiliations Financial support and sponsorship Nil.
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Abstract

Despite being decked as the most prized compounds in the nugget box of contrast agents for clinical radiologists, and carrying an indisputable tag of safety of the US Food and Drug Administration for close to three decades, all may not be seemingly well with the family of gadolinium compounds. If the first signs of violations of primum non nocere in relation to gadolinium-based contrast agents (GBCAs) appeared in the millennium year with the first published report of skin fibrosis in patients with compromised renal function, the causal relationship between the development of nephrogenic systemic fibrosis (NSF) and GBCAs, first proposed by two European groups in 2006, further precluded their use in renocompromised patients. The toxicity, pharmacokinetics, and pharmacodynamics of GBCAs, however, has come under hawk-eyed scrutiny with recent reports that gadolinium tends to deposit cumulatively in the brain of patients with normal hepatobiliary function and intact blood–brain barrier. While the jury on the long-term hazard significance of this critical scientific finding is still out, the use of GBCAs must be guided by due clinical diligence, avoidance of repeated doses, and preferring GBCAs with the best safety profiles.

Keywords

Gadolinium-based contrast agents - long-term toxicity - nephrogenic systemic fibrosis - neuronal deposition


Publication History

Article published online:
27 July 2021

© 2017. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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