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Gadolinium Deposition and Toxicity: A Global Concern

  • Global Radiology Concerns: Income, Academics, Quality, Safety (R Semelka, Section Editor)
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Abstract

Purpose of Review

Gadolinium-based contrast agents (GBCAs) have been used since 1988 for magnetic resonance imaging. These agents were considered very safe and, excluding nephrogenic systemic fibrosis in patients with renal failure, no clinical entities were associated with its administration. Our purpose is to summarize gadolinium induced toxicity by reviewing the most recent literature in this subject.

Recent Findings

It was believed that GBCAs distribute rapidly in the extracellular volume after intravenous administration and eliminate rapidly, almost completely, via renal excretion. Currently, we know that this is not entirely true. Some GBCAs may be retained, undergo dechelation and induce gadolinium deposition in different tissues such as liver, bone or brain in patients with normal renal function. The retained gadolinium, whether dechelated and associated with different compounds or in its original formulation, may trigger gadolinium-related toxic effects. This potential toxicity became a global concern.

Summary

This review summarizes the most recent published data regarding gadolinium deposition, possible clinical significance of gadolinium tissue retention and accumulation, strategies to limit gadolinium body burden and some future trends in this area.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. University of North Carolina Hospital, Chapel Hill, NC, USA

    Joana Ramalho, Miguel Ramalho & Richard C. Semelka

  2. Centro Hospitalar de Lisboa Central, Lisbon, Portugal

    Joana Ramalho

  3. Hospital Garcia de Orta, Almada, Portugal

    Miguel Ramalho

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Correspondence to Joana Ramalho.

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Conflict of Interest

Joana Ramalho and Miguel Ramalho declare no potential conflicts of interest. Richard C. Semelka reports research support from Siemens and personal fees from Guerbet and Bracco. Richard C. Semelka is a section editor for Current Radiology Reports.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical collection on Global Radiology Concerns: Income, Academics, Quality, Safety.

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Ramalho, J., Ramalho, M. & Semelka, R.C. Gadolinium Deposition and Toxicity: A Global Concern. Curr Radiol Rep 4, 59 (2016). https://doi.org/10.1007/s40134-016-0187-3

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  • DOI: https://doi.org/10.1007/s40134-016-0187-3

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