European Radiology

, Volume 23, Issue 2, pp 307–318 | Cite as

Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines

  • Henrik S. Thomsen
  • Sameh K. Morcos
  • Torsten Almén
  • Marie-France Bellin
  • Michele Bertolotto
  • Georg Bongartz
  • Olivier Clement
  • Peter Leander
  • Gertraud Heinz-Peer
  • Peter Reimer
  • Fulvio Stacul
  • Aart van der Molen
  • Judith AW Webb
Contrast Media



To update the guidelines of the Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) on nephrogenic systemic fibrosis and gadolinium-based contrast media.

Areas covered

Topics reviewed include the history, clinical features and prevalence of nephrogenic systemic fibrosis and the current understanding of its pathophysiology. The risk factors for NSF are discussed and prophylactic measures are recommended. The stability of the different gadolinium-based contrast media and the potential long-term effects of gadolinium in the body have also been reviewed.

Key Points

Clinical features, risk factors and prevention of nephrogenic systemic fibrosis are reviewed

Patients with GFR below 30 ml/min/1.73 m 2 have increased risk of developing NSF

Low stability gadolinium contrast media show the strongest association with NSF

Following guidelines regarding gadolinium contrast agents minimises the risk of NSF

Potential long-term harm from gadolinium accumulation in the body is discussed


Nephrogenic systemic fibrosis Contrast media Gadolinium Renal insufficiency 



Members of the Committee: H.S. Thomsen (Chairman, University of Copenhagen, Denmark), F. Stacul (Secretary, University of Trieste, Italy), T. Almén (University of Lund, Sweden), M.-F. Bellin (University of Paris, France), Michele Bertolotto (University of Trieste, Italy), G. Bongartz (University of Basle, Switzerland), O. Clement (University of Paris, France), G. Heinz-Peer (University of Vienna, Austria), Peter Leander (University of Lund, Sweden), S.K. Morcos (University of Sheffield, United Kingdom), P. Reimer (University of Freiburg, Germany), A. van der Molen (University of Leiden, the Netherlands), J.A.W. Webb (St. Bartholomew’s Hospital, United Kingdom). Consultants to the Committee: Eric Lancelot (Guerbet, France), P. Lengsfeld (Bayer Pharma, Germany), A. Spinazzi (Bracco, Italy). ESUR:


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Copyright information

© European Society of Radiology 2012

Authors and Affiliations

  • Henrik S. Thomsen
    • 1
  • Sameh K. Morcos
    • 2
  • Torsten Almén
    • 3
  • Marie-France Bellin
    • 5
    • 6
  • Michele Bertolotto
    • 4
  • Georg Bongartz
    • 7
  • Olivier Clement
    • 8
    • 9
  • Peter Leander
    • 11
  • Gertraud Heinz-Peer
    • 10
  • Peter Reimer
    • 12
  • Fulvio Stacul
    • 13
  • Aart van der Molen
    • 14
  • Judith AW Webb
    • 15
  1. 1.Department of Diagnostic Radiology 54E2Copenhagen University Hospital HerlevHerlevDenmark
  2. 2.SheffieldUK
  3. 3.FalsterboSweden
  4. 4.Department of RadiologyUniversity of TriesteTriesteItaly
  5. 5.Service de Radiologie Générale AdultesHôpital de Bicètre, Secteur Paul BrocaLe-Krimlin-Bicètre CedexFrance
  6. 6.University Paris-SudParisFrance
  7. 7.Department of Diagnostic RadiologyUniversity Hospitals of BaselBaselSwitzerland
  8. 8.Paris Cardiovascular Research CenterINSERM U970, Université Paris DescartesParisFrance
  9. 9.Department of RadiologyAssistance Publique—Hôpitaux de Paris, Hôpital Européen Georges PompidouParisFrance
  10. 10.Department of Radiology, University Hospital Vienna, AKHViennaAustria
  11. 11.Department of RadiologySkåne University Hospital MalmöMalmöSweden
  12. 12.Radiology, Klinikum KarlsruheAcademic Teaching Hospital of the University of FreiburgKarlsruheGermany
  13. 13.S.C. Radiologia Ospedale MaggioreTriesteItaly
  14. 14.Department of Radiology, C2-SLeiden University Medical CenterLeidenThe Netherlands
  15. 15.Department of Radiology, St. Bartholomew’s HospitalUniversity of LondonLondonUnited Kingdom

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