Use and Safety of Gadolinium Based Contrast Agents in Pediatric MR Imaging

  • Stephanie Holowka
  • Manohar Shroff
  • Govind B. ChavhanEmail author
Review Article


Gadolinium-based contrast agents (GBCA) used for MR imaging are a valuable imaging resource that has benefited patient management over last three decades and largely have a high safety profile. However, recently, adverse effects related to GBCA like nephrogenic systemic fibrosis (NSF) and asymptomatic gadolinium deposition in tissues including brain are concerning. While NSF has largely stopped occurring due to precautions and guidelines to not use GBCA in patients with poor renal function, the long term effects of gadolinium deposition, especially in brain, are not known at this stage. Cautious approach needs to be taken with risk-benefit analysis in each patient to avoid its administration when not necessary. In this review, authors discuss basics of gadolinium, mechanism of enhancement, agents in clinical use and safety issues, and in the end, offer some solutions for safety concerns.


Gadolinium-based contrast agents MRI NSF Gadolinium deposition Children 


Authors’ Contributions

All authors contributed to literature search, writing the manuscript and review of the manuscript. GBC will act as guarantor for this paper.

Compliance with Ethical Standards

Conflict of Interest

GBC received Moderator Honararium in 2018 from Bayer Inc.

Source of Funding



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Copyright information

© Dr. K C Chaudhuri Foundation 2019

Authors and Affiliations

  1. 1.Department of Diagnostic Imaging, The Hospital For Sick Children and Medical ImagingUniversity of TorontoTorontoCanada

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