Gadolinium-Based Contrast Media
Matthew S Davenport1
1University of Michigan, Ann Arbor, MI, United States

Synopsis

Gadolinium-based contrast media are safe. Key potential risks include: nephrogenic systemic fibrosis, hypersensitivity reactions and gadolinium retention. These risks differ between the different GBCM. The risk of NSF from Group II GBCM is very small (upper bound risk: 0.07%). The risk of NSF from Group III GBCM likely small, but more data needed (upper bound risk: 1.1%). Gadolinium retention occurs, but has unclear importance; patient handouts now available. Immediate reactions are rare (0.09%), but breakthrough reactions are common (40%). GBCA tradeoffs require thought. Consider both the provider's and patient’s point of view.

Gadolinium-based contrast media are safe. Key potential risks include: nephrogenic systemic fibrosis, hypersensitivity reactions and gadolinium retention. These risks differ between the different GBCM.
•Risk of NSF from Group II GBCM is very small –Upper bound risk: 0.07%
•Risk of NSF from Group III GBCM likely small, more data needed –Upper bound risk: 1.1%
•Gadolinium retention occurs, but has unclear importance –Patient handouts now available
•Immediate reactions are rare (0.09%), but breakthrough reactions are common: ~40%
•GBCA tradeoffs require thought –Consider both the provider's and patient’s point of view

Acknowledgements

No acknowledgement found.

References

ACR Manual on Contrast Media, v.10.3. https://www.acr.org/Clinical-Resources/Contrast-Manual

Weinreb JC et al. Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Radiology 2021; 298:28-35.

Proc. Intl. Soc. Mag. Reson. Med. 29 (2021)