title: Gadolinium deposition within the dentate nucleus and globus pallidus after repeated administrations of gadolinium-based contrast agents-current status.
abstract: BACKGROUND
  Gadolinium-based contrast agents (GBCAs) have been used clinically since 1988 for contrast-enhanced magnetic resonance imaging (CE-MRI). Generally, GBCAs are considered to have an excellent safety profile. However, GBCA administration has been associated with increased occurrence of nephrogenic systemic fibrosis (NSF) in patients with severely compromised renal function, and several studies have shown evidence of gadolinium deposition in specific brain structures, the globus pallidus and dentate nucleus, in patients with normal renal function.
  
  
  METHODS
  Gadolinium deposition in the brain following repeated CE-MRI scans has been demonstrated in patients using T1-weighted unenhanced MRI and inductively coupled plasma mass spectroscopy. Additionally, rodent studies with controlled GBCA administration also resulted in neural gadolinium deposits.
  
  
  RESULTS
  Repeated GBCA use is associated with gadolinium deposition in the brain. This is especially true with the use of less-stable, linear GBCAs. In spite of increasing evidence of gadolinium deposits in the brains of patients after multiple GBCA administrations, the clinical significance of these deposits continues to be unclear.
  
  
  CONCLUSIONS
  Here, we discuss the current state of scientific evidence surrounding gadolinium deposition in the brain following GBCA use, and the potential clinical significance of gadolinium deposition. There is considerable need for further research, both to understand the mechanism by which gadolinium deposition in the brain occurs and how it affects the patients in which it occurs.
authors.affiliation: Faculty of Medicine, University of Nis, Bul. Dr. Zorana Djindjica 81, Nis, 18000, Serbia. drstojanov@gmail.com.|Center for Radiology, Clinical Center Nis, Nis, Serbia. drstojanov@gmail.com.
authors.forename: Dragan
authors.identifier: http://orcid.org/0000-0001-7693-5775
authors.initials: D
authors.lastname: Stojanov
authors.affiliation: Center for Radiology, Clinical Center Nis, Nis, Serbia.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Aracki-Trenkic
authors.affiliation: Faculty of Medicine, University of Nis, Bul. Dr. Zorana Djindjica 81, Nis, 18000, Serbia.
authors.forename: Daniela
authors.initials: D
authors.lastname: Benedeto-Stojanov
mesh_terms: D000818:Animals; D002529:Cerebellar Nuclei / Q000000981:diagnostic imaging / Q000378:metabolism*; D003198:Computer Simulation; D003287:Contrast Media / Q000008:administration & dosage / Q000493:pharmacokinetics; D004334:Drug Administration Schedule; D005682:Gadolinium / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D005917:Globus Pallidus / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008657:Metabolic Clearance Rate; D008959:Models, Neurological; D059906:Neuroimaging / Q000379:methods; D009928:Organ Specificity / Q000187:drug effects / Q000502:physiology; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014018:Tissue Distribution
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: Contrast media; Dentate nucleus; Gadolinium deposition; Globus pallidus; Magnetic resonance imaging