Gadolinium deposition in the brain.
Gadolinium is highly toxic. Gadolinium-based contrast agents (GBCAs) consist of gadolinium ions and a chelating agent that binds the gadolinium ion tightly in order not to manifest its toxicity. Knowledge regarding gadolinium deposition in patients with normal renal function has advanced dramatically. Since 2014, increasing attention has been given to residual gadolinium known to accumulate in the tissues of patients with normal renal function. High signal intensity on T1-weighted images (T1WI) in the dentate nucleus, globus pallidus, and pulvinar region of the thalamus correlate roughly with the number of previous GBCA administrations. Pathological analyses have revealed that residual gadolinium is deposited not only in these brain regions, but also in extracranial tissues such as liver, skin and bone. The risks attendant with these deposits are unknown. Common sense dictates that gadolinium deposition be kept as low as possible, and that gadolinium contrast agents be used only when absolutely necessary, with preferential use of macrocyclic chelates, which seem to be deposited at lower concentrations.
Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan. Electronic address: k_a@hotmail.co.jp.
Tomonori
T
Kanda
Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Yudai
Y
Nakai
Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Hiroshi
H
Oba
Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Keiko
K
Toyoda
Department of Radiology, Hyogo College of Medicine, Hyogo 663-8501, Japan.
Kazuhiro
K
Kitajima
Department of Radiology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Shigeru
S
Furui
D001921:Brain / Q000187:drug effects / Q000378:metabolism*; D003287:Contrast Media / Q000009:adverse effects / Q000378:metabolism*; D005682:Gadolinium / Q000009:adverse effects / Q000378:metabolism*; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies
D003287:Contrast Media; D005682:Gadolinium
Dentate nucleus; Gadolinium; Gadolinium based contrast agent (GBCA); Magnetic resonance image (MRI)