title: Gadolinium-based contrast agents: A comprehensive risk assessment.
abstract: Gadolinium-based contrast agents (GBCAs) have been used in magnetic resonance imaging (MRI) since the 1980s and are now administered in up to 35% of all MRI examinations. While GBCAs were initially felt to carry minimal risk, the subsequent identification of GBCAs as the key etiologic factor in the development of nephrogenic systemic fibrosis (NSF) has raised concerns about the broader health impacts of gadolinium exposure. Clinicians, radiologists, and patients should be aware of the most up-to-date data pertaining to the risks of GBCA administration. Specific issues covered in this review article include immediate adverse reactions; pregnancy and lactation; and gadolinium deposition and toxicity, with a special focus on NSF. Practice recommendations based on the presented data, as well as current professional society guidelines, are provided for each section.
  
  
  
  1 Technical Efficacy: Stage 5 J. MAGN. RESON. IMAGING 2017;46:338-353.
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA.
authors.forename: Tyler J
authors.initials: TJ
authors.lastname: Fraum
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Ludwig
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, North Carolina, USA.|Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Mustafa R
authors.initials: MR
authors.lastname: Bashir
authors.affiliation: Mallinckrodt Institute of Radiology, Washington University, Saint Louis, Missouri, USA.
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Fowler
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000009:adverse effects* / Q000633:toxicity; D005260:Female; D005682:Gadolinium / Q000009:adverse effects* / Q000633:toxicity; D006801:Humans; D007774:Lactation / Q000187:drug effects; D008279:Magnetic Resonance Imaging / Q000009:adverse effects; D018811:Maternal Exposure; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced*; D011247:Pregnancy; D018570:Risk Assessment; D012307:Risk Factors; D014018:Tissue Distribution; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: MRI; gadolinium-based contrast agent; review