Possible Safety Concerns with Gadolinium Contrast Agents

July 19, 2018

Originally found in: National Multiple Sclerosis Society

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Possible Safety Concerns with Gadolinium Contrast Agents 

A contrast agent, known as gadolinium, is often injected into the vein during an MRI scan. Gadolinium is used to identify areas of active inflammation that can be associated with MS.   There are several forms of gadolinium-based contrast agents (GBCAs) used. Although the use of GBCAs can be helpful, there are some risks to using them that you should know about.
What are the risks of using CBGAs:

  • Nephrogenic Systemic Fibrosis (NSF)-a rare and serious condition that causes thickening of the skin and damage to internal organs that can occur in people with poor kidney function who are given GBCAs.
  • Retention of GBCAs-deposits have been found in the brains and other body tissues of some people who received GBCAs for an MRI. It is not known if these deposits are harmful.

What you should know about these risks:

  • The FDA has issued a safety communication on the use of GBCAs and made recommendations for they types of gadolinium that  are less likely to be retained in the body
  • The FDA is also requiring the makers of gadolinium contrast agents to conduct research to determine if there are harmful effects of gadolinium deposits.
  • The Consortium of MS Centers (CMSC) published a MRI Protocol and Clinical Guidelines for the Diagnosis and Follow-up of MS.  These guidelines address the safety concerns with GBCAs and make recommendations for when using a contrast agent is necessary.

What you can do:

  • Ask your doctor if you need to receive a GBCA for your next MRI scan.  It may not be needed for all MRIs.
  • Have your doctor check your kidney function with a blood test prior to receiving GBCA. This will reduce the risk of developing NSF.
  • Ask the center doing your MRI what type of GBCA they use. Macrocyclic agents are less likely to be retained in the body. Macrocyclic GBCAs are marketed under the names Dotarem®, Gadavist® and ProHance®.

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