Purpose or Case Report: Gadolinium based contrast agents (GBCAs) are widely used in medical imaging with 10 million annual doses given in the US alone. There is a very low 0.03% risk of serious adverse reactions. GBCAs were thought entirely safe until 2006 when reports of nephrogenic system fibrosis (NSF) surfaced. NSF was nearly eliminated by 2009 through careful screening and reducing dosage. In 2014, it was reported that GBCAs may deposit in the brains of patients. The purpose of this review is to examine the literature to date.
Methods & Materials: Every article on brain gadolinium deposition to date was reviewed and compiled for this presentation.
Results: Brain gadolinium deposition is seen in patients with normal renal function. It is associated with both the number of gadolonium dose administrations as well as the overall dose of gadolinium. It is not associated with the mean interval between gadolinium administrations, patient age, sex, creatinine level, or history of chemotherapy or radiotherapy. Of the regions of the brain examined, the most gadolinium deposition is noted in the dentate nuclei. There is a significant risk of gadolinium deposition in the brain after ≥ 4 doses or ≥ 77 ml.
Conclusions: While it is now fairly certain that gadolinium does deposit within the brains of patients with normal renal function, the clinical implications of this are currently unknown. In addition, there is very little data in children. Further studies are needed