Researchers Continue To Investigate Gadolinium Deposition Disease (GDD) Following Gadolinium-Based Contrast Agents Injections
(Posted by Tom Lamb at DrugInjuryWatch.com)
In recent years it has been recognized that the gadolinium contained in certain contrast agents can break away from its bonding agent. As a result, gadolinium is left behind in the bones, brain, and various tissues within the body. In turn, when this happens, there might be gadolinium side effects.
Specifically, this situation can lead to Gadolinium Deposition Disease (GDD) in patients, which is a form of gadolinium toxicity and sometimes called, instead, Gadolinium Storage Condition.
Medical researchers continue to investigate the extent and severity of gadolinium retention following injections of gadolinium-based contrast agents for MRIs, MRAs, and CT scans.
Presented below is a collection of medical articles published in the past six months -- September 2018 to March 2019 -- about this still developing safety issue for contrast agents containing gadolinium.
Safety of Gadolinium Administration in Children
Pediatric Neurology medical journal (September 2018 edition) -- Abstract
The introduction of paramagnetic contrast in the late 1980s constituted a paradigm shift boosting the efficacy of magnetic resonance imaging. Due to its high magnetic moment, gadolinium-based contrast agent made its way smoothly as the flagship paramagnetic contrast. With the widespread application, reports of untoward effects started to surface. Allergic reactions, nephrogenic systemic sclerosis, and deposition in brain tissue dented the safety profile of gadolinium-based contrast agent. Better understanding of these adverse effects prompted preventive measures. This article elucidates the gadolinium-based contrast agent toxicity in the pediatric population based on the current available evidence.
How widespread is gadolinium accumulation in the brain?
AuntMinnie.com news report (October 31, 2018) -- Preview of November 28, 2018 scientific sessions at the annual RSNA show
Gadolinium accumulation in the brain may occur with both linear and macrocyclic contrast agents, and it could be more widespread than previously thought, according to researchers from Switzerland....
The researchers found that repeated administration of a gadolinium-based contrast agent (GBCA) was associated with increased overall signal intensity for both linear GBCAs and macrocyclic GBCAs. However, the most interesting findings were the locations of heightened signal intensity and the apparent causes.
The researchers found significant signal intensity increases in the dentate nucleus and globus pallidus after linear GBCA administration but not macrocyclic GBCA use. Conversely, they observed significant signal increases in the thalamus, putamen, amygdala, caudate, hippocampus, and accumbens from macrocyclic GBCAs but not linear GBCAs.
"Based on our findings, gadolinium accumulation in the brain may be more widespread than assumed and could occur with the use of both linear and macrocyclic GBCAs," the researchers concluded.
Gadolinium-Containing Contrast Agents
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Long-term Excretion of Gadolinium-based Contrast Agents: Linear versus Macrocyclic Agents in an Experimental Rat Model
Radiology medical journal (Published Online: November 13, 2018) -- Abstract
Purpose: To investigate the long-term course of MRI signal intensity (SI) changes and the presence of gadolinium in the rat brain during a 1-year period after multiple administrations of gadolinium-based contrast agents (GBCAs).
Conclusion: Increased signal intensity in the deep cerebellar nuclei of rats persists for at least 1 year after administration of linear gadolinium-based contrast agents (GBCAs), in line with persistent brain gadolinium concentrations with no elimination after the initial 5-week period. The animals that received macrocyclic GBCAs showed an ongoing elimination of gadolinium from the brain during the entire observation period.
Gadolinium retention in gliomas and adjacent normal brain tissue: association with tumor contrast enhancement and linear/macrocyclic agents
Neuroradiology medical journal (First Online: February 2, 2019) -- Abstract
Purpose: To quantitate gadolinium deposits in gliomas and adjacent normal brain specimens, and to evaluate their association with tumor contrast enhancement and the type of gadolinium-based contrast agent (GBCA) used.
Conclusion: Gadolinium can be detected in both enhancing and non-enhancing gliomas, neighboring normal brain, and necrosis. Gadolinium retention is higher after exposure to linear GBCAs compared with the macrocyclic gadoterate meglumine.
Be assured that we will continue to monitor the medical literature for developments related to gadolinium retention in connection with our investigation of cases of Gadolinium Deposition Disease (GDD) in patients who received injections of gadolinium based contrast agents for their MRI, MRA, or CT scan procedure.
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