Safety is an absolute requirement of contrast enhanced magnetic resonance imaging (CE-MRI). Safety comprises; short term adverse reactions to GBCAs, namely nausea, vomiting, anaphylactic reactions etc. and long term adverse reactions, namely Nephrogenic Systemic Fibrosis (NSF), a fatal condition, normally observed in patients with reduced renal function. More recently T1 hyper-signals have been reported in the patients with repeated doses of GBCAs, shown to be resulted from Gadolinium accumulation in the brain. EMA and MHRA have recently announced that less stable (Linear) GBCAs to be withdrawn from the market as their molecular structure allows a higher propensity to release free gadolinium, a process referred to as ‘transmetallation’. The structural stability of GBCAs is, therefore, crucial to be explored in order to understand the impact of structure on the safety of GBCAs. 

The webinar video focused on reviewing the current evidence for gadolinium retention, based on imaging findings as well as corroborating evidence from animal models and pathological studies. Current theories for entry into the brain and retention have also been discussed.

Learning objectives:

• Comparison of structural stability of commonly used GBCAs
• Mechanism of transmetallation leading to gadolinium accumulation
• Understand the timeline and current evidence for gadolinium retention
• Be aware of mechanisms of entry, and the regulatory responses to this finding

Duration:58 mins