MRI Contrast Health Risks

Gadolinium, or as it appears on the Periodic Table of Elements, Gd atomic No. 64, has received a lot of press in relation to its use as a contrast medium for magnetic resonance imaging, or MRI, tests. Under certain circumstances in certain people this metal agent causes serious side effects. Law firm reports litter the Internet with victorious cases of lawsuits, as they attempt to lure in more cases of the same reactions.

Definition

At the bottom of the Periodic Table of Elements, to the right of center, the innocuous letters Gd represent this silvery white lustrous metal. Because it has a strong attraction to magnets and can dissolve slowly in water or dilute acid, gadolinium makes an excellent contrast medium for use with the MRI test. Contrast medium does not get used for every MRI administered. It has specific applications where detail becomes important.

Uses

The MRI test has state-of-the-art capabilities of imaging what goes on inside the body. Considered safe without use of contrast, the MRI can improve images significantly with the administration of contrast medium. Tumors and other abnormalities absorb the dye and become more vivid. Even the smallest tumors show up with the addition of gadolinium. As the medium courses through the body, it lights up irregularities along the way. The test results not only give generous information about a tumor, they help guide a surgeon to its exact location, ensuring a swift extraction. The contrast MRI serves many other purposes as well.

Considerations

Like all contrast dyes, gadolinium is contraindicated for anyone with kidney disease or kidney failure. Because the contrast gets excreted by the kidneys, inefficient kidneys cannot rid the body of the dye. Patients with congestive heart failure or the blood disease multiple myeloma should refrain from the use of gadolinium, as these also impair clearance. According to "Current Medical Treatment and Diagnosis," 2010 edition, even a diluted dose of contrast has not proved safe for these patients. Some patients have an allergic reaction to the contrast. In a study conducted by the "American Journal of Roentgenology" that ended in 1994, out of 21,000 people who had taken gadolinium for an MRI, 36 had allergic reactions. These ranged from mild outbreaks of rash or hives to severe reactions that led to anaphylactic shock, which affected breathing. The severe cases represented 0.01 percent of their population studied. For those who have a mild reaction, prednisone can pre-treat the person and prevent a reaction with the next test.

Problems

Google the term "gadolinium" or "MRI contrast agent" and page after page of reports and lawsuits involving gadolinium emerge. The reports say a condition called nephrogenic systemic fibrosis, NSF, has stricken untold numbers of people as a result of receiving gadolinium-based contrast agents. NSF presents with fibrosis of the skin and connective tissue. It causes thickening of the skin that hinders bending at the joints. As NSF progresses, it causes the diaphragm to thicken, which makes breathing difficult and eventually causes death. The U.S. Food and Drug Administration stated in 2006 that those people afflicted with NSF originally had serious kidney disease or liver-related kidney disease, which prevented them from quickly and completely clearing the contrast agent from their bodies. The FDA cites various studies supporting this claim.

Conclusions

Recently, the FDA issued new warnings about gadolinium-based contrast agents. As of September 13, 2010, GBCAs must carry warnings on their labels about the risk of developing the potentially fatal condition, NSF, if the patient has serious kidney disease. When circumstances warrant use of GBCAs by kidney patients, measuring and monitoring kidney function become mandatory. The FDA concludes that use of the intravenous agent continues to have little consequence on the remainder of the population.