Contrast material in MRI - and kidney

[AdiosMS]

I just had an MRI, and the tech said my blood sample value was borderline for being able to have a contrast MRI. As I understand it, the blood test shows my kidneys are not clearing efficiently or effectively to rid my body of the contrast material. Is that correct, or am I misunderstanding? I'm wondering if this is something I should explore further. I think it's the creatinine levels.

[1eye]

Mri contrast is usually some form of gadolinium. This is a heavy metal that has magnetic properties that make the MRI contrast. It has some nasty properties in the human: it makes the skin have a hard, tough texture, like hard leather or wood. It can also damage kidneys. This radiologist is doing you a favour. Once it goes into tissue, it stays there. That's why you don't want it in your kidneys. I had a lot of it and now my kidneys have problems and the skin on my toes is very tough, like a hard surface.

You need kidneys. Take care of them.

[daniel]

1eye, how many times have you had gadolinium injections that it caused issues?

[1eye]

I think the largest dose I had was in my MRI that showed the black holes. Seemed like there were thousands of them. I had one every 3 months on a clinical trial but I think the dose was small. I didn't notice problems till after the last time I had it. I think it's cumulative and the reaction may take a long time. But what do I know?

Now I just hope I never have to have another one with contrast.

[NHE]

The last time I had an MRI I asked the tech about the different forms of gadolinium contrast. He said that they all dechelate to some extent.

[jackD]

NEWS FLASH!!! It accumulates in BRAIN also!!!

jackD

Radiology. 2015 May 5:142690. [Epub ahead of print]

Gadolinium-based Contrast Agent Accumulates in the Brain Even in Subjects without Severe Renal Dysfunction: Evaluation of Autopsy Brain Specimens with Inductively Coupled Plasma Mass Spectroscopy.

Kanda T1, Fukusato T, Matsuda M, Toyoda K, Oba H, Kotoku J, Haruyama T, Kitajima K, Furui S.

Abstract

Purpose To use inductively coupled plasma mass spectroscopy (ICP-MS) to evaluate gadolinium accumulation in brain tissues, including the dentate nucleus (DN) and globus pallidus (GP), in subjects who received a gadolinium-based contrast agent (GBCA). Materials and Methods Institutional review board approval was obtained for this study. Written informed consent for postmortem investigation was obtained either from the subject prior to his or her death or afterward from the subject's relatives. Brain tissues obtained at autopsy in five subjects who received a linear GBCA (GBCA group) and five subjects with no history of GBCA administration (non-GBCA group) were examined with ICP-MS. Formalin-fixed DN tissue, the inner segment of the GP, cerebellar white matter, the frontal lobe cortex, and frontal lobe white matter were obtained, and their gadolinium concentrations were measured. None of the subjects had received a diagnosis of severely compromised renal function (estimated glomerular filtration rate <45 mL/min/1.73 m2) or acute renal failure. Fisher permutation test was used to compare gadolinium concentrations between the two groups and among brain regions. Results Gadolinium was detected in all specimens in the GBCA agent group (mean, 0.25 µg per gram of brain tissue ± 0.44 [standard deviation]), with significantly higher concentrations in each region (P = .004 vs the non-GBCA group for all regions). In the GBCA group, the DN and GP showed significantly higher gadolinium concentrations (mean, 0.44 µg/g ± 0.63) than other regions (0.12 µg/g ± 0.16) (P = .029).

Conclusion Even in subjects without severe renal dysfunction, GBCA administration causes gadolinium accumulation in the brain, especially in the DN and GP. © RSNA, 2015.


PMID: 25942417 [PubMed - as supplied by publisher]

[MrChris]

What i ask myself about everything going through this ordeal is does the benefits out weigh the risks? Only you can make that decision.

[AdiosMS]

This is only the second time I've had an MRI with contrast. This is the first time a tech made me sign a waiver, saying my levels were borderline and waiving their liability.

So the question is: do I need to get kidney function tests? Do I refuse to have any more MRIs with contrast? I'm confused as to the questions I should be asking and the implications of this blood test result.

Thoughts?

[centenarian100]

I think you should ask the person who ordered the MRI scan how critical the gadolinium is. Generally speaking glomerular filtration rate of 30 is the cutoff.

[jackD]

NEWS FLASH!!! It accumulates in BRAIN also!!!

jackD

Radiology. 2015 May 5:142690. [Epub ahead of print]

Gadolinium-based Contrast Agent Accumulates in the Brain Even in Subjects without Severe Renal Dysfunction: Evaluation of Autopsy Brain Specimens with Inductively Coupled Plasma Mass Spectroscopy.

Kanda T1, Fukusato T, Matsuda M, Toyoda K, Oba H, Kotoku J, Haruyama T, Kitajima K, Furui S.

Abstract

Purpose To use inductively coupled plasma mass spectroscopy (ICP-MS) to evaluate gadolinium accumulation in brain tissues, including the dentate nucleus (DN) and globus pallidus (GP), in subjects who received a gadolinium-based contrast agent (GBCA). Materials and Methods Institutional review board approval was obtained for this study. Written informed consent for postmortem investigation was obtained either from the subject prior to his or her death or afterward from the subject's relatives. Brain tissues obtained at autopsy in five subjects who received a linear GBCA (GBCA group) and five subjects with no history of GBCA administration (non-GBCA group) were examined with ICP-MS. Formalin-fixed DN tissue, the inner segment of the GP, cerebellar white matter, the frontal lobe cortex, and frontal lobe white matter were obtained, and their gadolinium concentrations were measured. None of the subjects had received a diagnosis of severely compromised renal function (estimated glomerular filtration rate <45 mL/min/1.73 m2) or acute renal failure. Fisher permutation test was used to compare gadolinium concentrations between the two groups and among brain regions. Results Gadolinium was detected in all specimens in the GBCA agent group (mean, 0.25 µg per gram of brain tissue ± 0.44 [standard deviation]), with significantly higher concentrations in each region (P = .004 vs the non-GBCA group for all regions). In the GBCA group, the DN and GP showed significantly higher gadolinium concentrations (mean, 0.44 µg/g ± 0.63) than other regions (0.12 µg/g ± 0.16) (P = .029).

Conclusion Even in subjects without severe renal dysfunction, GBCA administration causes gadolinium accumulation in the brain, especially in the DN and GP. © RSNA, 2015.


PMID: 25942417 [PubMed - as supplied by publisher]

Gadolinium-based Contrast Agents for Magnetic Resonance Imaging (MRI): Drug Safety Communication - FDA Evaluating the Risk of Brain Deposits With Repeated Use


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Gadolinium-based Contrast Agents for Magnetic Resonance Imaging (MRI): Drug Safety Communication - FDA Evaluating the Risk of Brain Deposits With Repeated Use

July 27, 2015
Food and Drug Administration (US)


AUDIENCE: Radiology

ISSUE: FDA is investigating the risk of brain deposits following repeated use of gadolinium-based contrast agents (GBCAs) for magnetic resonance imaging (MRI). Recent publications in the medical literature have reported that deposits of GBCAs remain in the brains of some patients who undergo four or more contrast MRI scans, long after the last administration. It is unknown whether these gadolinium deposits are harmful or can lead to adverse health effects.

FDA, including its National Center for Toxicological Research (NCTR), will study this possible safety risk further. FDA is working with the research community and industry to understand the mechanism of gadolinium retention and to determine if there are any potential adverse health effects. Based on the need for additional information, at this time, FDA is not requiring manufacturers to make changes to the labels of GBCA products.

BACKGROUND: After being administered, GBCAs are mostly eliminated from the body through the kidneys. However, trace amounts of gadolinium may stay in the body long-term. Recent studies conducted in people and animals have confirmed that gadolinium can remain in the brain, even in individuals with normal kidney function. Available information does not identify any adverse health effects.

RECOMMENDATION: To reduce the potential for gadolinium accumulation, health care professionals should consider limiting GBCA use to clinical circumstances in which the additional information provided by the contrast is necessary. Health care professionals are also urged to reassess the necessity of repetitive GBCA MRIs in established treatment protocols.

Patients, parents, and caregivers should talk to their health care professionals if they have any questions about the use of GBCAs with MRIs. This issue affects only GBCAs; it does not apply to other types of scanning agents used for other imaging procedures, such as those that are iodine-based or radioisotopes.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

jackD