Gadolinium-based contrast agents (GBCA): toxicity

Evidence-based neurology checklist on gadolinium-based contrast agents (gbca): toxicity: Imaging features Gadolinium deposition is visible on T1-weighted MRI It shows as high signal intensity index It is particularly seen in the dentate nucleus It is also seen in the globus pallidus and pulvinar…

Imaging features

  • Gadolinium deposition is visible on T1-weighted MRI
  • It shows as high signal intensity index
  • It is particularly seen in the dentate nucleus
  • It is also seen in the globus pallidus and pulvinar

Extracranial deposition

Reported clinical manifestations of brain deposition

Precautions to reduce toxicity

Emerging techniques of avoiding toxicity

References

  1. Ramalho J, Semelka RC, Ramalho M, Nunes RH, AlObaidy M, Castillo M. Gadolinium-based contrast agent accumulation and toxicity: an update. Am J Neuroradiol 2016; 37:1192-1198. 
  2. Quattrocchi CC, Parillo M, Spani F, et al. Skin thickening of the scalp and high signal intensity of dentate nucleus in multiple sclerosis: association with linear versus macrocyclic gadolinium-based contrast agents administration. Invest Radiol 2023; 58:223-230.
  3. Kanda T, Nakai Y, Oba H, Toyoda K, Kitajima K, Furui S. Gadolinium deposition in the brain. Magn Reson Imaging 2016; 34:1346-1350. 
  4. Murata N, Murata K, Gonzalez-Cuyar LF, Maravilla KR. Gadolinium tissue deposition in brain and bone. Magn Reson Imaging 2016; 34:1359-1365. 
  5. Lord ML, Chettle DR, Gräfe JL, Noseworthy MD, McNeill FE. Observed deposition of gadolinium in bone using a new noninvasive in vivo biomedical device: results of a small pilot feasibility study. Radiology 2018; 287:96-103. 
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