Contrast agent guidelines help prevent debilitating disorder

May 17, 2011

A simple blood test may help prevent a serious complication associated with a contrast agent commonly used in MRI exams, according to a study published in the July issue of Radiology.

Within the past five years, use of gadolinium-based (GBCA) has been linked to the development of nephrogenic systemic fibrosis (NSF), a rare disorder mainly affecting patients with severe kidney disease. But since 2008, restrictive GBCA administration guidelines implemented by Massachusetts General Hospital have proven effective in preventing NSF.

"It is important for the public to know that gadolinium products are safe for most patients and the risk of NSF should not deter them from GBCA-enhanced exams, such as MRIs," said the study's lead author Hani H. Abujudeh, M.D., M.B.A., associate professor of radiology at Harvard Medical School in Boston.

NSF is characterized by widespread . Patients with NSF experience an increase of collagen in the tissues, causing thickening and hardening of the skin of the extremities, and often resulting in immobility and tightening or deformity of the joints. NSF can develop rapidly and may result in patients becoming wheelchair-bound within just a few weeks. In some cases, there is involvement of other tissues, including the lungs, heart, diaphragm, esophagus and .

Massachusetts General Hospital began implementing restrictive GBCA guidelines in May 2007 in order to protect patients from possibly developing NSF. The guidelines require that a blood test be done on patients over age 60 or at risk for . The blood test measures how well the kidneys are doing. That number is then converted via a formula to estimate the glomerular filtration rate (eGFR), which measures the rate of through the kidneys. The guidelines stipulate a maximum GBCA dose of 20mL for patients with a low eGFR (below 60 mL/ min/m2). GBCA should not be administered at all to patients currently undergoing or with a very low (below 30 mL/min/ m2).

For the study, Dr. Abujudeh and colleagues reviewed the hospital's medical records during the pre-guideline and transition period (January 2002 through December 2007) and the post-adoption period (January 2008 to March 2010). Prior to adoption of the guidelines and during the transition period, 113,120 contrast-enhanced MRI exams were performed, and 34 cases of NSF were subsequently identified. During the post-guideline period, 52,954 contrast-enhanced MRIs were performed with no new cases of NSF identified.

"The findings prove that these guidelines are effective," Dr. Abujudeh said, "and that strategies can be put into practice to ensure patient safety."

More information: "Incidence of Nephrogenic Systemic Fibrosis after Adoption of Restrictive Gadolinium-based Contrast Agent Guidelines." radiology.rsna.org/

Related Stories

Recommended for you

The 'love hormone' may quiet tinnitus

September 23, 2016

(HealthDay)—People suffering from chronic ringing in the ears—called tinnitus—may find some relief by spraying the hormone oxytocin in their nose, a small initial study by Brazilian researchers suggests.

Bile acid uptake inhibitor prevents NASH / fatty liver in mice

September 21, 2016

Drugs that interfere with bile acid recycling can prevent several aspects of NASH (nonalcoholic steatohepatitis) in mice fed a high-fat diet, scientists from Emory University School of Medicine and Children's Healthcare of ...

New therapeutic target for Crohn's disease

September 20, 2016

Research from the Sanford Burnham Prebys Medical Discovery Institute (SBP) identifies a promising new target for future drugs to treat inflammatory bowel disease (IBD). The study, published today in Cell Reports, also indicates ...

Mosquitoes, Zika and biotech regulation

September 19, 2016

In a new Policy Forum article in Science, NC State professor Jennifer Kuzma argues that federal authorities are missing an opportunity to revise outdated regulatory processes not fit for modern innovations in biotechnology, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.