Abstract:
:The issue of dechelation (transmetallation) in vivo after administration of the linear gadolinium-based contrast agents, and potential safety concerns, is considered on the basis of an extensive, focused literature review. Early indications of potential problems included the high level of excess ligand used in the formulation of 2 agents (indeed the 2 least stable thermodynamically) and interference with laboratory tests when blood was drawn from patients relatively soon after administration of these same agents. The advent of nephrogenic systemic fibrosis in the late 2000s raised additional major concerns.The correlation in 2014 of dentate nucleus hyperintensity on precontrast T1-weighted scans with multiple prior injections of linear gadolinium chelates, in patients with normal renal function, has driven subsequent research concerning dechelation of these agents in vivo. Unexpectedly high levels of gadolinium in the bone, skin, and liver have been found long term after administration, in animal models and in humans, although the latter data are limited. Bone may serve as a long-term reservoir, with a residual excretion phase for gadolinium after intravenous injection of the linear agents due to a subsequent slow release from bone. Many different patient populations could be vulnerable and potentially later develop clinical symptoms, although at this stage there are only limited data and small retrospective uncontrolled studies. Possible vulnerable populations include children, menopausal women, patients with osteoporosis (who are predisposed to fractures and often slow to heal or heal poorly), those receiving multiple doses, those with proinflammatory conditions, moderate renal dysfunction, or an undefined genetic predisposition. Of particular concern would be nephrogenic systemic fibrosis-like symptoms-including particularly pain and skin/joint symptoms, or disease related to the incorporation of gadolinium in hydroxyapatite in bone, in small subgroups of patients with a not yet defined propensity and/or cofactor. These concerns have led to withdrawal of the linear agents from the largest clinical market, Europe, with the exception of the hepatobiliary agents for delayed liver imaging, an indication that cannot be fulfilled by the current macrocyclic gadolinium chelates (for which these concerns do not apply).
journal_name
Invest Radioljournal_title
Investigative radiologyauthors
Runge VMdoi
10.1097/RLI.0000000000000507subject
Has Abstractpub_date
2018-10-01 00:00:00pages
571-578issue
10eissn
0020-9996issn
1536-0210journal_volume
53pub_type
杂志文章,评审abstract:OBJECTIVE:The purpose of this study was to assess the ability of a flow-sensitive alternating inversion recovery-arterial spin labeling (FAIR-ASL) technique to track renal perfusion changes during pharmacologic and physiologic alterations in renal blood flow using microspheres as a gold standard. MATERIALS AND METHODS...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0b013e3181f5e101
更新日期:2011-02-01 00:00:00
abstract::Milestones in the history of phlebography are shortly reviewed. The present state of phlebography with emphasis upon the role of new nonionic contrast media is presented. ...
journal_title:Investigative radiology
pub_type: 临床试验,杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The problem of inhomogeneous mixing encountered during hepatic artery (HA) chemotherapy infusion was assessed and a practical solution examined. A glass model of the human HA distribution was used to determine mixing homogeneity of low flow (1.4 mL/minute) dye infusion into pulsatile flow (280-300 mL/minute) of a flui...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198807000-00007
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journal_title:Investigative radiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00004424-199405001-00015
更新日期:1994-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/RLI.0b013e31827b711e
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000392
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000028
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journal_title:Investigative radiology
pub_type: 临床试验,杂志文章
doi:10.1097/RLI.0b013e31827a4a17
更新日期:2013-06-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/01.rli.0000221323.38443.8d
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000429
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199709000-00004
更新日期:1997-09-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-197901000-00014
更新日期:1979-01-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198706000-00005
更新日期:1987-06-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198303000-00018
更新日期:1983-03-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199909000-00002
更新日期:1999-09-01 00:00:00
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/RLI.0000000000000712
更新日期:2021-02-01 00:00:00
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journal_title:Investigative radiology
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doi:10.1097/00004424-199302000-00009
更新日期:1993-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/01.rli.0000167421.83203.4e
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198805000-00011
更新日期:1988-05-01 00:00:00
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journal_title:Investigative radiology
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doi:10.1097/00004424-197901000-00012
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-199905000-00007
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journal_title:Investigative radiology
pub_type: 杂志文章
doi:
更新日期:2005-01-01 00:00:00
abstract::Radiolabeled ioversol was injected intravenously into two male and two female beagle dogs (6.7 to 10.4 kg) at two dose levels each (0.2 and 1.0 g I/kg). Blood levels of radioactivity were monitored at 2, 5, 10, 20, 40, 60, 90, and 120 minutes and at one and two days. Urine and feces were collected in metabolism cages ...
journal_title:Investigative radiology
pub_type: 杂志文章
doi:10.1097/00004424-198906001-00005
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更新日期:2004-06-01 00:00:00
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journal_title:Investigative radiology
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journal_title:Investigative radiology
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:1988-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00004424-197607000-00009
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journal_title:Investigative radiology
pub_type: 杂志文章
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更新日期:2009-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00004424-200101000-00006
更新日期:2001-01-01 00:00:00