People typically undergo a magnetic resonance imaging (MRI) scan with a gadolinium-based contrast agent (GBCA), an approved class of drugs. It is used to improve the contrast quality of the scan. However, your patients and the radiologists in your imaging center may experience various side effects, including altered taste, pins and needles sensation, or coldness at the injection site, from exposure from its use.
If you are a radiologist, you may be wondering whether to go on with using gadolinium-based agents. You may also be worried about putting yourself, your colleagues, and your patients at risk of legal exposure if you continue doing it. To learn more about gadolinium retention and how it affects MRI, use this article as your guide.
What Is Gadolinium Retention?
GBCAs contain gadolinium, meaning it can stay in your body for months after exposure. As a result, you acquire a condition called gadolinium retention, wherein small amounts of metal can accumulate in the skin, bone, brain, and kidney tissue.
What Are the Reported Side Effects of GBCAs?
GBCAs have been used in MRI for years, but the term “gadolinium deposition disease (GDD)” was first described in 2016. It indicates the self-reported symptoms in patients with a normal renal function who received GBCAs. Eventually, the authors decided that these signs represent GDD and then suggested diagnostic criteria for this newly proposed disease. Patients are considered to have GDD if they exhibit at least three of the following broad symptoms clusters within a period of hours to two months after receiving the drugs:
- Buzzing sensation
- Clouded mentation
- Distal extremity and skin substrate thickening, discoloration, and pain
- Fatigue
- Headache
- Peripheral neuropathic pain
- Joint stiffness
- Muscle spasms
Further research is being conducted about GDD at this stage. However, patients who feel that they meet the criteria for the disease filed a lawsuit. In fact, there has even been a high-profile case related to this issue, including a lawsuit that Chuck Norris and his wife Gena dropped. The FDA states that GDD cannot be proven or disproven yet, but they now require imaging centers like yours to inform patients of potential gadolinium risk.
What Can My Imaging Center Do?
As a radiologist, you may be concerned about your patients hesitating to head to your imaging center due to fear of legal exposure. You can emphasize that, at present, the only known and proven disease cases from GCBAs are nephrogenic systemic fibrosis. It is common among patients with impaired renal function. There is no report yet about their harmful effects in patients with normal kidneys.
You can post this information on your website or create a blog post or engaging content about it and share it on your imaging center’s social media page. Another way to become a more responsible radiologist is to have conversations with your patients based on what has been proven so far about GCBAs. Finally, highlight the importance of these agents and how they help get a clear enough image for an accurate diagnosis.
Conclusion
GCBAs are essential in MRI, but they have reported side effects that can cause panic among your patients. To ease their worries and prevent the spread of misinformation, remember the information and follow the tips mentioned in this guide. You also have to prioritize offering better service by keeping your machine in excellent condition, like seeking MRI coil repair when necessary.
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