Gadolinium Toxicity

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Confirmation of Gadolinium Retention from as far back as 1989

While most of the published research on Gadolinium has been related to NSF (Nephrogenic Systemic Fibrosis) and patients with severe renal disease, more recent studies by Errante (2014), Kanda (2013) and Xia (2010) have presented evidence of Gadolinium retention in patients without severe kidney problems.

Some authors and members of the radiology community seem to be surprised by finding evidence of Gadolinium in abnormal brain tissue in patients with normal renal function, but based on what has been published about Gadolinium-Based Contrast Agents, it seems that this might be expected to occur.  Each of the manufacturers’ package inserts notes that GBCAs deposit in abnormal tissue, and none of the literature that I have read indicates that renal function plays any part in Gadolinium enhancement of abnormal tissue.     (more…)

Mast Cells and Gadolinium Toxicity, is there a connection?

In the summer of 2012, I was asked if I had ever read anything about mast cells and Gadolinium or NSF.  I vaguely remembered mast cells being mentioned in one study, but it obviously didn’t strike me as being important or I would have done some research on it then.  But after digging around a bit, I came away thinking that there might be a connection between mast cells and the disease progression of NSF/GASF.

For those who don’t know, mast cells are found in tissues throughout the body, particularly in association with structures such as blood vessels, peripheral nerves, in mucosal membranes, skin and subcutaneous tissue.  Mast cells are bone marrow-derived and particularly dependent upon stem cell factor for their survival.  They express a variety of phenotypic features within tissues that are determined by their local environment.  Mast cells appear to be highly engineered cells with multiple critical biological functions.  (more…)

Study reports brain abnormalities on MRI in patients with normal kidney function

In the October 2014 issue of Investigative Radiology, Errante et al report study findings that confirm the association between the increase in the unenhanced T1-weighted signal intensity of the dentate nucleus and the number of gadolinium-enhanced MRI scans.  (The dentate nucleus is located within the deep white matter of the brain.)

The study included 38 patients with Multiple Sclerosis (MS) and 37 patients with brain metastases (BMs) who had undergone at least 2 consecutive enhanced MRIs.  After calculating the dentate nuclei-to-pons (DNP) signal intensity ratio, these values were compared between patients with less than 6 and those with 6 or more contrast-enhanced MRI.  A progressive increase in the T1 signal intensity of the DNP ratio was observed in both the MS group and the BM group.  All patients had normal kidney function. (more…)

Difference between Linear and Macrocyclic GBCAs

GBCAs can be divided into two categories based on their molecular structure.  Linear and Macrocyclic GBCAs have different properties that may contribute to their propensity to dechelate at some time after administration. This very short video explains the difference between linear and macrocyclic GBCAs and it hits on transmetallation too. (more…)

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