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American Board of Magnetic Resonance Safety (ABMRS)
MRI safety recently took a step forward with the formation of the American Board of Magnetic Resonance Safety (ABMRS). According to its website, the not-for-profit corporation’s purpose is to improve the safety of medical and research magnetic resonance (MR) environments. That includes the safety of MR facilities and the certification and qualification of the professionals who oversee the physical and operational safety of the MR equipment, environment, and processes.
The leadership of the founding Board of Directors includes the following:
- Chair: Emanuel Kanal, MD, Director of MR Services at the University of Pittsburgh Medical Center
- Vice Chair: Max Amurao, Phd, Director of Radiation Safety for Clinical Programs at Columbia University/New York Presbyterian Hospitals
- Secretary/Treasure: Tobias Gilk, MArch, Sr. Vice President of Radiology-Planning and Founder of Gilk Radiology Consulting
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…)
Gadolinium-Associated Plaques (GAP) in a patient without renal disease.
On November 12, 2014, an article was published online about a new condition called Gadolinium-Associated Plaques or GAP. The JAMA Dermatology article by Gathings, Reddy, Santa Cruz, and Brodell is titled, “Case Report/Case Series, Gadolinium-Associated Plaques – A New, Distinctive Clinical Entity”. The full-article is not freely available online at this time; however, the abstract can be found at http://dx.doi.org/10.1001/jamadermatol.2014.2660.
While this case series reports on only 2 patients, its findings are especially significant for patients with normal renal (kidney) function. Both patients had erythematous plaques which were determined to be sclerotic bodies in various stages of calcification. Previously these sclerotic bodies were thought to be associated with NSF (Nephrogenic Systemic Fibrosis) in patients with chronic renal disease after exposure to a Gadolinium-based Contrast Agent (GBCA). The significance of this case series is that neither patient had NSF; while one patient did have renal disease, the other patient did not. (more…)
We have an important advocate in Dr. Manny Kanal.
After years of trying to get the FDA and medical community’s attention about the issue of Gadolinium retention in patients with normal kidney function, it looks like our efforts have begun to pay off.
I want to share some news about Dr. Emanuel (Manny) Kanal. If you aren’t familiar with his name, Dr. Kanal is a leading radiologist and someone the FDA looks to for advice on matters related to MRI Safety. Duke and I have been in communication with him since October of 2013.
As you might imagine, MRI Safety is an important issue that requires medical professionals to stay well-informed about safety issues directly related to MR devices as well as the Gadolinium-based Contrast Agents administered for contrast-enhanced MRI and MRA. Since June of this year, Dr. Kanal has been conducting MRI Safety Officer (MRSO) and MRI Medical Director (MRMD) Seminars.
During a seminar on September 9, 2014, Dr. Kanal provided a “Gadolinium Contrast Overview”. According to the MRI Patient Safety blog, besides describing the state of NSF, he described “new and growing concerns about non-NSF bio-retention”. (more…)
Gadolinium Toxicity 