Gadolinium Toxicity

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Pilot study reports elevated gadolinium levels 30 days after MRIs with contrast

A new study by Alwasiyah et al. concluded that the current reference range of 0.7 μg/24hr for 24-hour urinary gadolinium is not applicable to patients for at least 30 days following exposure to a gadolinium-based contrast agent (GBCA).  In the study, the authors “calculated an estimated average of 57 days for the urinary gadolinium to creatinine ratio to reach below the current reference range following GBCA exposure and possibly much longer (i.e., 80+ days)”.  The article, “Urinary Gadolinium Levels After Contrast-Enhanced MRI in Individuals with Normal Renal Function: a Pilot Study”, was published online December 12, 2018 in the Journal of Medical Toxicology.

This was a prospective, observational pilot study to determine urine gadolinium concentrations over a 30-day period after GBCA administration in patients with normal renal function.  The 13 subjects were between 18 and 65 years of age and were reported to have received a gadolinium-based contrast agent for the first time.  Prior to contrast administration, spot urine samples were obtained and tested for gadolinium and creatinine.  All testing was performed by Mayo Medical Laboratories in Rochester, MN.  Post-MRI 24-hour urine testing was performed on day 3, 10 and 30.  Eight subjects received gadobutrol (Gadavist®), four received gadopentetate dimeglumine (Magnevist®), and 1 received gadoxetate disodium (Eovist®) for their MRIs with contrast.  The authors reported that all 13 subjects had 24-hour gadolinium levels higher than 0.7 μg/24hr on day 3, day 10, and day 30 after contrast administration.  The authors estimated that “urinary gadolinium levels will often remain above the current reference range for >50 days”. (more…)

New MRI Safety Certification Exams cover long-term adverse effects of GBCAs

On June 24, 2015, the American Board of Magnetic Resonance Safety (ABMRS) administered exams, which will for the first time, certify Magnetic Resonance Medical Directors/Physicians (MRMD) and Magnetic Resonance Safety Officers (MRSO).  A third test, for Magnetic Resonance Safety Experts (MRSE), is expected to be ready for administration on or after the 4th quarter of 2015.

As we previously reported, the purpose of the ABMRS 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.

Dr. Emanuel Kanal, ABMRS Chairman, told us that he included in the examination content requirements that ABMRS certified MR practitioners be familiar with gadolinium based contrast agent safety issues – and that among the issues with which they want them to be familiar are long-term potential adverse effects of the administration of gadolinium-based contrast agents.   (more…)

My experience with Gadolinium urine testing

My first urine test for Gadolinium was not done until a full two years after my last dose of contrast.  Part of the delay was because I did not know about the test until almost 18 months had gone by.

I wanted my first test to be performed by Mayo Clinic Labs; however, I had difficulty making that happen.  The lab affiliated with the medical clinic where most of my doctors are located told me that they could not do any testing for heavy metals or send specimens out to another lab for the testing.  But I finally found a way around that problem.

The lab at our local hospital regularly sends specimens to Mayo Clinic in Rochester, Minnesota.  (more…)

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