Gadolinium is a contrast agent solution used during an MRI or magnetic resonance imaging. Commonly used to detect tumors in the body and brain, Gadolinium is injected into the bloodstream where it highlights the features of the body and displays any abnormal growths when exposed to MRI scanning. The solution is colorless, resembling clear water and is non-radioactive. When the solution is exposed to the MRI, it becomes very bright, highlighting any deposits of the fluid which indicates abnormal tissue growth. Typically, scans are taken both before and after the contrast agent is injected, providing two or more pictures for comparison.
Also known as Gadodiamide, Gadolinium is known by several trade names. The most well known is Magnevist, manufactured by Bayer Healthcare Pharmaceuticals and approved by the US Food and Drug Administration (FDA) in 1988. Magnevist has been used more than 80 million times worldwide and is marketed in more than 100 countries. Another Gadolinium based contrast agent branded as Omniscan was released for use in 1993 and is typically used in scans of the central nervous system. The last, named ProHance, is manufactured by Bracco Diagnostics and was approved by the FDA in 1992.
Using gadolinium during an MRI allows the physician to see the exact size and location of the tumor that needs to be treated. Contrast agents that use Gadolinium provide the physician with greater clarity and makes the smaller tumors very bright and easy to see. Once administered, the solution is rapidly removed from the body by the kidneys. The most common side effects associated with the use of Gadolinium based contrast agents are headache, nausea, and a localized burning sensation. Some individuals have been found to be allergic to Gadolinium, experiencing hives, eye irritation, and shortness of breath.
Contrast agents containing Gadolinium have been found to cause complications in some individuals with kidney problems. The most serious of these complications are nephrogenic systemic fibrosis (NSF), also known as nephrogenic fibrosing dermopathy (NFD). Nephrogenic systemic fibrosis is a disorder that causes swelling and tightening of the skin in the extremities. This condition typically affects patients in moderate to end stage kidney disease who have been given a Gadolinium based contrast agent prior to an MRI. The condition can begin any time between 2 days and 18 months after the initial injection of Gadolinium. The symptoms of NSF include itching, swelling, hardening, and burning of the skin; dark or red patches appearing on the skin; trouble moving or straightening the arms, legs, hands, or feet; yellow spots on the whites of the eyes; muscle weakness; and pain in the hips or ribs. NSF is a debilitating disease that can cause the death of the patient afflicted.
NSF/NFD is a rare condition, affecting less than 300 people worldwide. In the cases of the condition studied by the FDA, all of the patients were in an advanced state of kidney disease and all received a Gadolinium based contrast agent prior to undergoing an MRI. These results prompted the FDA to issue an advisory to healthcare professionals and the public warning of the increased risk of developing the condition after the use of Gadolinium based contrast agents. Any individual that believes they may have developed NSF/NFD is advised to contact their healthcare professional as soon as possible as the condition can scar bodily organs as well as skin. There is no successful treatment available for the condition, but the progress of the disorder can be halted or reversed by improving renal function.