Long-Term Effects of Gadolinium-Based Contrast Media: Current Data and Recommendations

Gadolinium (Gd)-based contrast media are an essential part of diagnosis using magnetic resonance (MR) imaging. Certain disease processes may be diagnosed significantly earlier when MR studies are conducted with contrast media, improving treatment prospects and patient outcomes.

Gd-based contrast media are in widespread use. They were first approved by FDA in 1988 and are thought to be safer than the iodine-based media used in x-ray applications, particularly for patients with impaired kidney function (Joffe et al. 1998). Since the introduction of Gd-based media, over 450 million doses have been administered worldwide (Levine et al. 2018). About 30% of all MR studies performed in the United States use Gd contrast enhancement (Harvey et al. 2020).

Despite their benefits, Gd-based contrast media also are associated with long-term risks—most notably nephrogenic systemic fibrosis (NSF), a disease that is rare but potentially devastating. It is therefore important to...