Gadolinium Risks During MRI with Contrast May Be Avoided with Safer Alternative: Study

New research suggests that there may be a safer alternative for those concerned about the potential side effects of gadolinium commonly used in MRI contrasting agents, which have been linked to serious risks, especially for those with kidney issues. 

In findings published this month by the medical journal Radiology, researchers from Massachusetts General Hospital say they may have developed an alternative to gadolinium-based contrasting agents (GBCAs), such as Omniscan and Magnevist, which are used to enhance images from MRI examinations.

In tests conducted on baboons, the researchers found that a manganese-based contrasting agent, known as Mn-PyC3A, was as effective as gadolinium in improving magnetic resonance imaging (MRI) results. Previous mouse studies found that 99% of the manganese-based MRI solutions were excreted from the body within 24 hours, and that it was not retained in the liver or kidneys.

Those findings, while in no way conclusive, suggest that this new MRI may not carry some of the health risks of gadolinium toxicity.

“Mn-PyC3A enables contrast-enhanced MR angiography with comparable contrast enhancement to gadolinium-based agents and may overcome concerns regarding gadolinium-associated toxicity and retention,” the researchers concluded.

Gadolinium Contrast Agent Health Concerns

According to allegations raised in a growing number of MRI contrast agent poisoning lawsuits, gadolinium contained in products like Magnevist, Gadavist, and Ominscan may leave patients with persistent headaches, bone and joint pain, reduced cognitive function, tendon and ligament pain, thickening of soft tissues and other complications.

The condition is known known as gadolinium deposition disease (GDD), and it is considered incurable and progressive, meaning that the symptoms worsen over time.

In addition, several years ago concerns emerged about a link between MRI gadolinium contrast agents and a severe and life-threatening skin condition, known as nephrogenic systemic fibrosis (NSF), which was found to occur among patients with impaired kidney function, causing their skin to thicken and harden, severely restricting movement.

Sometimes referred to as gadolinium associated systemic fibrosis, NSF is a painful disorder that has no known cure and often results in confinement to a wheelchair and then death.

In 2007, the FDA limited gadolinium contrast doses in most patients and contraindicated it for others, which limited the risk of NSF. In September 2010, the FDA went even further and banned the use of Bayer’s Magnevist on patients with kidney problems, due to the heightened risk of NSF.

The agency also required label changes for all gadolinium agents, warning healthcare professionals to screen patients before injecting gadolinium to identify those suffering from acute kidney injury or chronic, severe kidney disease.

However, the new lawsuits indicate that the plaintiffs or family members who suffered gadolinium poisoning suffered no reduced kidney function, raising questions as to whether the gadolinium contrast agent side effects are limited to those with kidney problems.

Recently, there have also been growing concerns over signs of gadolinium build-up in the body. In September, the FDA’s Medical Imaging Drugs Advisory Committee voted to recommend the FDA require new MRI contrast agent warnings about the risk of gadolinium build up in the brain. However, in May the FDA concluded that gadolinium in the brain appeared to carry no threat of health effects.

The FDA is continuing to assess their safety, and its National Center for Toxicological Research is currently conducting a study on gadolinium brain retention in rats.