|
2
|
Iacobellis F, Di Serafino M, Russo C, Ronza R, Caruso M, Dell’Aversano Orabona G, Camillo C, Sabatino V, Grimaldi D, Rinaldo C, Barbuto L, Verde F, Giacobbe G, Schillirò ML, Scarano E, Romano L. Safe and Informed Use of Gadolinium-Based Contrast Agent in Body Magnetic Resonance Imaging: Where We Were and Where We Are. J Clin Med 2024; 13:2193. [PMID: 38673466 PMCID: PMC11051151 DOI: 10.3390/jcm13082193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Gadolinium-based contrast agents (GBCAs) have helped to improve the role of magnetic resonance imaging (MRI) for the diagnosis and treatment of diseases. There are currently nine different commercially available gadolinium-based contrast agents (GBCAs) that can be used for body MRI cases, and which are classifiable according to their structures (cyclic or linear) or biodistribution (extracellular-space agents, target/specific-agents, and blood-pool agents). The aim of this review is to illustrate the commercially available MRI contrast agents, their effect on imaging, and adverse reaction on the body, with the goal to lead to their proper selection in different clinical contexts. When we have to choose between the different GBCAs, we have to consider several factors: (1) safety and clinical impact; (2) biodistribution and diagnostic application; (3) higher relaxivity and better lesion detection; (4) higher stability and lower tissue deposit; (5) gadolinium dose/concentration and lower volume injection; (6) pulse sequences and protocol optimization; (7) higher contrast-to-noise ratio at 3.0 T than at 1.5 T. Knowing the patient's clinical information, the relevant GBCAs properties and their effect on body MRI sequences are the key features to perform efficient and high-quality MRI examination.
Collapse
Affiliation(s)
- Francesca Iacobellis
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Marco Di Serafino
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Camilla Russo
- Neuroradiology Unit, Department of Neuroscience Santobono-Pausilipon Children’s Hospital, 80122 Naples, Italy;
| | - Roberto Ronza
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Martina Caruso
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Giuseppina Dell’Aversano Orabona
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Costanza Camillo
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Vittorio Sabatino
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Dario Grimaldi
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Chiara Rinaldo
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Luigi Barbuto
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Francesco Verde
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Giuliana Giacobbe
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Maria Laura Schillirò
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| | - Enrico Scarano
- Department of Radiology, “San Carlo” Hospital, 85100 Potenza, Italy;
| | - Luigia Romano
- Department of General and Emergency Radiology, “A. Cardarelli” Hospital, 80131 Naples, Italy; (M.D.S.); (M.C.); (G.D.O.); (C.C.); (V.S.); (D.G.); (C.R.); (L.B.); (F.V.); (G.G.); (M.L.S.); (L.R.)
| |
Collapse
|
|
3
|
Gallo-Bernal S, Patino-Jaramillo N, Calixto CA, Higuera SA, Forero JF, Lara Fernandes J, Góngora C, Gee MS, Ghoshhajra B, Medina HM. Nephrogenic Systemic Fibrosis in Patients with Chronic Kidney Disease after the Use of Gadolinium-Based Contrast Agents: A Review for the Cardiovascular Imager. Diagnostics (Basel) 2022; 12:diagnostics12081816. [PMID: 36010167 PMCID: PMC9406537 DOI: 10.3390/diagnostics12081816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/11/2022] [Accepted: 07/22/2022] [Indexed: 11/16/2022] Open
Abstract
Gadolinium-enhanced cardiac magnetic resonance has revolutionized cardiac imaging in the last two decades and has emerged as an essential and powerful tool for the characterization and treatment guidance of a wide range of cardiovascular diseases. However, due to the high prevalence of chronic renal dysfunction in patients with cardiovascular conditions, the risk of nephrogenic systemic fibrosis (NSF) after gadolinium exposure has been a permanent concern. Even though the newer macrocyclic agents have proven to be much safer in patients with chronic kidney disease and end-stage renal failure, clinicians must fully understand the clinical characteristics and risk factors of this devastating pathology and maintain a high degree of suspicion to prevent and recognize it. This review aimed to summarize the existing evidence regarding the physiopathology, clinical manifestations, diagnosis, and prevention of NSF related to the use of gadolinium-based contrast agents.
Collapse
Affiliation(s)
- Sebastian Gallo-Bernal
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Correspondence:
| | - Nasly Patino-Jaramillo
- Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia; (N.P.-J.); (S.A.H.); (H.M.M.)
| | - Camilo A. Calixto
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Department of Radiology Boston Children’s Hospital, Boston, MA 02115, USA
| | - Sergio A. Higuera
- Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia; (N.P.-J.); (S.A.H.); (H.M.M.)
| | - Julian F. Forero
- Division of Radiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia;
| | - Juliano Lara Fernandes
- Jose Michel Kalaf Research Institute, Radiologia Clinica de Campinas, São Paulo 13092-123, Brazil;
| | - Carlos Góngora
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Cardiovascular Imaging Research Center (CIRC), Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, USA; (C.G.); (B.G.)
| | - Michael S. Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA 02114, USA;
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
| | - Brian Ghoshhajra
- Department of Radiology, Harvard Medical School, Boston, MA 02115, USA;
- Cardiovascular Imaging Research Center (CIRC), Division of Cardiology, Massachusetts General Hospital, Boston, MA 02114, USA; (C.G.); (B.G.)
| | - Hector M. Medina
- Division of Cardiology, Fundacion Cardioinfantil-LaCardio, Bogota 110131, Colombia; (N.P.-J.); (S.A.H.); (H.M.M.)
| |
Collapse
|
|
6
|
Weinreb JC, Rodby RA, Yee J, Wang CL, Fine D, McDonald RJ, Perazella MA, Dillman JR, Davenport MS. Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Radiology 2020; 298:28-35. [PMID: 33170103 DOI: 10.1148/radiol.2020202903] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Inaugural consensus statements were developed and endorsed by the American College of Radiology (ACR) and the National Kidney Foundation to improve and standardize the care of patients with kidney disease who have indication(s) to receive ACR-designated group II or group III intravenous gadolinium-based contrast media (GBCM). The risk of nephrogenic systemic fibrosis (NSF) from group II GBCM in patients with advanced kidney disease is thought to be very low (zero events following 4931 administrations to patients with estimated glomerular filtration rate [eGFR] <30 mL/min per 1.73 m2; upper bounds of the 95% confidence intervals: 0.07% overall, 0.2% for stage 5D chronic kidney disease [CKD], 0.5% for stage 5 CKD and no dialysis). No unconfounded cases of NSF have been reported for the only available group III GBCM (gadoxetate disodium). Depending on the clinical indication, the potential harms of delaying or withholding group II or group III GBCM for an MRI in a patient with acute kidney injury or eGFR less than 30 mL/min per 1.73 m2 should be balanced against and may outweigh the risk of NSF. Dialysis initiation or alteration is likely unnecessary based on group II or group III GBCM administration. This article is a simultaneous joint publication in Radiology and Kidney Medicine. The articles are identical except for stylistic changes in keeping with each journal's style. Either version may be used in citing this article.
Collapse
Affiliation(s)
- Jeffrey C Weinreb
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Roger A Rodby
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Jerry Yee
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Carolyn L Wang
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Derek Fine
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Robert J McDonald
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Mark A Perazella
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Jonathan R Dillman
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| | - Matthew S Davenport
- From the American College of Radiology, Reston, Va (J.C.W., C.L.W., R.J.M., J.R.D., M.S.D.); National Kidney Foundation, New York, NY (R.A.R., J.Y., D.F., M.A.P.); Department of Radiology and Biomedical Imaging (J.C.W.) and Department of Internal Medicine, Section of Nephrology (M.A.P.), Yale University School of Medicine, New Haven, Conn; Department of Nephrology, Rush University Medical Center, Chicago, Ill (R.A.R.); Department of Nephrology, Henry Ford Health System, Detroit, Mich (J.Y.); Department of Radiology, University of Washington, Seattle, Wash (C.L.W.); Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Md (D.F.); Department of Radiology, Mayo Clinic, Rochester, Minn (R.J.M.); Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, Ohio (J.R.D.); Departments of Radiology (M.S.D.) and Urology (M.S.D.), Michigan Medicine, 1500 E Medical Center Dr, Room B2 A209P, Ann Arbor, MI 48109-5030; and Michigan Radiology Quality Collaborative, Ann Arbor, Mich (M.S.D.)
| |
Collapse
|
|
7
|
Weinreb JC, Rodby RA, Yee J, Wang CL, Fine D, McDonald RJ, Perazella MA, Dillman JR, Davenport MS. Use of Intravenous Gadolinium-Based Contrast Media in Patients With Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Kidney Med 2020; 3:142-150. [PMID: 33604544 PMCID: PMC7873723 DOI: 10.1016/j.xkme.2020.10.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Inaugural consensus statements were developed and endorsed by the American College of Radiology (ACR) and National Kidney Foundation to improve and standardize the care of patients with kidney disease who have indication(s) to receive ACR-designated group II or group III intravenous gadolinium-based contrast media (GBCM). The risk of nephrogenic systemic fibrosis (NSF) from group II GBCM in patients with advanced kidney disease is thought to be very low (zero events following 4931 administrations to patients with estimated glomerular filtration rate [eGFR] <30 mL/min per 1.73 m2; upper bounds of the 95% confidence intervals: 0.07% overall, 0.2% for stage 5D chronic kidney disease [CKD], 0.5% for stage 5 CKD and no dialysis). No unconfounded cases of NSF have been reported for the only available group III GBCM (gadoxetate disodium). Depending on the clinical indication, the potential harms of delaying or withholding group II or group III GBCM for an MRI in a patient with acute kidney injury or eGFR less than 30 mL/min per 1.73 m2 should be balanced against and may outweigh the risk of NSF. Dialysis initiation or alteration is likely unnecessary based on group II or group III GBCM administration.
Collapse
Affiliation(s)
- Jeffrey C Weinreb
- American College of Radiology, Reston, VA.,Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT
| | - Roger A Rodby
- National Kidney Foundation, New York, NY.,Department of Nephrology, Rush University Medical Center, Chicago, IL
| | - Jerry Yee
- National Kidney Foundation, New York, NY.,Department of Nephrology, Henry Ford Health System, Detroit, MI
| | - Carolyn L Wang
- American College of Radiology, Reston, VA.,Department of Radiology, University of Washington, Seattle, WA
| | - Derek Fine
- National Kidney Foundation, New York, NY.,Department of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Robert J McDonald
- American College of Radiology, Reston, VA.,Department of Radiology, Mayo Clinic, Rochester, MN
| | - Mark A Perazella
- National Kidney Foundation, New York, NY.,Department of Internal Medicine, Section of Nephrology, Yale University School of Medicine, New Haven, CT
| | - Jonathan R Dillman
- American College of Radiology, Reston, VA.,Department of Radiology, Cincinnati Children's Hospital Medical Center at University of Cincinnati College of Medicine, Cincinnati, OH
| | - Matthew S Davenport
- American College of Radiology, Reston, VA.,Department of Radiology, Michigan Medicine, Ann Arbor, MI.,Department of Urology, Michigan Medicine, Ann Arbor, MI.,Michigan Radiology Quality Collaborative, Ann Arbor, Mich
| |
Collapse
|
|
8
|
Palamuthusingam D, Reyaldeen R, Johnson DW, Hawley CM, Pascoe EM, Wahi S, Fahim M. Assessment of cardiac structure and function in kidney failure: understanding echocardiography and magnetic resonance imaging for the nephrologist. Int Urol Nephrol 2020; 53:699-712. [PMID: 32865773 DOI: 10.1007/s11255-020-02610-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 08/12/2020] [Indexed: 11/25/2022]
Abstract
Cardiovascular disease is the leading cause of death in patients with kidney failure or on chronic dialysis. Patients on chronic dialysis have a 10- to 50-fold increased risk of sudden cardiac death compared to patients with normal kidney function. Adverse changes in cardiac structure and function may not manifest with clinical symptoms in patients with kidney failure and, therefore, pose a challenge in identifying cardiac dysfunction early. Fortunately, there are multi-modality cardiac imaging techniques available, including echocardiography and cardiac magnetic resonance imaging, that can help our understanding of the pathophysiology of cardiac dysfunction in kidney failure. This review describes the benefits and limitations of these two commonly available cardiac imaging modalities to assess cardiac structure and function, thereby aiding nephrologists in choosing the most appropriate investigative tool based on individual clinical circumstances. For the purposes of this review, cardiac imaging for detection of coronary artery disease has been omitted.
Collapse
Affiliation(s)
- Dharmenaan Palamuthusingam
- Metro South and Integrated Nephrology and Transplant Services, Logan Hospital, Armstrong Road & Loganlea Road, Meadowbrook, QLD, 4131, Australia. .,Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia. .,School of Medicine, Griffith University, Mount Gravatt, QLD, Australia.
| | - Reza Reyaldeen
- Cardiovascular Imaging Section, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - David Wayne Johnson
- Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia.,Metro South and Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia.,Translational Research Institute, Brisbane, Australia
| | - Camel M Hawley
- Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia.,Metro South and Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
| | - Elaine M Pascoe
- Centre for Health Services Research, University of Queensland, St Lucia, QLD, 4072, Australia
| | - Sudhir Wahi
- Metro South and Integrated Nephrology and Transplant Services, Logan Hospital, Armstrong Road & Loganlea Road, Meadowbrook, QLD, 4131, Australia
| | - Magid Fahim
- Faculty of Medicine, University of Queensland, St Lucia, QLD, 4072, Australia.,Metro South and Integrated Nephrology and Transplant Services, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, QLD, 4102, Australia
| |
Collapse
|