Conventional Contrast Agents (Gadolinium Chelates) v3 11-21-10

Introduction Magnetic resonance contrast agents, in particular the gadolinium-based agents, are very safe and lack the nephrotoxicity (when injected intravenously in the approved dose range) associated with iodinated contrast media.[1-3] Minor adverse effects occur infrequently and include nausea, taste perversion, and hives. Whereas these agents cannot be differentiated on the basis of mild adverse effects, they do differ in regard to chelate stability, with clinical lab abnormalities known with the less stable agents. The issue of nephrogenic systemic fibrosis (NSF) and its relationship to the gadolinium chelates, and specifically their in vivo stability, is discussed in depth in the text that follows, together with recommendations for clinical practice.