![]() ![]() Gadobenic acid (USAN gadobenate dimeglumine) ![]() Gadopentetic acid (USAN gadopentetate dimeglumine) Status of gadolinium-containing contrast agents after the review Brand leader product name ![]() When using one of the linear GdCAs that will remain on the market, weigh the possible diagnostic advantages in patients who will require repeated scans against the potential for deposition of gadolinium in the brain and other tissues. The European Medicines Agency has issued information to patients about the review. There is currently no evidence that gadolinium deposition in the brain has caused adverse neurological effects in patients however, data on long-term effects of gadolinium deposition in the brain or other tissues are very limited. In view of the evidence of retention of gadolinium in brain and other tissues following exposure to these agents, the risks of gadodiamide and intravenous gadopentetic acid are considered to outweigh their benefits. This is because they are more stable and do not release gadolinium to any significant extent from the ligand molecule. Data on stability, as well as in-vitro and non-clinical studies, show that macrocyclic agents have a significantly lower potential to cause retention of gadolinium in the body. Low levels of gadolinium deposition in the brain, particularly in the dentate nucleus of the cerebellum and in the sub-cortical structure the globus pallidus, have been confirmed by mass spectrometry and studies of MRI data. Gadolinium retention in the brain and other tissuesĪ European-level scientific review to investigate gadolinium retention in brain and other tissues has now completed. Since 2006, the use of linear GdCAs has decreased markedly in the UK, and most patients now receive macrocyclic GdCAs. In 2010, we published advice aiming to minimise the risk of NSF. Linear GdCAs were categorised as having a higher risk of causing NSF than macrocyclic GdCAs. GdCAs contain gadolinium bound to a ligand molecule and can be divided into two groups based on their chemical structure - linear and macrocyclic.Ī 2007 European-level review identified a risk of nephrogenic systemic fibrosis (NSF) following use of GdCAs in patients with severely impaired renal function. Gadolinium-containing contrast agents (GdCAs) are indicated for the enhancement of magnetic resonance imaging (MRI).
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