Benefit-to-risk ratio of GBCAs remains 'extremely high'—but evaluation should be done for each exam

Despite reports questioning if gadolinium-based contrast agents (GBCAs) can accumulate in the body and lead to adverse health effects, imaging providers should still use them when necessary, according to an editorial published online April 13 in the Journal of the American College of Radiology.  

The authors, a team of researchers from the Johns Hopkins University School of Medicine in Baltimore, advised that a benefit-risk analysis should be done for each imaging exam. Additionally, multiple scans on the same patient should be avoided, especially for children, pregnant women and patients know to be sensitive to contrast agents.

Academic interest in studying the phenomenon of "gadolinium deposition disease" (GDD) has grown since 2014, when a paper published in Radiology observed gadolinium deposition in the brains of patients who received GBCA administration, the authors wrote. In May 2017, the FDA and Medical Imaging Drugs Advisory Committee required additional research be conducted regarding the health effects associated with GDD.  

Overall, the authors asserted that healthcare personnel should weigh the "necessity, benefits and risks" of GBCAs when a patient may require an imaging examination.  

"The benefit-to-risk ratio for GBCAs remains extremely high, as they provide essential diagnostic information in a large number of clinical indications," wrote lead author Peter Barker, DPhil. "Taking a page from medical imaging studies using radiation, in which each study is weighted according to radiation exposure, magnetic resonance studies that require GBCAs should be carefully triaged to minimize any associated risks."