Contrast-Enhanced MRA in the NSF Era: Potential for Contrast Dose Reduction

Matthew J. Kuhn¹

Higher doses of gadolinium-based contrast agents are often required when performing MR angiography in order to achieve sufficient intravascular signal intensity. However, patients with moderate-to-severe CKD undergoing contrast-enhanced MR imaging are at increased risk for developing NSF, particularly with higher doses or repeated exposure to MR contrast agents. The results of 7 intraindividual crossover studies, in which the higher-relaxivity contrast agent gadobenate dimeglumine (Gd-BOPTA) is compared with conventional MR contrast agents for MRA in various vascular territories, demonstrate that Gd-BOPTA may be used at lower dose without compromise of diagnostic efficacy, potentially limiting patient exposure to contrast.