Honglei Zhang1, Giles H. Roditi2,
Tim Leiner3, Walter Kucharczyk4, Martin R. Prince1
1Radiology, Weill Medical College of
Cornell University, New York, NY, United States; 2Radiology,
Glasgow Royal Infirmary, Scotland; 3Maastricht University
Hospital, Netherlands; 4University of Toronto, Toronto, Ontario,
Canada
Concern
about the association between GBCA and NSF has led to widespread screening of
MRI patients for renal dysfunction and withholding GBCA when GFR is < 30
mL/min. Analysis of 78 retrospective
case series reporting 292 NSF cases explores the risk factors for NSF. Elimination of multiple risk factors by
using single dose GBCA, dialyzing dialysis patients quickly following GBCA
administration, avoiding GBCA in acute renal failure while serum creatinine
is rising, and avoiding non-ionic linear GBCA in renal failure patients, may
reduce NSF risk more than a thousand fold, thereby allowing safe GBCA
enhanced MRI in virtually all patients.