Gadolinium-based contrast agents (GBCAs) revolutionized magnetic resonance imaging (MRI) examinations by depiction of pathology otherwise undetectable on unenhanced MRI or other imaging modalities. Since initial regulatory approval in 1988, it is estimated that more than 450 million GBCA doses have been administered worldwide. In the United States, it is estimated that approximately 8.8 million MRI procedures involving gadolinium administration were performed in 2016.1 GBCAs have excellent safety profiles with rates of acute adverse reactions (0.07%-2.4%) substantially lower than adverse events observed with iodinated contrast material used during computed tomography or angiography. Most reactions are mild, including injection site pain, headache, nausea, paresthesias, and dizziness. Anaphylactic reactions are rare (0.001%-0.01%).
Levine D, McDonald RJ, Kressel HY. Gadolinium Retention After Contrast-Enhanced MRI. JAMA. 2018;320(18):1853–1854. doi:10.1001/jama.2018.13362
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