Blood test helps prevent serious contrast-agent complications

A simple blood test for certain patients about to receive an MRI exam can stem serious complications related to contrast agents, according to a study. 

During the past five years, use of gadolinium-based contrast agents (GBCA) has been linked to the development of nephrogenic systemic fibrosis (NSF), a rare and potentially fatal disorder that mainly impacts patients with severe kidney disease. However, since 2008, restrictive GBCA administration guidelines adopted by Massachusetts General Hospital have proven to be effective in stopping NSF.

NSF is a condition involving the formation of excess fibrous connective tissue in the skin, joints, eyes, and internal organs--sometimes making patients wheelchair-bound within a few weeks. GBCA has received close scrutiny from the Food and Drug Administration, and last fall, the agency required that the agents carry new warnings on their labels about the risk of NSF.

The hospital's guidelines require that a blood test be done on patients over age 60 or at risk for kidney disease, according to the study appearing in the July issue of Radiology. The blood test measures how well the kidneys are doing and whether GBCA should be administered.

Prior to adoption of the guidelines and during the transition period, 113,120 contrast-enhanced MRI exams were performed at the hospital, and 34 cases of NSF were identified. In the post-guideline period, 52,954 contrast-enhanced MRIs were performed, but no new cases of NSF were identified.

"It is important for the public to know that gadolinium products are safe for most patients and the risk of NSF should not deter them from GBCA-enhanced exams, such as MRIs," said the study's lead author Hani H. Abujudeh, MD, associate professor of radiology at Harvard Medical School in Boston, in a statement.

For more details:
- see an article in Cardiovascular Business
- see an announcement about the study