Adverse effects of gadolinium-based contrast agents in organ systems: a literature review

Denas Andrijauskis1, Ieva Keturkaite1

1Lithuanian University of Health Sciences, Academy of Medicine, Faculty of Medicine, Kaunas, Lithuania


Background and aim: Gadolinium based contrast agents are widely used materials in magnetic resonance imaging (MRI) diagnostic procedures. Gadolinium based contrast agents (GBCAs) are classified by structure to linear or macrocyclic. It is suspected that the difference of the structure may be responsible for the mechanism of side effects after MRI. The aim of this article is to assess the side effects of MRI contrast agents in various organ systems.

Materials and methods: The study was conducted by an electronic database subscription of Lithuanian University of Health Sciences: PubMed (Medline), EMBASE, ClinicalKey, ScienceDirect. We tried to review and summarize the published literature of GBCAs effect in various organ systems. Our research also carried out a forward citation and bibliographic search of identifying studies regarding nephrogenic systemic fibrosis (NSF), gadolinium deposition, gadolinium retention, gadolinium based contrast agents in the brain.

Results: There are evidence that linear GBCAs affect the body more than their macrocyclic structure.  GBCAs cause uncommon conditions such as deposits in brain and NSF. NSF firstly affects skin and spreads to liver, bones, lungs and other organs.

Conclusions: Gadolinium based contrast agents should be under strict regulation just like other pharmaceuticals for their adverse effects and damage of organs structures. Therefore, these agents should be strictly monitored and reviewed case by case before administration to patients to avoid gadolinium accumulation in tissues and possible diseases.

Keywords: nephrogenic systemic fibrosis, gadolinium based contrast agents, magnetic resonance imaging.