Gadolinium Deposition in Brain: Current Scientific Evidence and Future Perspectives

Abstract

In the past 4 years, many publications described a concentration-dependent deposition of gadolinium in the brain both in adults and children, seen as high signal intensities in the globus pallidus and dentate nucleus on unenhanced T1-weighted images. Postmortem human or animal studies have validated gadolinium deposition in these T1-hyperintensity areas, raising new concerns on the safety of gadolinium-based contrast agents (GBCAs). Residual gadolinium is deposited not only in brain, but also in extracranial tissues such as liver, skin, and bone. This review summarizes the current evidence on gadolinium deposition in the human and animal bodies, evaluates the effects of different types of GBCAs on the gadolinium deposition, introduces the possible entrance or clearance mechanism of the gadolinium and potential side effects that may be related to the gadolinium deposition on human or animals, and puts forward some suggestions for further research.

Dynamic contrast‐enhanced MRI of brown and beige adipose tissues

“…However, the main limitation of our study is the use of gadolinium based contrast agent for quantification of perfusion in BAT and beige adipose tissues. Deposition of gadolinium in the brain has been recently reported, and it may cause long‐term risks for the patient population . Use of a limited number of animals per group and also the sparse distribution of beige tissue (few pixels in images) is also another limitation of the study.…”

“…Deposition of gadolinium in the brain has been recently reported, and it may cause long-term risks for the patient population. 67,68 Use of a limited number of animals per group and also the sparse distribution of beige tissue (few pixels in images) is also another limitation of the study. Further studies can be explored by combining DCE-MRI in positron emission tomography/MR systems to achieve multi-parametric information with good spatial and temporal resolution for better understanding of functional and structural asspects of BAT metabolism.…”

Analysis of retention of gadolinium by brain, bone, and blood following linear gadolinium‐based contrast agent administration in rats with experimental sepsis

“…Historically, toxicity concerns have focused on allergic reactions, and in patients with advanced renal failure, on nephrogenic systemic fibrosis . Since 2014, additional concerns have been raised, based on increased T 1 signal and supported by mass spectroscopy, that Gd deposition occurs in the brain following GBCA administration as a result of dechelation of linear, rather than macrocyclic, formulations . This has been challenged by observations that unenhanced T 1 signal intensity increases with normal myelination as children mature, and by underlying pathological processes, which may complicate the interpretation of increasing unenhanced T 1 signal intensity as indicative of Gd deposition in patients who undergo multiple MRI examinations over time .…”

Amino Acid‐Derived Sensors for Specific Zn2+ Detection Using Hyperpolarized 13C Magnetic Resonance Spectroscopy

“…Toxicity concerns are unlikely based on the known toxicology profile of cysteine . The majority of Zn 2+ imaging probes are gadolinium‐based contrast agents, which face the concern of their deposition in brain and environment, a concern which would be avoided in this case . A final potential benefit of this method is the broad range of zinc concentration in serum and other tissues, potentially enabling high image contrast.…”