ArticlePediatric radiology2020
Brain tissue gadolinium retention in pediatric patients after contrast-enhanced magnetic resonance exams: pathological confirmation.
Article in Pediatric radiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 1 of them a synthesis that pooled it.
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Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 91 citations in OpenAlex.
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- Dose-Lowering in Contrast-Enhanced MRI of the Central Nervous System: A Retrospective, Parallel-Group Comparison Using Gadobenate Dimeglumine.Journal of magnetic resonance imaging : JMRI · 2021Trial
- Short- and Long-Term Effects of a Single Exposure to Gadoteric Acid in Healthy Rats-Gadolinium, Iron and Other Metal Accumulation in Kidney and Brain.International journal of molecular sciences · 2026Article
- Clinical Validation of a Fast MRI Method to Evaluate Brain Vascular and Parenchymal Abnormalities in Sturge-Weber Syndrome.Journal of magnetic resonance imaging : JMRI · 2026Observational
- Gadolinium-based contrast agents in pediatric MRI: renal safety, risk mitigation, and emerging alternatives.Pediatric radiology · 2026Review
- Efficacy of Various Complexing Agents for Displacing Biologically Important Ligands from Eu(III) and Cm(III) Complexes in Artificial Body Fluids-An In Vitro Decorporation Study.International journal of molecular sciences · 2025Article
- How useful is contrast-enhanced MRI in the long-term surveillance of glioma? A multicentre retrospective longitudinal cohort study.European radiology · 2025Article
- Precipitation of gadolinium from magnetic resonance imaging contrast agents may be the Brass tacks of toxicity.Magnetic resonance imaging · 2025Article
- Gadolinium Contrast Agent Deposition in Children.Journal of magnetic resonance imaging : JMRI · 2025Review
- Assessing Mild Traumatic Brain Injury-Associated Blood-Brain Barrier (BBB) Damage and Restoration Using Late-Phase Perfusion Analysis by 3D ASL MRI: Implications for Predicting Progressive Brain Injury in a Focused Review.International journal of molecular sciences · 2024Review
- Feasibility and Potential Diagnostic Value of Noncontrast Brain MRI in Nonsedated Children With Sturge-Weber Syndrome and Healthy Siblings.Journal of child neurology · 2024Article
- A Combination of Amide Proton Transfer, Tumor Blood Flow, and Apparent Diffusion Coefficient Histogram Analysis Is Useful for Differentiating Malignant from Benign Intracranial Tumors in Young Patients: A Preliminary Study.Diagnostics (Basel, Switzerland) · 2024Article
- Imaging Assessment of Radiation Therapy-Related Normal Tissue Injury in Children: A PENTEC Visionary Statement.International journal of radiation oncology, biology, physics · 2024Review
- The safety of magnetic resonance imaging contrast agents.Frontiers in toxicology · 2024Article
- Brain deposition of gadobutrol in children-a cross-sectional and longitudinal MRI T1 mapping study.European radiology · 2023Article
- Safety considerations related to intravenous contrast agents in pediatric imaging.Pediatric radiology · 2023Review
- The onset of rare earth metallosis begins with renal gadolinium-rich nanoparticles from magnetic resonance imaging contrast agent exposure.Scientific reports · 2023Article
- Long-term safety of MRI-guided administration of AAV2-GDNF and gadoteridol in the putamen of individuals with Parkinson's disease.Molecular therapy : the journal of the American Society of Gene Therapy · 2022Article
- Utility of Gadolinium Use in the Imaging Follow-Up of Nonenhancing Primary Brain Neoplasms in Children.Cureus · 2022Article
- Spectral imaging in the pediatric chest: past, present and future.Pediatric radiology · 2022Review
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRetained gadolinium from gadolinium-based contrast agents (GBCAs) used in MR exams has been inferred based on signal changes on serial brain MRI and subsequently demonstrated pathologically in adults. Retention has been similarly inferred in children but pathological demonstration in pediatric patients is limited. The long-term effects of retained gadolinium are unknown but are potentially of greater concern in children given their increased vulnerability from continuing development and their expected longer period of exposure. Several factors can influence gadolinium retention. In adults as well as in children, greater accumulation has been demonstrated based on MR signal changes with linear compared with macrocyclic gadolinium chelates, attributed to lower chelate affinity with linear agents. Effects of age at exposure on retention are unknown, while differences in GBCA washout rates are still under investigation and might affect gadolinium retention relative to time of GBCA administration.
objectiveThe purpose of this study was to confirm whether gadolinium brain deposits are present in pediatric patients who received GBCAs and to quantify the amounts present. MATERIALS AND
methodsBrain autopsy specimens from 10 pediatric patients between 1 year and 13 years of age who underwent at least one contrast-enhanced MR exam were analyzed for elemental gadolinium using inductively coupled plasma mass spectrometry. Brain samples included white matter, basal ganglia (putamen, globus pallidus), thalamus, dentate nucleus and tumor tissue as available. Type and dose of contrast agent, number and timing of contrast-enhanced MR exams and renal function (estimated glomerular filtration rate [eGFR]) were documented for each child.
resultsPatient exposures ranged from 1 dose to 20 doses of GBCAs including both macrocyclic and linear ionic agents. Gadolinium was found to be present in brain tissue in all children and was generally highest in the globus pallidus. Those who received only macrocyclic agents showed lower levels of gadolinium retention.
conclusionThis study demonstrates pathological confirmation of gadolinium retention in brain tissue of a series of pediatric patients exposed to GBCAs including not only linear ionic agents but also macrocyclic agents with both nonionic and ionic compounds. The distribution and deposition levels in this small pediatric population are comparable with the findings in adults. While the clinical significance of these deposits remains unknown, at this point it would be prudent to exert caution and avoid unnecessary use of GBCAs in pediatric patients.
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