What to Consider When Administering GBCAs

Radiologists should carefully consider the reasons why they’re injecting gadolinium-based contrast agents (GBCAs) before administering the drug, suggests a new study. According to researchers at Case Western University, physicians should evaluate a series of factors including pharmacokinetics, potential allergic reactions, patient age, the need for additional MRI, and costs when deciding on whether or not to use the contrast agent.

Since GBCAs were introduced in 1987, more than 300 million doses of the drug have been injected. The substance illuminates the patient’s veins to give radiologists a brighter and more accurate depiction of their brain topography. Reports have found that GBCAs leave a “residual brightness of tissue in the deep nuclei of the brain,” although there’s no data available on the adverse side effects of depositing the drug. However, GBCAs can have negative repercussions on those with kidney and renal problems.

“The detection of gadolinium deposition in the brain is concerning,” write the researchers. “However, there are no reliable data regarding its clinical or biological significance, if any.” The lack of information regarding side effects should motivate physicians to only use GBCAs when necessary. The Food and Drug Administration has also taken a stance on the use of GBCAs, and has recommended that “health care professionals should consider limiting GBCA use to clinical circumstances in which the additional information provided by the contrast is necessary. Health care professionals are also urged to reassess the necessity of repetitive GBCA MRIs in established treatment protocols.”

Bottom line: although physicians have been administering GBCAs for 30 years, we still don’t know how the drug potentially impacts neural activity. This study demands the need for further research on GBCAs, and the protocol physicians should take when deciding on whether or not to administer the drug.