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Nephrogenic systemic fibrosis

James R Costello, Bobby Kalb, Diego R Martin
Since their clinical introduction in 1988, gadolinium-based contrast agents (GBCAs) have demonstrated an excellent safety profile with a reported acute adverse reaction rate ranging from 0.01% to 2%. By comparison, the acute adverse reaction rate of low osmolar nonionic computed tomography contrast agents (CTCs) ranges from 0.7% to 3.1%. Many of the risk factors associated with CTC reactions (drug allergies, asthma, atopy, prior contrast reaction) also point toward an increased incidence of acute adverse events to GBCAs...
June 29, 2016: Topics in Magnetic Resonance Imaging: TMRI
Philippe Soyer, Anthony Dohan, Deepak Patkar, Andreas Gottschalk
PURPOSE: To investigate the safety of gadoterate meglumine and identify the incidence of nephrogenic systemic fibrosis (NSF). MATERIALS AND METHODS: An international prospective observational study was conducted from November 2008 to June 2013. A total of 35,499 adults and children who were scheduled to undergo contrast-enhanced MRI using gadoterate meglumine were analyzed (female, 53.1%; mean age: 49.5 years; range: 0-98 years). At least 3-month follow-up was planned for patients with an estimated creatinine clearance or glomerular filtration rate <60 mL/min (/1...
October 11, 2016: Journal of Magnetic Resonance Imaging: JMRI
Nozomu Murata, Kiyoko Murata, Luis F Gonzalez-Cuyar, Kenneth Maravilla
Until recognition of the association of nephrogenic systemic fibrosis (NSF) and gadolinium based contrast agents (GBCA) in 2006, these agents were considered extremely safe and without major adverse effects. Even after the recognition of NSF, most physicians considered all GBCAs to be safe when used in patients with normal renal function. This belief has been called into question with the discovery by Kanda in 2014 that Gd is deposited in brain tissue in patients with normal kidney function. Since that initial report, there have been a number of important studies analyzing the effects of various GBCAs in brain using MR T1 signal intensity measurements and postmortem tissue analyses with inductively coupled plasma mass spectrometry...
October 5, 2016: Magnetic Resonance Imaging
Yumi Ozawa, Shujiro Hayashi, Yoichiro Hamasaki, Atsushi Hatamochi
Nephrogenic systemic fibrosis (NSF) is a disease characterized by fibrosis of the systemic organs in patients with renal failure. Following the findings of recent epidemiological studies and the finding of gadolinium (Gd) in the skin tissue of NSF patients, it is now definitely known that the use of Gd contrast agents can trigger NSF. To date, however, the exact mechanism underlying the induction of fibrosis in various organs by Gd remains unexplained. This study was undertaken to evaluate the influence of Gd on the proliferation activity and collagen production of cultured fibroblasts...
September 28, 2016: Archives of Dermatological Research
Gautam R Shroff, Paolo Raggi
Extensive myocardial fibrosis is known to occur in patients undergoing dialysis due to a variety of mechanisms not necessarily restricted to coronary artery disease. Fibrosis may predispose to reentry arrhythmias and long-term myocardial dysfunction, and sudden death and congestive heart failure are the most frequent causes of death in patients undergoing renal replacement therapy. Despite the high accuracy of magnetic resonance for imaging of myocardial fibrosis, its use has been restricted by the risk of inducing nephrogenic systemic sclerosis with the injection of gadolinium...
October 2016: Kidney International
Joel G Ray, Marian J Vermeulen, Aditya Bharatha, Walter J Montanera, Alison L Park
IMPORTANCE: Fetal safety of magnetic resonance imaging (MRI) during the first trimester of pregnancy or with gadolinium enhancement at any time of pregnancy is unknown. OBJECTIVE: To evaluate the long-term safety after exposure to MRI in the first trimester of pregnancy or to gadolinium at any time during pregnancy. DESIGN, SETTING, AND PARTICIPANTS: Universal health care databases in the province of Ontario, Canada, were used to identify all births of more than 20 weeks, from 2003-2015...
September 6, 2016: JAMA: the Journal of the American Medical Association
Sundararaman Swaminathan
Gadolinium-based magnetic resonance (MR) contrast agents (GBCM) causes a devastating systemic fibrosing illness, nephrogenic systemic fibrosis (NSF), in patients with reduced kidney function. GBCM targets iron-recycling CD163- and ferroportin-expressing macrophages to release labile iron that mediates gadolinium toxicity and NSF. GBCA might similarly target iron-rich, ferroportin-expressing structures such as globus pallidus and cerebellar dentate nucleus in the brain to result in metal accumulation and potential toxicity...
August 28, 2016: Magnetic Resonance Imaging
Hakan Demirtaş, Tuna Parpar, Bumin Değirmenci, Mustafa Kara, Ahmet Orhan Çelik, Ayşe Umul, Mustafa Kayan, Ömer Yılmaz
PURPOSE: This study aimed to investigate the feasibility and diagnostic power of unenhanced 3D turbo spin echo MR angiography sequence (a technique based on subtraction of corresponding images acquired in diastole and systole, Syngo Native Space-Siemens healthcare) to identify peripheral artery disease (PAD). MATERIALS AND METHODS: Thirty patients (619 arterial segments in total) suspected with PAD and who were assessed with lower extremity MDCT angiography were examined starting from the level of aortic bifurcation for both lower extremities by 3D native space MR angiography...
August 29, 2016: La Radiologia Medica
Henrik J Michaely, Manuela Aschauer, Hannes Deutschmann, Georg Bongartz, Matthias Gutberlet, Ramona Woitek, Birgit Ertl-Wagner, Walter Kucharczyk, Renate Hammerstingl, Francesco De Cobelli, Martin Rosenberg, Thomas Balzer, Jan Endrikat
OBJECTIVE: The aim of this study was to assess the potential risk of gadobutrol-enhanced magnetic resonance imaging (MRI) in patients with moderate to severe renal impairment for the development of nephrogenic systemic fibrosis (NSF). MATERIALS AND METHODS: We performed a prospective, international, multicenter, open-label study in 55 centers. Patients with moderate to severe renal impairment scheduled for any gadobutrol-enhanced MRI were included. All patients received a single intravenous bolus injection of gadobutrol at a dose of 0...
August 15, 2016: Investigative Radiology
Rosaria Lupica, Enricomaria Mormina, Antonio Lacquaniti, Domenico Trimboli, Biagio Bianchimano, Silvia Marino, Placido Bramanti, Marcello Longo, Michele Buemi, Francesca Granata
BACKGROUND/AIMS: CT, MRI and ultrasound are currently used for screening and follow-up of individuals affected by autosomal dominant polycystic kidney disease (ADPKD). Dynamic contrast-enhanced MRI studies renal perfusion after gadolinium administration, with possible side effects, such as nephrogenic systemic fibrosis. The aim of our study was to evaluate the clinical application of 3 Tesla (3T)-diffusion tensor image (DTI) in ADPKD patients, correlating its parameters, such as fractional anisotropy (FA), and apparent diffusion coefficient (ADC) with kidney function tests...
2016: Nephron
Eric de Kerviler, Kenneth Maravilla, Jean-François Meder, Olivier Naggara, Corinne Dubourdieu, Vincent Jullien, Pierre Desché
OBJECTIVE: The aim of this study was to evaluate the safety profile of gadoterate meglumine from clinical trials, postmarketing observational studies, and pharmacovigilance reports of adverse drug reactions (ADRs) encompassing 25 years of clinical use and over 50 million administered doses. MATERIALS AND METHODS: Assessment of the safety of gadoterate meglumine through processing and review of all safety data was collected after magnetic resonance imaging procedures...
September 2016: Investigative Radiology
Elaine Rutherford, Mohammed A Talle, Kenneth Mangion, Elizabeth Bell, Samuli M Rauhalammi, Giles Roditi, Christie McComb, Aleksandra Radjenovic, Paul Welsh, Rosemary Woodward, Allan D Struthers, Alan G Jardine, Rajan K Patel, Colin Berry, Patrick B Mark
Noninvasive quantification of myocardial fibrosis in end-stage renal disease is challenging. Gadolinium contrast agents previously used for cardiac magnetic resonance imaging (MRI) are contraindicated because of an association with nephrogenic systemic fibrosis. In other populations, increased myocardial native T1 times on cardiac MRI have been shown to be a surrogate marker of myocardial fibrosis. We applied this method to 33 incident hemodialysis patients and 28 age- and sex-matched healthy volunteers who underwent MRI at 3...
October 2016: Kidney International
B Değirmenci, M Kara, V Kıdır, S İnal, T Sezer, A Umul, H Orhan, A O Çelik, H Demirtaş, Ö Yilmaz
PURPOSE: To compare unenhanced three-dimensional (3D) NATIVE(®) true fast imaging with steady-state precession (TrueFISP) magnetic resonance (MR) angiography with the more conventional MR angiography technique obtained after intravenous administration of a gadolinium chelate in the evaluation of renal arteries and their branches in patients with suspected renal artery stenosis. MATERIALS AND METHODS: A total of 39 patients (25 men, 14 women) with a mean age of 51...
August 5, 2016: Diagnostic and Interventional Imaging
Reza Forghani
Gadolinium-based contrast agents have been used for magnetic resonance imaging (MRI) examinations since the late 1980s with an excellent overall cumulative safety record. Initially favored for use in patients with renal impairment because of lack of significant nephrotoxic effect at clinical doses, in 2006, multiple reports convincingly linked the rare but serious disease nephrogenic systemic fibrosis to the administration of gadolinium-based contrast agents in patients with severe renal failure. This in turn led to new policies on administration of these agents, resulting in changes in practice patterns that have virtually resulted in the elimination of the disease after the year 2009...
August 2016: Topics in Magnetic Resonance Imaging: TMRI
Jeffrey R Wesolowski, Andrew Kaiser
Gadolinium has been widely used as the contrast agent of choice for magnetic resonance imaging (MRI). However, gadolinium administration is not always desired due to its inherent enhancement properties and potential side effects (nephrogenic systemic fibrosis). This article reviews gadolinium alternatives, iron-, and manganese- based agents, and their current clinical usage for contrast-enhanced MRI examinations.
August 2016: Topics in Magnetic Resonance Imaging: TMRI
K Seitz, D Strobel
The approval of microbubbles with the inert gas sulfur hexafluoride (SF6) and a palmitic acid shell (SonoVue(®), Bracco Geneva, CH) for the diagnostic imaging of liver tumors in adults and children by the FDA in the United States represents a milestone for contrast-enhanced ultrasound (CEUS).This warrants a look back at the history of the development of CEUS. The first publications based on echocardiographic observations of right ventricular contrast phenomena caused by tiny air bubbles following i. v...
June 2016: Ultraschall in der Medizin
G Laurent, C Bernhard, S Dufort, G Jiménez Sánchez, R Bazzi, F Boschetti, M Moreau, T H Vu, B Collin, A Oudot, N Herath, H Requardt, S Laurent, L Vander Elst, R Muller, M Dutreix, M Meyer, F Brunotte, P Perriat, F Lux, O Tillement, G Le Duc, F Denat, S Roux
Many studies have been devoted to adapting the design of gold nanoparticles to efficiently exploit their promising capability to enhance the effects of radiotherapy. In particular, the addition of magnetic resonance imaging modality constitutes an attractive strategy for enhancing the selectivity of radiotherapy since it allows the determination of the most suited delay between the injection of nanoparticles and irradiation. This requires the functionalization of the gold core by an organic shell composed of thiolated gadolinium chelates...
June 9, 2016: Nanoscale
JongUn Lee, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim
Nitric oxide (NO) is synthesized by a family of NO synthases (NOS), including neuronal, inducible, and endothelial NOS (n/i/eNOS). NO-mediated effects can be beneficial or harmful depending on the specific risk factors affecting the disease. In hypertension, the vascular relaxation response to acetylcholine is blunted, and that to direct NO donors is maintained. A reduction in the activity of eNOS is mainly responsible for the elevation of blood pressure, and an abnormal expression of iNOS is likely to be related to the progression of vascular dysfunction...
May 2016: Chonnam Medical Journal
Richard C Semelka, Miguel Ramalho, Mamdoh AlObaidy, Joana Ramalho
OBJECTIVE: The literature informs us that gadolinium can cause health issues. At least four major gadolinium disorders, including the two well-recognized nephrogenic systemic fibrosis and severe acute adverse event, have been identified. CONCLUSION: We propose naming the histopathologically proven presence of gadolinium in brain tissue "gadolinium storage condition," and we describe a new entity that represents symptomatic deposition of gadolinium in individuals with normal renal function, for which we propose the designation "gadolinium deposition disease...
August 2016: AJR. American Journal of Roentgenology
J P Finn, K-L Nguyen, F Han, Z Zhou, I Salusky, I Ayad, P Hu
The practice of contrast-enhanced magnetic resonance angiography (CEMRA) has changed significantly in the span of a decade. Concerns regarding gadolinium (Gd)-associated nephrogenic systemic fibrosis in those with severely impaired renal function spurred developments in low-dose CEMRA and non-contrast MRA as well as efforts to seek alternative MR contrast agents. Originally developed for MR imaging use, ferumoxytol (an ultra-small superparamagnetic iron oxide nanoparticle), is currently approved by the US Food and Drug Administration for the treatment of iron deficiency anaemia in adults with renal disease...
August 2016: Clinical Radiology
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