Children May Experience Gadolinium Retention After Multiple Macrocylic MRI Contrast Dye Exposures

Published on January 24, 2019 by Sandy Liebhard

Multiple studies have already confirmed the potential or gadolinium to remain in the body following the administration of Omniscan and other linear MRI contrast dyes.

However, new research now suggests that children may also experience gadolinium retention when they undergo multiple MRIs with macrocylic agents.

Gadolinium MRI Contrast Dyes

Gadolinium is a heavy metal used in MRI contrast dyes to improve the visibility of images on a scan.

Until recently, it was assumed that gadolinium was quickly eliminated from the bodies of patients with normal kidney function. However, mounting research now indicates that this is not the case.

In December 2017, in fact, the U.S. Food & Drug Administration (FDA) warned that gadolinium could be retained in the brain and other organs for months or years after an MRI, even when a patient has healthy kidneys.

Among other things, the FDA suggested linear gadolinium agents were associated with a greater risk of retention compared to macrocylic dyes.

Linear gadolinium-based MRI contrast dyes approved for sale in the United States include:

• Omniscan (gadodiamide)
• OptiMARK (gadoversetamide)
• Eovist (gadoxetate disodium)
• Magnevist (gadopentetate dimeglumine)
• MultiHance (gadobenate dimeglumine)

The following macrocylic agents are also approved:

• Dotarem (gadoterate meglumine)
• Gadavist (gadobutrol)
• ProHance (gadoteridol)

Children and Gadolinium Retention

This latest study was published in PLoS One and looked at 43 children who had undergone at least 4 MRIs with macrocylic gadolinium agents within a span of 8 to 84 months. The researchers excluded patients who received linear gadolinium agents, had a history of brain radiation, or who suffered from kidney or liver impairment.

The research team divided the subjects into two groups:

• Those who received their first gadolinium injection before the age of 2
• Those who received their first gadolinium injection after the age of 2

This distinction is important, as the myelination process (the formation of the protective myelin sheath on nerve endings) is generally completed by the age of 2.

The study authors then analyzed the patients’ unenhanced MRI for increased signal intensity within certain brain structures,  which is considered a possible sign of gadolinium retention.

Interestingly, children who received their first gadolinium injection over the age of 2 – before the myelination process was complete — had significantly lower levels of signal retention compared to those who received their first injection after the age of 2.

“Maturation of the brain may affect both signal intensity of brain structures and susceptibility to GBCAs; thus, assessment of signal intensity of the brain structure should be conducted taking into account the age of a child,” the researchers concluded.

Gadolinium Retention Lawsuits Mounting in U.S. Courts

Publication of this study comes as a growing number of plaintiffs file suit in courts throughout the United States over adverse health effects they claim resulted from gadolinium retention. All of these individuals allegedly had healthy kidneys when they received gadolinium MRI contrast dyes and assert that deposits remaining in their bodies have caused a range of debilitating symptoms, including:

• Intense burning of the skin and skin substrate
• Intense boring pain in bones or joints
• Brain fog or mental confusion
• Muscle vibrations, pins and needles sensation
• Headache
• Thickening, discoloration, pain in the skin or skin substrate of the distal arms and legs.

Their lawsuits characterize this collection of side effects as “Gadolinium Deposition Disease.”

Among other things, plaintiffs claim that MRI contrast dye manufacturers were aware of the potential for gadolinium retention in individuals with normal kidney function, but failed to warn doctors and patients about this risk.