ISMRM 25th Annual Meeting & Exhibition • 22-27 April 2017 • Honolulu, HI, USA

Plenary Session: Gadolinium Deposition

Plenary Session

ORGANIZERS: Peter Caravan, Ph.D. & Winfried Willinek, M.D.

Monday, 24 April 2017
Plenary Hall  10:45 - 12:15

Slack Channel: #plenary
Session Number: P01

This plenary session will address increased concerns about Gadolinium (Gd) deposition and Gd-associated toxicity have impacted how Gadolinium is currently used. This plenary session will examine the state of the art with respect to toxicity and tissue deposition, and how this depends on the specific contrast agent. Perspectives on how recent concerns about Gd are impacting practice around the world will be discussed.

Educational Objectives
Upon completion of this course, participants should be able to:
-Summarize the history of Gadolinium contrast development;
-Illustrate NSF and Gadolinium deposition;
-Analyze the link between chemical structure and toxicity/deposition;
-Evaluate alternatives available and under development;
-Discuss the European perspective on how practice is impacted including whether Gadolinium can and should be avoided as well as liability and patient concerns; and
-Explain the Asian and North American perspectives on how practice is impacted including whether Gadolinium can and should be avoided as well as liability and patient concerns.


Gadolinium Safety & Deposition: Past, Present, & Future
Michael Tweedle
The jarring clinical facts of NSF and the recent detection by MRI (an insensitive tool) of gadolinium in the dentate nucleus of the brain have brought GBCA stability and Gd deposition to attention.  Numerous recent studies are contributing to a more thorough understanding of in vivo chemical deposition and pharmacokinetics and speciation of GBCA, and will soon stimulate studies to more deeply understand the toxicology of those species. This lecture will describe basic design and function principles and historical development of the GBCA emphasizing the links between chemical structure and gadolinium dissociation and deposition. 

Gd Safety & Deposition: Impact on Practice, European Perspective - permission withheld
Harriet Thöny
The detection of NSF in patients with impaired renal function and the deposition of GBCA in the brain of patients with normal renal function has led to a dramatic change in the administration of these agents in Europe.

How Does Gd Enter the Brain, When the BBB is Intact?
Shinji Naganawa
Both linear-type and macrocyclic-type gadolinium based contrast agents (GBCAs) enter the CSF and perivascular spaces even without BBB disruption and renal insufficiency. Intrathecally injected GBCAs distribute in the brain parenchyma when the BBB is intact. The glymphatic pathway, the waste clearance system of the brain, is key to the Gd deposition issue.

Adjournment & Meet the Teachers



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