ISMRM 24th Annual Meeting & Exhibition 07-13 May 2016 Singapore

Educational Session: ISMRM/SMRT Joint Forum: Update on MRI Contrast Agents: Recent Controversies

Skill Level: Beginner

Organizers: Chris Kokkinos, B.App.Sc., Pg.Cert.(MRI) & Scott B. Reeder, M.D., Ph.D.

Monday 09 May 2016

The number and variety of available MR-based contrast agents continues to evolve. In this session, recent controversies surrounding the use and safety of gadolinium and iron based contrast agents will be discussed in an interactive session, aimed at generating discussion and interaction among experts in the field.

Target Audience
This course is designed for:

  • Physicians including cardiologists and neurologists, Radiologists, MRI Technologists, MR Engineers or Physicists, Bioengineers and all fields related to these disciplines;
  • Medical, Biological and Industrial Researchers with an interest in MRI Contrast Agents;
  • Experienced researchers seeking to learn about MRI Contrast Agents, and is actively engaged in research in this or related fields; and
  • Undergraduate, graduate students, and technologists are highly encouraged to participate.

Educational Objectives
Upon completion of this course, participants should be able to:

  • Assess recent safety data on nephrogenic systemic fibrosis (NSF) and the emerging role of screening to avoid NSF;
  • Interpret recently reported data on deposition of gadolinium in the brain; and
  • Evaluate emerging applications and recent safety considerations regarding the use of ferumoxytol as an MRI contrast agent.

Moderators: Jeffrey C. Weinreb
Update on Nephrogenic Systemic Fibrosis: Should We Stop Screening? - Permission Withheld
Sadhana Nandwana
This presentation will provide a current update on nephrogenic systemic fibrosis (NSF) and where we stand with exposure of selected gadolinium based contrast agents (GBCAs) in renally impaired patients and risk of NSF. Risk stratification based on safety profiles of GBCAs and current national and international guidelines and recommendations will be examined. Evaluation of whether these guidelines should be modified in light of recent publications demonstrating a lack of NSF occurrence in patients exposed to specific GBCAs will be discussed. 

Panel Discussion
Gadolinium Deposition: Imaging Phenomenon or Should We Change Our Practice?
Greg C. Brown1
1Centre for Advanced Imaging, The University of Queensland, St Lucia, Australia
Reports of gadolinium accumulation in the brain have surprised many practitioners, and raised questions of potential harm to patients. The FDA & NIH recommend reconsideration of GBCA use while investigations continues. The accumulation calls into doubt a common assumption that existing renal function mediated guidelines are sufficient to avoid significant biological interaction.

This presentation reviews the recent reports and presents literature concerning gadolinium chelate stability, transmetalation, gadolinium interactions in biochemistry, observations of bone and skin accumulation (beyond NSF definitions), and environmental build up to provide a context for a reconsideration  by clinical and research practitioners of our current GBCA usage.

Panel Discussion
Ferumoxytol: Should We Be Using It in Clinical Practice?
Mustafa Bashir1
1Duke University Medical Center
Ferumoxytol has seen increasing use as a contrast agent in both clinical and research MRI.  This talk will describe some of the potential uses and risks associated with the agent.

Panel Discussion
Adjournment & Meet the Teachers

The International Society for Magnetic Resonance in Medicine is accredited by the Accreditation Council for
Continuing Medical Education to provide continuing medical education for physicians.