Medicinal Use of Gadolinium

Gadolinium is a chemical element; a special form of which is used to enhance the results of MRI (magnetic resonance imaging) scans. When injected into the bloodstream, gadolinium functions like a mild dye, allowing medical professionals to better distinguish between normal tissues and anomalous cell structures. This is due to special magnetic properties of gadolinium that allow it to respond to radio waves sent throughout the body during an MRI scan. The result of a gadolinium-enhanced MRI scan is a detailed 3-D image of the body where abnormal cell clusters appear significantly brighter than the surrounding normal tissue.

Gadolinium-enhanced MRIs are commonly used to diagnose and analyze the extent of such conditions as multiple sclerosis, stroke and tumors. These scans provide doctors with more detailed diagnostic information than conventional (unenhanced) MRIs, helping them determine the best course of treatment. Since first becoming available in 1988, the use of gadolinium-enhanced MRIs has increased markedly.

Use of Gadolinium During MRA Scans

Currently, five gadolinium-based contrast agents are approved by the FDA for use in MRI scans: Magnevist, MultiHance, Omniscan, OptiMark and ProHance. While these substances have been approved only for an MRI, many doctors are also using them for the MRA scan. MRA (magnetic resonance angiography) is a special type of MRI used to provide detailed images of blood vessels. The MRA scan is often invaluable for diagnosing and evaluating such potentially dangerous conditions as aneurysms, blood clots and plaque buildup in blood vessels.

While gadolinium can provide more detailed MRA results, its use for this procedure is somewhat controversial. The main problem is that the MRA procedure requires significantly more gadolinium than a typical MRI scan. As a result, the patient is injected with a greater amount of gadolinium-based contrast agent than deemed safe by the FDA. While most patients who undergo gadolinium-enhanced MRA scans do not develop any considerable complications, in certain patients gadolinium exposure causes the onset of a debilitating, serious disease referred to as nephrogenic systemic fibrosis / nephrogenic fibrosing dermopathy (NSF / NFD).

Gadolinium and NSF / NFD

Most side effects of gadolinium are mild and include lightheadedness, nausea and light headache. However, in rare cases patients develop the potentially fatal NSF / NFD disease after being exposed to gadolinium. While it has not been proved conclusively that gadolinium exposure causes NSF / NFD, currently more than 90 percent of all reported cases of this disease have occurred in people who have received gadolinium injections as part of their MRI/MRA scans. It appears that people who are most susceptible to developing NSF / NFD are those with serious kidney problems, such as renal insufficiency. This might be due to the fact that gadolinium is eliminated from the body through the kidneys. If the kidneys are unable to filter gadolinium out of the system, the patient develops gadolinium poisoning, which can lead to NSF / NFD.

NSF / NFD is a devastating disease that causes hardening of the skin and internal tissues. Victims of NSF / NFD may also experience a range of other symptoms, including burning, itching and swelling of the skin, high blood pressure, deep pain in the hip bones and ribs and muscle weakness. Since NSF / NFD is a progressing condition, it often leads to severe joint stiffness rendering the patient wheelchair-dependent. If the disease advances to the stage where it causes hardening and scarring of vital internal organs, it often causes death.   

NSF / NFD Legal Recourse

Currently, there is no cure for NSF / NFD. While improving kidney function through dialysis or kidney transplant procedure can sometimes slow the progress of NSF / NFD, no therapy can stop the disease completely. Thus, victims of NSF / NFD often become unable to work and require extensive medical attention to manage the pain and other symptoms of this disease.