Gadolinium For Radiologist

 This is a supplement to our previous post on  MRI contrast media, submitted by Dr MGK Murthy.

• Chemical element with Atomic No 64 in periodic table in lanthanide series  
• Atomic weight of 157.25g.mol_1 
• malleable 
• world produces pure gadolinium of appx 400 tonnes  
• because of nature of high absorption of neutrons used in nuclear medicine 
• because of paramagentic properties used in MRI for contrast after chelating, as free gadolinum is toxic

Recommendation with no bias for any specific chemical or marketing production houses :

 

• If the patient has normal renal function, use of any gadolinium compound makes no difference as renal excretion gets it out of the body 
• If the patient has moderate renal dysfunction, use of less dose, interval of at least 7days between repeat doses and preferable use of macromolecule varities would help 
• If the patient has severe renal dysfunction, use of macromolecules would be advised
• In extremes of age and lactating mothers , macromolecules is recommended
• If the patient has Calculated GFR of < 30ml/mt/1.73m2, Gadolinuim use is prohibited
• In pregnancy , Gadolinium is contraindicated