Carlo A Mallio1, Àlex Rovira2, Paul M Parizel3, Carlo C Quattrocchi4. 1. Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy. c.mallio@unicampus.it. 2. Section of Neuroradiology, Department of Radiology, Autonomous University of Barcelona and Hospital Vall d'Hebron, Passeig Vall d'Hebron, Barcelona, Spain. 3. Department of Radiology, Antwerp University Hospital, Edegem, Belgium. 4. Departmental Faculty of Medicine and Surgery, Unit of Diagnostic Imaging and Interventional Radiology, Università Campus Bio-Medico di Roma, Rome, Italy.
Abstract
PURPOSE: Gadolinium is a rare-earth lanthanide metal that is known to have a direct neurotoxic effect. The scope of the present review is to summarize the current preclinical and clinical evidence on the association between exposure to gadolinium of the central nervous system and neurotoxicity. METHODS: A literature review was performed by searching for original research papers investigating on gadolinium exposure and neurotoxicity. RESULTS: Gadolinium is neurotoxic through multiple mechanisms, mainly involving Ca++ homeostasis and mitochondrial functions, as shown by preclinical in vitro studies. The available evidence related to the four different classes of gadolinium-based contrast agents commonly applied in clinical practice (i.e., linear and macrocyclic based on ligand structure, and ionic and non-ionic based on their net molecular charge) suggests that serial intravenous injections of gadolinium-based contrast agents and gadolinium brain depositions are not associated to histological changes, as confirmed by preclinical animal and human (MR imaging and autopsy) studies. CONCLUSION: To date, no cause-effect relationship has been demonstrated in patients between brain gadolinium exposure and clinical consequences specific to neurological toxicity.
PURPOSE:Gadolinium is a rare-earth lanthanidemetal that is known to have a direct neurotoxic effect. The scope of the present review is to summarize the current preclinical and clinical evidence on the association between exposure to gadolinium of the central nervous system and neurotoxicity. METHODS: A literature review was performed by searching for original research papers investigating on gadolinium exposure and neurotoxicity. RESULTS:Gadolinium is neurotoxic through multiple mechanisms, mainly involving Ca++ homeostasis and mitochondrial functions, as shown by preclinical in vitro studies. The available evidence related to the four different classes of gadolinium-based contrast agents commonly applied in clinical practice (i.e., linear and macrocyclic based on ligand structure, and ionic and non-ionic based on their net molecular charge) suggests that serial intravenous injections of gadolinium-based contrast agents and gadolinium brain depositions are not associated to histological changes, as confirmed by preclinical animal and human (MR imaging and autopsy) studies. CONCLUSION: To date, no cause-effect relationship has been demonstrated in patients between brain gadolinium exposure and clinical consequences specific to neurological toxicity.
Authors: Jennifer Ayers-Ringler; Jennifer S McDonald; Margaret A Connors; Cody R Fisher; Susie Han; Daniel R Jakaitis; Bradley Scherer; Gabriel Tutor; Katheryn M Wininger; Daying Dai; Doo-Sup Choi; Jeffrey L Salisbury; Paul J Jannetto; Joshua A Bornhorst; Ram Kadirvel; David F Kallmes; Robert J McDonald Journal: Radiology Date: 2021-12-21 Impact factor: 11.105
Authors: Carlo A Mallio; Laura Messina; Marco Parillo; Gianguido Lo Vullo; Bruno Beomonte Zobel; Paul M Parizel; Carlo C Quattrocchi Journal: Sci Rep Date: 2020-09-11 Impact factor: 4.379