by
Barbara Kram, Editor | January 30, 2007
"While I appreciate the conservative approach of the FDA," Dr. Kuo said, "my colleagues and I are concerned that expanding the warning to millions of patients with only moderate renal disease might have a negative impact on patient care."
Dr. Kuo noted that only three percent of patients with renal failure who are given gadolinium agents will develop NSF, and that an overwhelming majority of the reported cases of NSF are tied specifically to gadodiamide. "That leaves a large percentage of patients who can gain the benefits of a contrast-enhanced scan without developing NSF," he said.
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Dr. Kuo and colleagues recommend not using gadodiamide in patients with kidney disease, but he pointed out that there are circumstances where the benefits of other gadolinium-based agents outweigh the risks.
"MRI with contrast is simply the best exam in many situations," Dr. Kuo said. "One has to wonder if excluding large numbers of patients with moderate renal failure from the best exam would do more harm than good."
The editorial is published online at http://radiology.rsnajnls.org/cgi/content/full/2423061640v1.
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Journal attribution:
Radiology is a monthly scientific journal devoted to clinical radiology and allied sciences. The journal is edited by Anthony V. Proto, M.D., School of Medicine, Virginia Commonwealth University, Richmond, Va. Radiology is owned and published by the Radiological Society of North America, Inc. (RSNA.org/radiologyjnl)
The Radiological Society of North America (RSNA) is an association of more than 40,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill. (RSNA.org)
"Gadolinium-based MRI Contrast Agents and Nephrogenic Systemic Fibrosis." Collaborating with Dr. Kuo on this report were Emanuel Kanal, M.D., Ali K. Abu-Alfa, M.D., and Shawn E. Cowper, M.D.
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