IV Contrast for MRI and CT: Risks and Benefits of Contrast Administration
The potential risks for developing serious skin conditions such as nephrogenic systemic fibrosis (NSF) related to the modern gadolinium-based contrast agents are extremely low even in patients with advanced kidney disease. In the most recent literature of nearly 5,000 patients with advanced kidney disease, there were zero cases of nephrogenic systemic fibrosis (NSF) identified (Weinreb et al., 2021). To date, of the millions of doses of this contrast agent given annually, there have only been two case reports of patients developing NSF possibly related to these agents.
Weinreb JC, Rodby RA, Yee J, Wang CL, Fine D, McDonald RJ, Perazella MA, Dillman JR, Davenport MS. Use of Intravenous Gadolinium-based Contrast Media in Patients with Kidney Disease: Consensus Statements from the American College of Radiology and the National Kidney Foundation. Radiology. 2021 Jan;298(1):28-35. doi: 10.1148/radiol.2020202903. Epub 2020 Nov 10. PMID: 33170103.
These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.