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MRI’s are wonderful — the radiologist can now see in great detail what is happening inside your body without opening you up. Before CT’s and MRI’s they used to do “exploratory surgery,” opening you up to pain, stress, and risk of infection in addition to whatever you were worrying about.
CT’s involve radiation; MRI’s do not. The use electromagnetic waves to explore and create an image of what is under your skin. Nonetheless, the image is still gray-on-gray. To assist in identifying small structures, the radiologist may want to use “contrast,” a kind of dye injected into your bloodstream that makes one kind of structure more intense, providing a color contrast to assist in analysis of the image.
The primary contrast medium used with MRI’s is called gadolinium. Research is being done to understand how the gadolinium is eliminated from the body and what (if anything) might be left behind. For people who have an occasional MRI, there are no significant concerns, though some people may be more sensitive to its effects than others. But for people who need multiple MRIs, sometimes over the course of years, even a small accumulation can add up. The FDA is investigating to determine how much we should be concerned.
Joyce and Robin talk with Dr. Richard Samelka, who is involved in investigations into the long-term effects of the use of gadolinium.
Richard Samelka, M.D., University of North Carolina School of Medicine, is a radiologist who has written more than 400 articles and contributed to more than 50 textbooks. The focus of his research is the safety of imaging modalities including CT and MRI and their contrast agents. He recently spoke at the European Congress of Radiology in Vienna on this topic.
Dr. Semelka reminds us that each of us needs to understand our own sensitivities and risk factors, and be our own advocate with physicians and radiologists. Age, kidney function, and the likelihood that you will need more imaging studies are all important factors. In general, one occasional imaging study, especially for an emergency situation, is not an issue. The risk goes up when you have a situation requiring a series of imaging studies. The greatest risks of long-term effects are from:
- radiation: of highest concern for younger patients since they will live a long time and may develop secondary issues 20-30 years later; medium risks for people up to 50 years old; lowest risks for people over 50.
- Contrast-induced nephthropothy (CIN) or risk of injury to the kidneys from iodine-based contrast agents used with CT. Anyone with reduced kidney function should confer with the ordering physician and the radiologist about the best approach.
- Gadolinium contrast used with Magnetic Resonance Imaging (MRI). The most serious consequence is Nephrogenic Systemic Fibrosis (NSF), which was of high concern 10 years ago. Since then the contrast agents have been reformulated and improved. Dr. Semelka’s chart shows the risks associated with different agents, having to do with the probability that the agent will leave behind some bits in your tissues that might cause secondary problems over time. The agents which have shown to be the most stable and therefore lowest risk are MultiHance and Dotarem.
Dr. Semelka recommends that people who need to have many MRIs should seek an MRI center that uses Dotarem.
Early signs of Nephrogenic Systemic Fibrosis include pain in the lower limbs and hands. If someone is concerned, they can request a 24-hour urine test for gadolinium. There is also a patient support website that discusses more possible side-effects, gadoliniumtoxicity.com
Disclaimer – GadoliniumToxicity.com is for general information purposes only. No one affiliated with this website is a medical professional and nothing presented is intended nor recommended as a substitute for medical advice, diagnosis or treatment of any health condition or symptom.
Always consult your physician or other qualified healthcare professional before trying any treatments or supplements mentioned anywhere on GadoliniumToxicity.com. Health-related research is ongoing and the information contained on this website may be outdated, incomplete or incorrect.
