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Pediatr Radiol. 2017 Mar 10. doi: 10.1007/s00247-017-3807-z. [Epub ahead of print]

Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report.

Author information

1
Department of Radiology, Albert Einstein College of Medicine, Jacobi Medical Center, 1400 Pelham Parkway, South Bronx, NY, 10461, USA. einat.blumfield@nbhn.net.
2
Department of Radiology, Penn State Hershey Children's Hospital, The Pennsylvania State University College of Medicine, Hershey, PA, USA.
3
Department of Radiology, Children's Hospital and Medical Center, University of Nebraska Medical Center, Omaha, NE, USA.
4
Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
5
Department of Radiology, Children's Hospital of Georgia, Augusta University, Augusta, GA, USA.
6
Wake Radiology, Raleigh, NC, USA.
7
Department of Medical Imaging, Nemours Children's Hospital, Orlando, FL, USA.
8
Department of Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
9
Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
10
Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, USA.
11
Department of Radiology, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, MI, USA.

Abstract

BACKGROUND:

Gadolinium-based contrast agents (GBCAs) have been used for magnetic resonance (MR) imaging over the last three decades. Recent reports demonstrated gadolinium retention in patients' brains following intravenous administration. Since gadolinium is a highly toxic heavy metal, there is a potential for adverse effects from prolonged retention or deposition, particularly in children. For this reason, the Society (SPR) for Pediatric Radiology Quality and Safety committee conducted a survey to evaluate the current status of GBCAs usage among pediatric radiologists.

OBJECTIVE:

To assess the usage of GBCAs among SPR members.

MATERIALS AND METHODS:

An online 15-question survey was distributed to SPR members. Survey questions pertained to the type of GBCAs used, protocoling workflow, requirement of renal function or pregnancy tests, and various clinical indications for contrast-enhanced MRI examinations.

RESULTS:

A total of 163 survey responses were compiled (11.1% of survey invitations), the majority of these from academic institutions in the United States. Ninety-four percent reported that MR studies are always or usually protocoled by pediatric radiologists. The most common GBCA utilized by survey respondents were Eovist (60.7%), Ablavar (45.4%), Gadovist (38.7%), Magnevist (34.4%) and Dotarem (32.5%). For several clinical indications, survey responses regarding GBCA administration were concordant with American College of Radiology (ACR) Appropriateness Criteria, including seizures, headache and osteomyelitis. For other indications, including growth hormone deficiency and suspected vascular ring, survey responses revealed potential overutilization of GBCAs when compared to ACR recommendations.

CONCLUSION:

Survey results demonstrate that GBCAs are administered judiciously in children, yet there is an opportunity to improve their utilization with the goal of reducing potential future adverse effects.

KEYWORDS:

Children; Contrast; Gadolinium-based contrast agent; Magnetic resonance imaging; Survey

PMID:
28283728
DOI:
10.1007/s00247-017-3807-z
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