Pediatric x ray Hospitals Moving to Macrocyclic MR Contrast Agents
Macrocyclic gadolinium-based contrast agents (GBCA)
are increasingly preferred to a linear GBCA in pediatric hospitals, according
to a study published in the journal Pediatric Radiology.
Researchers from Northwestern University in Chicago,
Ill., and the University of Arizona in Phoenix sought to determine how
pediatric hospitals were using gadolinium, as well as learn more about the
knowledge base among radiologists and referring providers regarding GBCAs and
brain gadolinium deposition.
The researchers sent out surveys to 5,390 physicians
in various pediatric professional societies between January 2016 and March
2016. The groups included the Society of Chairs of Radiology in Children's
Hospitals (SCORCH), the Society for Pediatric Radiology, the Pediatric
Endocrine Society, as well as a group of pediatric neuro-oncology attending physicians,
pediatric neurology attending physicians, and pediatric infectious disease
program directors.
The results showed 80 percent of surveyed pediatric
hospitals used macrocyclic contrast agents and within the last year, 58 percent
switched their agent, most commonly to gadoterate meglumine. The most common
reason given was concern about brain gadolinium deposition. Another 23 percent
of hospitals were considering switching. Of these hospitals, 83 percent would
switch to gadoterate meglumine. The most common reasons given for the switch
were brain gadolinium deposition and safety.
Radiologists were more aware of brain gadolinium
deposition than non-radiologist physicians (87 percent versus 26 percent).
Radiologists and referring providers both expressed similar levels of concern
(95 percent and 89 percent). In addition, 12 percent of radiologists and 2
percent of referring providers reported patients asking about brain gadolinium
deposition. Radiologists were significantly more comfortable addressing patient
inquiries than referring pediatric physicians (48 percent versus 6 percent).
The number of MRIs requested by referring pediatric physicians correlated with
their knowledge of brain gadolinium deposition, contrast agent used by their
hospital, and comfort discussing brain gadolinium deposition with patients.
The researchers concluded many pediatric hospitals
have switched to or plan to switch to a more stable macrocyclic MR contrast
agent, most commonly gadoterate meglumine based on the discovery of the
presence of brain gadolinium deposition.
“Despite this, there is need for substantial further
education of radiologists and referring pediatric providers regarding GBCAs and
brain gadolinium deposition,” they wrote.
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