Contrast agents for magnetic resonance imaging (MRI) are typically based on chelated gadolinium (Gd) and share an identical mechanism of action. However, differences in the molecular structures of the chelating ligands result in marked differences in contrast efficacy and potential risks to patient safety. Because pharmacists are increasingly involved in the selection and acquisition of MRI contrast agents, it is important that the benefits and potential risks are clearly understood so that informed decisions can be made on which agents to include on the formulary. This review summarizes the properties of the currently available MRI contrast agents and discusses the benefits and potential drawbacks of each.
After completing this activity, participants should be better able to:
- Understanding the Role of the Pharmacist: To clarify the crucial role pharmacists play in the selection and acquisition of gadolinium-based contrast agents (GBCAs) for hospital and clinic formularies.
- Evaluating Contrast Agent Potency (Relaxivity): To understand how the potency, or relaxivity, of GBCAs differs significantly between agents and how these differences directly impact both the diagnostic quality of the MRI and the required dose for the patient.
- Assessing Safety and Stability Profiles: To differentiate between types of GBCAs (acyclic vs. macrocyclic) based on their kinetic stability and their associated risks, specifically regarding Nephrogenic Systemic Fibrosis (NSF) and gadolinium retention in the body.
- Promoting Sustainability and Dose Reduction: To recognize how high-relaxivity GBCAs allow for a significant (up to 50%) reduction in gadolinium dose without compromising diagnostic efficacy, thereby improving patient safety and reducing the environmental impact of medical imaging.
The target audience for this paper consists primarily of hospital and clinic pharmacists, specifically those involved in drug selection, formulary management, and the acquisition of diagnostic imaging agents.
The Washington State Pharmacy Association (WSPA) is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This application-based activity has been approved for 1.0 contact hour (0.1 CEU) of continuing education credit. To receive credit, participants must view the activity in its entirety and complete the online evaluation. This program’s Universal Activity Number (UAN) is [Insert UAN Number] and is valid for pharmacists and pharmacy technologists.
Release Date: TBD | Expires TBD
Faculty and Planner Disclosures:
As an accredited provider of continuing medical education, it is the policy of Northwest Imaging Forums, Inc. (NWIF) to ensure balance, independence, objectivity, and scientific rigor in all of its activities. In accordance with this policy, faculty and planners must disclose all relevant financial relationships with ineligible companies. Any relevant financial relationships have been mitigated by NWIF to ensure the integrity of the CME activity. The planner has nothing to disclose.
