Study Suggests Alternative to Gadolinium-Based MRI Contrast Dyes

Published on September 5, 2018 by Sandy Liebhard

A newly-published study suggests that iron-based agents could one day be a feasible alternative to gadolinium MRI contrast dyes.

The discovery comes as a growing number of plaintiffs pursue lawsuits over toxic side effects allegedly caused by gadolinium-based agents.

Iron-Based Agent Outperformed Gadolinium Dyes

According to a paper that recently appeared in ACS Nano, the iron-based agents were created after nanoscientists at Rice University in Houston developed a means of packing iron into nanoparticles. The new dyes outperformed gadolinium-based agents, which are currently the go-to dyes for most MRI scans.

“The possibility of eliminating gadolinium exposure and getting a two-fold improvement in T1 MRI contrast performance is going to intrigue radiologists,” lead researcher, Naomi Halas, said in a statement issued by Rice University. “When they hear we’ve done this with iron I expect they will be very surprised.”

Gadolinium from MRI Dyes Can be Retained in Brain, other Organs

Gadolinium-based contrast dyes are used in MRIs to improve the visibility of images on a scan. Currently, more than a half-dozen such agents are approved for use in the United States:

• Dotarem
• Eovist
• Gadavist
• Magnevist
• Multihance
• Omniscan
• OptimMARK
• Prohance

Gadolinium-based agents are generally contraindicated for patients with impaired kidneys due to their association with a serious disorder called nephrogenic systemic fibrosis (NSF). However, it was widely held that the gadolinium would be quickly eliminated from the body in patients with normal kidney function.

Since 2013, however, several studies have found gadolinium deposits in the brains, bones, and other organs of patients with healthy kidneys who had undergone MRIs with gadolinium-based agents.

In December 2017, the U.S. Food & Drug Administration (FDA) ordered the manufacturers of gadolinium- based MRI contrast dyes to update their prescribing information and medication guides with information regarding the potential for gadolinium retention. Among other things, the agency noted that linear agents (Eovist, Magnevist, Multihance, Omniscan, and OptimMARK) were associated with the highest risk of retention.

While the FDA has not linked gadolinium retention to any adverse events, the agency has ordered the manufacturers of gadolinium-based MRI agents to conduct animal and human studies to better assess the safety of these products.

Gadolinium Toxicity Lawsuits Mounting in U.S. Courts

In recent months, a growing number of plaintiffs have filed gadolinium MRI contrast dye lawsuits that seek compensation for injuries and complications allegedly associated with gadolinium retention.

In July, a group of plaintiffs filed a motion with the U.S. Judicial Panel on Multidistrict Litigation (JPML) seeking to centralize all such federal claims before a single judge in one U.S. District Court.

“Transfer and centralization is proper because each of these actions and future tag-along cases arise out of the same or similar nucleus of operative facts and the same or similar wrongful conduct, and will involve the same or similar questions of fact and law,” the motion stated. “In addition, pretrial discovery in all cases will be substantially similar and will involve the same liability and general causation documents and witnesses.”

The JPML is scheduled to hear oral arguments on the matter during its September 27^th in San Francisco, California.