Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology

a Quality and Safety Committee report

Einat Blumfield, Michael M. Moore, Mary K. Drake, Thomas R. Goodman, Kristopher N. Lewis, Laura T. Meyer, Thang D. Ngo, Christina Sammet, Arta Luana Stanescu, David W. Swenson, Thomas L. Slovis, Ramesh S. Iyer

Research output: Contribution to journalArticle

13 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)665-673
Number of pages9
JournalPediatric Radiology
Volume47
Issue number6
DOIs
StatePublished - May 1 2017

Fingerprint

Gadolinium
Contrast Media
Safety
Radiology
Pediatrics
Surveys and Questionnaires
Pregnancy Tests
Gadolinium DTPA
Workflow
Poisons
Osteomyelitis
Heavy Metals
Intravenous Administration
Growth Hormone
Blood Vessels
Headache
Seizures
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Kidney

Keywords

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

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Radiology Nuclear Medicine and imaging

Cite this

Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology : a Quality and Safety Committee report. / Blumfield, Einat; Moore, Michael M.; Drake, Mary K.; Goodman, Thomas R.; Lewis, Kristopher N.; Meyer, Laura T.; Ngo, Thang D.; Sammet, Christina; Stanescu, Arta Luana; Swenson, David W.; Slovis, Thomas L.; Iyer, Ramesh S.

In: Pediatric Radiology, Vol. 47, No. 6, 01.05.2017, p. 665-673.

Research output: Contribution to journalArticle

Blumfield, E, Moore, MM, Drake, MK, Goodman, TR, Lewis, KN, Meyer, LT, Ngo, TD, Sammet, C, Stanescu, AL, Swenson, DW, Slovis, TL & Iyer, RS 2017, 'Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology: a Quality and Safety Committee report', Pediatric Radiology, vol. 47, no. 6, pp. 665-673. https://doi.org/10.1007/s00247-017-3807-z
Blumfield, Einat ; Moore, Michael M. ; Drake, Mary K. ; Goodman, Thomas R. ; Lewis, Kristopher N. ; Meyer, Laura T. ; Ngo, Thang D. ; Sammet, Christina ; Stanescu, Arta Luana ; Swenson, David W. ; Slovis, Thomas L. ; Iyer, Ramesh S. / Survey of gadolinium-based contrast agent utilization among the members of the Society for Pediatric Radiology : a Quality and Safety Committee report. In: Pediatric Radiology. 2017 ; Vol. 47, No. 6. pp. 665-673.
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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.",
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