58% of radiologists don't report brain deposition of gadolinium

A worldwide study, published in Current Problems in Diagnostic Radiology, revealed wide inconsistencies in reporting brain gadolinium deposition (GD) based on a lack of understanding and an effort to minimize anxiety in patients.

 “Although the link between [gadolinium-based contrast agents] GBCA deposition and dentate T1 shortening is now well established, the clinical significance of intracranial GD accumulation, if any, remains unknown,” wrote corresponding author Vikas Agarwal, MD, with the department of radiology at the University of Pittsburgh Medical Center, and colleagues. “Nonetheless, some radiologists and their practices are not waiting for that evidence and instead are proactively making changes in the way they utilize GBCAs.”

A total of 94 radiologists from 30 different countries responded to the online survey. Fifty-seven (62 percent) radiologists observed brain GD on MRI brain studies, but only half reported seeing dentate T1 shortening rarely.

Of the total responses, 58 percent do not or wouldn’t include GD findings in a radiology report, while 12 percent included the findings in the impression of their report.

In the survey, the most common reason for not reporting gadolinium deposition was the risk of provoking unnecessary patient anxiety (29 percent). Recent data on GD has led to a reported practice change in 28 percent of survey participants.

“Time will tell whether or not GD represents a real risk to our patients. Until we know whether intracranial GD has negative health consequences, radiologists must be cognizant of the way in which we report the imaging manifestations of GD in the brain and consider the potential impact of what we report on our patients, referring physicians, and ourselves,” wrote Agarwal et al.