Experts may have discovered why some patients are more susceptible to GBCA-related side effects
New research is providing insight into why some people seem to retain more gadolinium deposits than others following GBCA administration.
Published in the journal Magnetic Resonance Imaging, the study focuses on the role oxalic acid may play in the body’s ability to excrete gadolinium. Oxalic acid is a naturally occurring compound in the body but can also be found in many fruits, vegetables, grains and nuts. It also bonds to metal ions and plays a role in the absorption and breakdown of certain nutrients.
Considering its bonding capabilities, experts hypothesized that it could play a role in gadolinium retention in patients who have been given GBCAs during MRI exams.
“Aside from endogenous metals and acidic conditions, little attention has been paid to the role of the biological milieu in the degradation of magnetic resonance imaging contrast agents into nanoparticles,” Brent Wagner, MD, from the Kidney Institute of New Mexico, and colleagues noted. “Herein, we describe the decomposition of the commercial magnetic resonance imaging contrast agents Omniscan and Dotarem in the presence of oxalic acid, a well-known endogenous compound.”
Researchers conducted an experiment with oxalic acid and two GBCAs to determine whether the acid might cause gadolinium to migrate away from the contrast agents. By combining the substances together in test tubes, they were able to observe the chemical reaction in real-time.
Through this, they found that when it the presence of oxalic acid, small amounts of gadolinium pull away from the GBCA and form nanoparticles. In their study, both GBCAs underwent this sort of decomposition to form gadolinium oxalate.
In theory, these nanoparticles can accumulate in different organs of the body, potentially causing side effects or evidence gadolinium deposits years after its initial administration. This effect is something that should be considered in future studies related to GBCA safety, the authors suggested.
“Studies concerning unexplained symptoms after magnetic resonance imaging contrast agent exposure need to consider gadolinium precipitation reactions. Rational therapies must address intracellular, nanoparticulated gadolinium, acknowledging that traces of gadolinium can persist in patients' bodies for years, potentially leading to chronic health issues.”
Learn more about the team’s work here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.