VIDEO: Gadolinium being substituted for iodine contrast in some procedures due to shortage
Interview with Alan H. Matsumoto, MD, FSIR, FACR, FAHA, professor of radiology, chair of the Department of Radiology at the University of Virginia, vice chair of the American College of Radiology (ACR) Board of Chancellors, and the chairman of the ACR Commission on Interventional and Cardiovascular Radiology. He explains the iodine contrast shortage has led to use of magnetic resonance imaging (MRI) gadolinium contrast agents as a substitute in some cases.
Gadolinium has about one-third the opacity of iodine contrast agents under X-ray imaging modalities, so it has limited applications, Matsumoto explained. But, to conserve iodine contrast, his center is using gadolinium for some procedures.
Currently at the University of Virginia, Matsumoto said gadolinium is being used in some specific applications in the gastro-intestinal (GI) tract to image pancreatic ducts and bile ducts, or the ureter and bladder. He said endoscopic retrograde cholangiopancreatography (ERCP) and retrograde urography are both being performed using gadolinium.
It can be used as an intravascular contrast agent for catheter based in the operating room (OR) or in the cath lab. About 20 years ago was investigated as a candidate to replace iodine agents in interventional procedures for patients with severe renal dysfunction. Matsumoto said it can be used in peripheral vascular applications in the legs and renal arteries. However, interventional cardiology colleagues at the University of Virginia who has used gadolinium in coronary artery procedures in the cath lab said the lower opacity makes it difficult to see the vessels.
Since gadolinium is not ideal for many imaging applications, he said they will usually send patients for alternative imaging exams, including MRI, PET-CT or contrast ultrasound.
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Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com