When is Gadolinium Appropriate?

  • eGFR > 40 Negligible risk. Single dose of gadolinium is appropriate.
  • eGFR 30-40 Recheck eGFR level if labs are not current, as levels may fluctuate day to day. If the eGFR level remains 30-40 AND if gadolinium is essential to the imaging question, use a minimal/single dose with the approval of radiology faculty.
  • eGFR < 30 (and/or on dialysis) High risk. Gadolinium is not recommended.

Note that a serum creatinine with calculation of eGFR should be performed within 6 weeks of the MRI study for all patients with risk factors for renal disease.

Please see the dedicated webpage MRI Contrast – Gadolinium Policy for a more complete discussion of contrast guidelines and the risks of gadolinium.