MRI with Contrast (Gadolinium-Containing) Policy

Guidelines on the Administration of Intravenous Gadolinium-Containing Contrast Media

Overview

  1. Gadolinium-based contrast agents (GBCAs) should only be administered when deemed necessary by the radiologist.
  2. Routine screening and laboratory testing for renal failure is no longer required prior to the administration of group II agents.
  3. If a patient presents with known renal failure, the necessity of a group II agent should be confirmed by the radiologist.
  4. If a group II agent is used in the setting of dialysis, hemodialysis should be performed as soon as possible after contrast administration.
  5. Group I agents are contraindicated in patients on dialysis, and are no longer used at UCSF.
  6. Group III agents (Eovist®) require informed consent when eGFR < 30

 

eGFR > 30

eGFR < 30

Group II GBCA
(Gadavist®)

Single dose appropriate

Confirm necessity of GBCA

Group III GBCA
(Eovist®)

Single dose appropriate

Informed consent needed
Risk of gadolinium administration in patients with impaired kidney function
Choice of gadolinium-containing contrast medium
Approach to intravenous gadolinium use in patients with impaired kidney function
Role of dialysis after gadolinium administration in patients with renal impairment
Creatinine testing prior to gadolinium administration
Estimated glomerular filtration rate (eGFR) calculation
eGFR and intravenous gadolinium administration for Group III agents
Pediatric eGFR and intravenous gadolinium administration
Off-label use of contrast media and power injectors
Brain Deposition of Gadolinium