The MRI contrast agent gadolinium has been implicated in a number of serious health problems in certain patients who undergo a medical scan. Gadolinium toxicity came to public attention in November 2017 when film actor Chuck Norris and his wife Gena filed a lawsuit after the latter developed what is known as “gadolinium deposition disease.” 

Among other health complications attributed to gadolinium are conditions known as nephrogenic systemic fibrosis (NSF) and contrast-induced nephropathy (CIN), diseases affecting the kidneys.

What is Gadolinium and Why is it Used?

Gadolinium is a rare earth element discovered by Swiss chemist Jean C.G. de Marignac in 1880. Because of its unusual metallurgic properties, scientists have found it very useful, particularly in imaging applications that include X-ray systems and video monitors.

In diagnostic medicine, gadolinium contrast dye is used as an MRI contrast agent. It is injected into patients in order to enhance the images produced, which is important in assisting doctors in making accurate diagnoses.

What is NSF?

Nephrogenic systemic fibrosis (NSF) disease is the direct result of gadolinium exposure. The symptoms resemble a condition known as scleroderma and are characterized by hardening or thickening of the skin, accompanied by brown or reddish, scaly areas. It can, and does, affect the internal organs as well.

Victims of NSF typically suffer chronic burning and itching, stiff joints and/or generalized muscular weakness. Symptoms may appear within as little as 24 hours of gadolinium exposure. People with pre-existing kidney dysfunction are at the highest risk for NSF.

What is CIN?

CIN, or contrast-induced nephropathy, is a kidney disease caused by exposure to a gadolinium-based MRI contrast agent, impacting about 2 percent of those who undergo such a procedure. Nephropathy, a disease of the kidneys, is caused by damage to the small blood vessels that clean the blood.

Comorbidities such as diabetes, heart disease, and chronic kidney disease can increase the risk for CIN to as much as 50 percent.

Contrast-induced nephropathy is characterized by a dramatic decrease in kidney function over 2 to 3 days; symptoms include generalized fatigue, depressed appetite, swelling of the lower extremities and dry, itchy skin. Fortunately, CIN can be treated and reversed in most cases.

Were Manufacturers Aware of the Problem?

A number of lawsuits naming Bayer AG and GE Healthcare as defendants have claimed that they knew their products, Magnevist and Omniscan, could leave toxic residue. Complaints citing a gadolinium-based MRI contrast agent as the cause of action go back to 2001 – only three years after these products were approved by the FDA. 

The FDA later warned of the dangers of using contrast agents.

Is There an Alternative MRI Contrast Agent Available?

In August 2018, a group of scientists at Rice University published a report in the journal NCS Nano, describing a method of using iron, which is generally non-toxic. This involves the insertion of ferrous (iron) molecules into microscopic particles (known as nanoparticles). By manipulating the shape of the nanoparticle, scientists can adjust and optimize the resonance frequency to produce clearer magnetic images. It turns out that using iron in this way is twice as effective as gadolinium.

Currently, there is a type of gadolinium-based MRI contrast agent available known as “macrolytic.” This form is surrounded by a molecule that is easier for the body to excrete, making it less likely to accumulate in tissues and cause NSF or CIN.