Brain MRIs make up the bulk of the gadolinium footprint in medical imaging.

BACKGROUND AND PURPOSE: Assess the evolution of gadolinium consumption and magnetic resonance imaging (MRI) scanners in France and Western Brittany (France) and compare regional practices between public and private hospitals for each organ specialty. MATERIAL AND METHODS: We collected data from national and universal health registries, and Western Brittany's health care structures, between 2011 and 2018, about the number of MR imaging exams and machines, the number of delivered GBCAs (gadolinium-based contrast agents), prescriptions and administration protocols. RESULTS: Over the last eight years, we observed an increase in the number of MRI machines implemented in France (62%), correlated with the increase of annual gadolinium consumption (amount of delivered GBCAs in kg, 64%), without modification of the annual quantity of gadolinium used per machine (2.7kg in 2018). In Western Brittany, gadolinium impact is assigned to neuroimaging exams (50% CI95% [45;56] of all the contrast-enhanced exams), followed by thorax and abdomen exams (23% CI95% [18;28]). The ratio of injected exams to all exams is greater in public than in private hospitals (respectively 48% CI95% [46;49] versus 29% CI95% [26;30]). CONCLUSION: Gadolinium consumption is increasing, correlated with the increase in the number of examinations carried out. Regionally, the main impact comes from neuroimaging exams. No change in practices has been observed in recent years despite some warnings about gadolinium deposits and environmental consequences.

Direct MR arthrography of the shoulder: current practice in the UK.

There is wide variation in the technique and type of contrast used for MR arthrography of shoulder. In this article, we discuss the current practice in UK and the reason for the change over the last few years.

Efectos adversos inducidos por gadopentotato dimeglumina en resonancia magnética / Adverse reactions induced by gadopentatate dimeglumine in magnetic resonance imaging

Fundamento y objetivos: Se considera que las sales de gadolinio utilizadas como medio de contraste en los estudios de resonancia magnética (RM) presentan un índice de reacciones adversas inferior a los medios de contraste yodado. El objetivo principal de este estudio es determinar la frecuencia e intensidad de las reacciones adversas relacionadas con la administración de gadopentotato dimeglumina (Gd-DTPA) y compararla con la tasa de reacciones adversas inducidas por los medios de contaste yodado. Material y métodos: Durante el periodo comprendido entre el 1 de enero de 2005 hasta el 30 de junio del 2006 se recogieron los efectos adversos de todos los estudios mediante RM en los que se aplicó contraste de Gd-DTPA, programados o urgentes, realizados en 11 Centros de Diagnostico por la Imagen Eresa situados en las provincias de Castellón y de Valencia. En dicho período se recogieron también los efectos adversos inducidos por las sales de yodo. Resultados: Se realizaron un total de 54.909 estudios con resonancia magnética en los diferentes centros de estudio, y 12.791 estudios con MCI. El total de reacciones adversas observado fue de 62 (0,11%) y 47 (0,36%) respectivamente. El perfil de reacciones adversas con ambos medios de contraste fue similar, excepto en las reacciones moderadas donde objetivamos un mayor porcentaje de edema palpebral y disnea con la utilización de MCI que con Gd-DTPA. No se objetivó ningún caso de anafilaxia ni exitus. Conclusiones: Los datos aportados por esta serie avalan un perfil de seguridad del Gadolinio superior al de los MCI

Background and objectives: It is considered that the Gadoliniumsalts used as a contrast medium in the Magnetic Resonance Imaging (MRI) studies present an index of adverse reactions below the iodine contrast mediums. The main objective of this study is to determine, in our medium, the frequency and intensity of the adverse reactions related to the administration of Gadopentotate Dimeglumine (Gd-DTPA) and compareit with the rate of adverse reactions induced by the iodine contrast mediums. Material and methods: During the period comprised between 1st of January 2005 and 30th of June 2006, the adverse affects were collected for all the studies by means of MRI in which the Gd-DTPA contrast was applied, programmed or urgent, performed in Eresa Diagnosis Centres by Image located ( 11 centre in total) in the provinces of Castellón and Valencia. The adverse effects induced by the iodine salts were also collected in this period. Results: A total of 54,909 studies with magnetic resonance were performedin the refered study centres, and 12,791 studies with MCI. The total of adverse reactions observed was 62 (0.11%) and 47 (0.36%) respectively.The profile of adverse reactions with both contrast mediums was similar, except in the moderate reactions where we objectively observed a greater percentage of palpebral edema and dyspnea with theusage of MCI than with Gd-DTPA. No cases of anaphylaxia or exitus were observed. Conclusions: The data contributed by this series support a safety profile of Gadolinium superior to that of the MCI in line with the results shown by extensive published series

Contrast echocardiography: clinical utility for the evaluation of left ventricular systolic function.

Despite continued improvements in imaging technology, transthoracic echocardiography does not reliably provide images adequate for interpretation in all patients. In these patients, the administration of ultrasound contrast agents can markedly enhance the diagnostic utility of the test. Contrast echocardiography relies on the ultrasound detection of contrast agents composed of encapsulated microbubbles that are generally smaller than red blood cells. Intravenous administration of microbubble contrast agents results in left ventricular opacification and facilitates delineation of the endocardial border. This procedure has been shown to consistently increase the number of myocardial segments that can be interpreted, to improve accuracy of assessing regional and global left ventricular function, to decrease interinterpreter variability, to increase interpreter confidence, and to be a cost-effective strategy. Accordingly, patient selection for contrast echocardiography should be based not only on adequacy of the baseline images, but also on the clinical question being asked.

Small changes, vendor partnerships drive down hospital's imaging costs.

Imaging departments offer great potential for cost reductions. That's what Baptist Hospital of Miami found out when they put their operation under the microscope and solicited assistance from some of their vendors. By paying attention to the details, the hospital reduced costs by more than $500,000 a year. Find out how.

[Contrast media: present status and future of their production and use]. / Kontrastnye sredstva: itogi i perspektivy sozdaniia i primeneniia.

Analysis of the problems involving the design and application of Soviet-made radiocontrast agents showed that the synthesis of such drugs as Iodamid, Triombrast, Etiotrast, Bilimin, and Bilignost in this country made it possible to eliminate the arrears in this field. Together with the elaboration of topics concerning the pharmacokinetics and adverse effects of the above contrast agents, this helped to create a sound scientific base for further work on the unsolved problems, primarily, (1) to synthesize Soviet non-ionogenic radiocontrast agents; (2) to prepare and introduce Soviet ultrasonographic contrast agents into practice; (3) to prepare and introduce magnetic resonance contrast ones into practice; and (4) to introduce unique radiocontrast agents such as triombrast as oil emulsion, oleoferrotrast, fine-dispersion barium sulphate, and chromoetiotrast into clinical practice and to set up their production.