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Brain MRI scans using gadolinium-based contrast agents (GBCAs) have played a central role in diagnosing and monitoring patients with multiple sclerosis (MS).1 GBCAs were initially considered extremely safe.2 Measurable GBCA tissue accumulation has been demonstrated in the dentate nucleus and other CNS structures as increased signal intensity on unenhanced T1-weighted images.3 Due to the potential toxicity of free gadolinium, these reports have raised concern within the scientific community, and among patients with MS and their families. Although no evidence currently exists linking brain gadolinium deposits with clinical consequences, regulatory agencies both in the United States and Europe clearly caution that GBCA should only be administered when informative for patient care.
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