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August 06, 2019; 93 (6) Editorial

Use of gadolinium for MRI diagnostic or surveillance studies in patients with MS

Lukas Haider, Robert T. Naismith, Alex Rovira
First published July 8, 2019, DOI: https://doi.org/10.1212/WNL.0000000000007891
Lukas Haider
From the NMR Research Unit (L.H.), Queens Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Science, University College London, UK; Department of Biomedical Imaging and Image Guided Therapy (L.H.), Medical University of Vienna, Austria; Washington University School of Medicine (R.T.N.), Saint Louis, MO; and Section of Neuroradiology, Department of Radiology (A.R.), University Hospital Vall d'Hebron, Barcelona, Spain.
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Robert T. Naismith
From the NMR Research Unit (L.H.), Queens Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Science, University College London, UK; Department of Biomedical Imaging and Image Guided Therapy (L.H.), Medical University of Vienna, Austria; Washington University School of Medicine (R.T.N.), Saint Louis, MO; and Section of Neuroradiology, Department of Radiology (A.R.), University Hospital Vall d'Hebron, Barcelona, Spain.
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Alex Rovira
From the NMR Research Unit (L.H.), Queens Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Science, University College London, UK; Department of Biomedical Imaging and Image Guided Therapy (L.H.), Medical University of Vienna, Austria; Washington University School of Medicine (R.T.N.), Saint Louis, MO; and Section of Neuroradiology, Department of Radiology (A.R.), University Hospital Vall d'Hebron, Barcelona, Spain.
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Use of gadolinium for MRI diagnostic or surveillance studies in patients with MS
Lukas Haider, Robert T. Naismith, Alex Rovira
Neurology Aug 2019, 93 (6) 239-240; DOI: 10.1212/WNL.0000000000007891

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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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  • Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the editorial.

  • See page 248

  • © 2019 American Academy of Neurology
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