Biochemical safety profiles of gadolinium-based extracellular contrast agents and nephrogenic systemic fibrosis

J Magn Reson Imaging. 2007 Nov;26(5):1190-7. doi: 10.1002/jmri.21135.


Gadolinium (Gd)-based paramagnetic contrast agents are relatively safe when used in clinically recommended doses. However, with the rapidly expanding body of literature linking Gd-based paramagnetic contrast agents and nephrogenic systemic fibrosis (NSF), awareness of the potential side effects and adverse reactions from Gd is now an important requirement for practicing radiologists. In addition to the ongoing accumulation and analyses of clinical NSF data, it is also essential for the practicing radiologist to understand the biochemical characteristics of the extracellular Gd-chelates. The purpose of this review is to consolidate and update the available information on known side effects, adverse reactions, and toxicity of the Gd chelates, with particular emphasis on the potential mechanisms of NSF.

Publication types

  • Review

MeSH terms

  • Contrast Media / adverse effects*
  • Dose-Response Relationship, Drug
  • Fibrosis
  • Gadolinium / adverse effects*
  • Humans
  • Magnetic Resonance Imaging / adverse effects*
  • Renal Insufficiency / chemically induced*
  • Renal Insufficiency / prevention & control
  • Skin Diseases / chemically induced*
  • Skin Diseases / prevention & control


  • Contrast Media
  • Gadolinium