Nephrogenic systemic fibrosis: history and epidemiology

Radiol Clin North Am. 2009 Sep;47(5):827-31, vi. doi: 10.1016/j.rcl.2009.05.003.


Nephrogenic systemic fibrosis (NSF) is a new disease; the first case was diagnosed in 1997. It took 9 years before an association between NSF and gadolinium-based contrast agents (Gd-CAs) was identified. Gadolinium has several advantages for use in relation to enhanced MRI, but it is also a toxic heavy metal. For nearly 20 years, it was believed that Gd-CAs were safe, and they were used liberally. The prevalence of NSF cases varies between the various Gd-CAs, and adequate documentation of NSF cases after exposure to extracellular Gd-CAs remains a problem. All evidence points toward the fact that the real number of patients who have NSF has not been accurately totaled; the disease seems to be underdiagnosed for various reasons.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Contrast Media / adverse effects*
  • Contrast Media / history
  • Gadolinium DTPA / adverse effects*
  • Gadolinium DTPA / history
  • History, 20th Century
  • Humans
  • Magnetic Resonance Imaging* / history
  • Nephrogenic Fibrosing Dermopathy / chemically induced*
  • Nephrogenic Fibrosing Dermopathy / epidemiology*
  • Nephrogenic Fibrosing Dermopathy / history*
  • Prevalence


  • Contrast Media
  • Gadolinium DTPA