Eliminating Contrast Media Related Risks - Essay Example

Eliminating Contrast Media Related Risks Magnetic Resonance Imaging (MRI) has been an important and vital diagnostic tool in the radiologist’s repertoire in recent times. It offers an impeccable and detailed view of the morphological deviations and pathologic changes inside a patient without the need for any invasive procedures and guess work. In recent times, however there has been a growing concern of the adverse effects caused by the gadolinium based contrast agents used to enhance the detail and quality of the images obtained using this technology.

Dawn Berkeley, an MRI technologist at Omega Imaging in Mission Viejo, California has suggested switching over to contrast-agent free MRI techniques which along with giving similar if not better output, to the older techniques, eliminates the unnecessary risk to which the patients are exposed.Berkeley has brought to light the awareness of the FDA to the risks associated with the use of gadolinium and related products in causing nephrogenic systemic fibrosis (NSF) with serious consequences in the patient which can sometimes lead to fatality.

Despite the recent evidence of NSF in patients who had pre existing renal insufficiency after exposure to gadolinium, it has come to light that even patients with healthy renal histories at the time of the first administration were at a great risk of developing this disorder when exposed to a cumulative dose related effect of the contrast agent when undergoing subsequent or repeat MRI. According to Mark McGraw, Associate Editor at Advance newsmagazines, the fact that there are adverse effects of gadolinium is further substantiated by the personal experience of a qualified physician, Dr.

William Hartman who underwent exposure to this contrast agent three times between 1993 and 2005. He experienced discomfort initially in his feet which deteriorated to the extent that at present he is completely immobile and confined to bed. Although research in this matter is still in its infancy, the Food and Drugs Administration has issued a warning for cautious use of gadolinium after a connection between NSF in patients with pre existing renal disease and their exposure to this agent was discovered.

This fact was substantiated by the findings of researchers at Yale University School of Medicine and the medical regulatory agencies of the European Union. NSF patients usually experience an increase in collagen that causes thickening and hardening of the skin in the extremities resulting in tightening and deformity of the joints leading to immobility ultimately.According to Dawn Berkeley, the FDA has still not cleared the use of gadolinium in Magnetic Resonance Angiography (MRA), but it is being used for other procedures.

However the ‘off-label’ use of gadolinium based MRA has been practiced in the USA from 1988 ever since it gave good results and a better image quality, substantiated by the facts that no definite adverse effect had been reported with the procedure till that time.Dawn Berkeley has suggested a switchover to techniques and equipment which eliminate the use of contrast agents. She has suggested a system developed by Toshiba America Medical Systems, Inc. who have developed prototypes of contrast free imaging systems.

These techniques include fresh blood imaging (FBI), contrast free improved angiography (CIA) and time-spatial labeling inversion pulse (Time-SLIP). Contrast free techniques have been used extensively at Omega and have given results which were equal to if not better than the contrast based methods. The latest techniques of FBI, CIA and Time-SLIP have in fact given outstanding results in many cases at the Omega facility. These techniques were especially successful in critical cases and in pediatric use where the patients were already compromised and minimum invasive procedures need to be used.

Contrast based techniques have another major disadvantage as they have to be injected into the blood stream and extra-vasation or leakage can cause damage under the skin and adjacent tissues. The overall procedure time is also less with the above non contrast methods and there is no panic of time frames to be followed unlike contrast based methods where the bolus of the injected agent has to be rigorously traced within a specific time frame.It would be very right to conclude that minimal invasive procedures are the need of the day despite highly precise diagnostic plethora of equipment at the disposal of the medical diagnostic fraternity.

One should desist from using chemicals like gadolinium when better alternatives are available.