A multispecialty group has released guidance on the use of gadolinium-based contrast agents with MRI for interventional pain procedures. The document was published March 23 in the journal Anesthesia & Analgesia.
The guidance consists of a set of position statements and recommendations for the use of contrast in interventional pain procedures and includes experts from a team of 11 multinational and multispecialty organizations, including the Society for Interventional Radiology (SIR), wrote a team led by Dr. Honorio Benzon of Northwestern University Feinberg School of Medicine in Chicago. It is based on a literature review and addresses the risks of using gadolinium-based agents, which can include the following:
- Nephrogenic systemic fibrosis
- Gadolinium brain deposition/retention
- Encephalopathy and death after an unintentional intrathecal gadolinium injection
It offers recommendations on selecting gadolinium-based agents in patients with renal insufficiency, those who have had multiple MRI exams already with gadolinium, and cases of paraspinal injections, the team wrote.
The guideline was developed because interventional pain doctors may switch to a gadolinium-based contrast agent when a patient has had a reaction to iodinated contrast, the authors noted.
