• Sakura M Noda, Murat Alp Oztek, A Luana Stanescu, Ezekiel Maloney, ShawDennis W WDWWDepartment of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA.Department of Radiology, University of Washington School of Medicine, Seattle, WA, USA., and Ramesh S Iyer.
• Department of Radiology, Seattle Children's Hospital, M/S MA.7.220, P.O. Box 5731, Seattle, WA, 98145-5005, USA. sakura.noda@seattlechildrens.org.
• Pediatr Radiol. 2021 May 12.

AbstractGadolinium retention in the brain and other organs has recently been identified by imaging and confirmed histologically. No direct clinical effects of gadolinium retention, which occurs after gadolinium-based contrast agent (GBCA) administration for MRI, have been scientifically accepted at this time. However, there is understandable concern among medical professionals and the public about the potential effects of gadolinium retention, particularly in the brain. Part of this concern might stem from the identification of nephrogenic systemic fibrosis caused by GBCAs in people with severe renal failure in 2006. This article briefly describes the characteristics of GBCAs; reviews and differentiates gadolinium retention, nephrogenic systemic fibrosis, and "gadolinium deposition disease" or "gadolinium toxicity"; and discusses societal guidelines and current usage in children. With the belief that GBCAs should not be withheld for appropriate indications in the absence of evidence of its potential risks, we offer a framework for determining when GBCA use is appropriate and suggestions for discussing its risks and benefits with children and their families.

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