Abstract: TH-PO799
Magnetic Resonance Imaging Contrast Agents: Confounded Exposures Matter
Session Information
- Pathology and Lab Medicine - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Wagner, Brent, Kidney Institute of New Mexico, Albuquerque, New Mexico, United States
- Escobar, G. Patricia, Kidney Institute of New Mexico, Albuquerque, New Mexico, United States
- Howard, Tamara A., University of New Mexico Health Sciences Center, Albuquerque, New Mexico, United States
- Ali, Abdul Mehdi S., University of New Mexico, Albuquerque, New Mexico, United States
- Deaguero, Joshua, Kidney Institute of New Mexico, Albuquerque, New Mexico, United States
- Dokladny, Karol, Kidney Institute of New Mexico, Albuquerque, New Mexico, United States
Group or Team Name
- Kidney Institute of New Mexico.
Background
Gadolinium-induced systemic fibrosis involves the monocyte chemoattractant protein-1/C-C chemokine receptor 2 pathway. Observational analyses measuring the risk of nephrogenic systemic fibrosis universally discounted exposures to multiple brands. The patients who contact the Kidney Institute of New Mexico report exposure to various brands or American College of Radiology Group 2 agents. Using our rodent model, we examined the pathology and metal retention of combined Group1/2 exposures.
Methods
We treated rodents for one week with Omniscan and three weeks of Dotarem (and vice versa) according to our standard, published protocols. Specimens were analyzed using conventional histology and electron microscopy. We quantified gadolinium with ICP-MS (Nexion 300D, Perkin-Elmer).
Results
Confounded treatments (Omniscan followed by Dotarem or vice versa) led to the formation of intracellular nanoparticles in the renal proximal tubules.
Conclusion
Measuring the incidences of gadolinium-induced complications has been artificially reduced by excluding confounded contrast agent exposures. Our results demonstrate that Le Chatellier's principle must be entertained in estimating the risk from magnetic resonance imaging contrast agents. Because routine magnetic resonance imaging contrast agent administration leads to gadolinium-rich nanoparticles in the brain and the kidney, defending particular brands is a fragile position.
Mixed exposures to class 1 and 2 magnetic resonance imaging contrast agents (Omnisan, Dotarem) led to intracellular gadolinium-rich nanoparticles in the renal proximal tubule. Transmission electron microscopy, Hitachi H7700. Kidney gadolinium levels were similarly elevated regardless of the magnetic resonance imaging contrast agent treatment group. *** P < 0.001, ANOVA, TukeyHSD.
Funding
- NIDDK Support