ECR 2014 / C-1924
Intramedullary Gadolinium (Gd) Residuals in Kidneys of Pediatric Oncology Patients: a Word of Caution
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Keywords:
Toxicity, Contrast agent-intravenous, MR, CT, Paediatric, Oncology, Kidney
Authors:
P. I. Kalmar, U. Wiesspeiner, M. Riccabona; Graz/AT
DOI:
10.1594/ecr2014/C-1924
Methods and materials
A database search was performed to identify all pediatric patients on oncology follow-up who had a non-enhanced CT after a Gd-enhanced MRI on the same day.
In all cases,
Gadobutrol was administered at a dose of 0.1mmol/kg body weight intravenously with a flow rate adjusted to the size of the vascular access (usually 1 ml/s).
As these were follow-up chest studies for assessment of pulmonary metastasis,
no contrast agent was administered.
A sufficient display of some renal medulla on the chest CT scan after MRI was the main prerequisite for inclusion,
which had to be determined by inspection.
Mandatory inclusion criteria were healthy kidneys,
not having undergone previous contrast-enhanced studies within the previous 14 days,
and being examined by non-enhanced CT using comparable protocols with a tube voltage of 120 kV.
Overall,
32 examinations of 23 patients matched all criteria and were evaluated.
The patients were anonymized and patient age,
sex,
weight and height were documented together with serum creatinine; medullary density was measured on CT scans.The time interval between the examinations was noted.
Glomerular filtration rate (GFR) was calculated using the updated Schwartz formula eGFR = 0.41 * height (cm)/Scr (mg/dl).
A control group consisting of 10 children (4 male,
median age 10.5 years,
range 3-17 years) who underwent oncology follow-up and had not undergone a prior ce-MRI study was recruited by randomly selecting patients at the same age who had a non-enhanced CT in the same period applying comparable CT-protocols.
As with the study cohort,
the renal medullae were inspected for visually perceptible densities on CT and CT density was measured.
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