Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols

Diego R Martin, Saravanan K. Krishnamoorthy, Bobby T Kalb, Khalil N. Salman, Puneet Sharma, John D. Carew, Phillip A. Martin, Arlene B. Chapman, Gaye L. Ray, Christian P. Larsen, Thomas C. Pearson

Research output: Contribution to journalArticle

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Abstract

Purpose: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in patients on dialysis administered either a lower dose high-relaxivity linear gadolinium-chelate, gadobenate dimeglumine (Multi-Hance, MH), compared to a standard dose linear gadolinium chelate, gadodiamide (Omniscan, OM). Materials and Methods: This study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved. As per institution standardized contrast-enhanced magnetic resonance imaging (MRI) protocols, patients on dialysis were imaged using either MH, between 2/2007 to 9/2008, or OM between 10/2003 and 1/2007. Rates of NSF were compared using 95% score-based confidence intervals (CI). The Wilcoxon rank sum test was used to test similarity/ difference between contrast doses given to each patient group. Results: Overall, 312 patients on dialysis received OM and eight (2.6%) developed NSF (95% CI: 1.30%-4.98%). In all, 784 patients on dialysis received MH at a mean cumulative dose of 0.11 mmol/kg (0.05-0.75 mmol/kg) and no cases of NSF were identified (upper 95% confidence bound of 0.45%). The mean cumulative dose of OM was 0.16 mmol/kg (0.1-0.9 mmol/kg) for all patients and 0.28 mmol/kg (0.1-0.8 mmol/kg) for the patients with NSF. The median OM dose was greater in patients who developed NSF (P = 0.03), and was greater than the median MH dose (P < 0.005).

Original languageEnglish (US)
Pages (from-to)440-446
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Volume31
Issue number2
DOIs
StatePublished - Feb 2010
Externally publishedYes

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gadodiamide
Nephrogenic Fibrosing Dermopathy
Gadolinium
Dialysis
Magnetic Resonance Imaging
Incidence
Nonparametric Statistics
Confidence Intervals
Health Insurance Portability and Accountability Act
Research Ethics Committees

Keywords

  • Dialysis
  • ESRD
  • Gadolinium
  • MRI
  • NSF

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols. / Martin, Diego R; Krishnamoorthy, Saravanan K.; Kalb, Bobby T; Salman, Khalil N.; Sharma, Puneet; Carew, John D.; Martin, Phillip A.; Chapman, Arlene B.; Ray, Gaye L.; Larsen, Christian P.; Pearson, Thomas C.

In: Journal of Magnetic Resonance Imaging, Vol. 31, No. 2, 02.2010, p. 440-446.

Research output: Contribution to journalArticle

Martin, DR, Krishnamoorthy, SK, Kalb, BT, Salman, KN, Sharma, P, Carew, JD, Martin, PA, Chapman, AB, Ray, GL, Larsen, CP & Pearson, TC 2010, 'Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols', Journal of Magnetic Resonance Imaging, vol. 31, no. 2, pp. 440-446. https://doi.org/10.1002/jmri.22024
Martin, Diego R ; Krishnamoorthy, Saravanan K. ; Kalb, Bobby T ; Salman, Khalil N. ; Sharma, Puneet ; Carew, John D. ; Martin, Phillip A. ; Chapman, Arlene B. ; Ray, Gaye L. ; Larsen, Christian P. ; Pearson, Thomas C. / Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols. In: Journal of Magnetic Resonance Imaging. 2010 ; Vol. 31, No. 2. pp. 440-446.
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abstract = "Purpose: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in patients on dialysis administered either a lower dose high-relaxivity linear gadolinium-chelate, gadobenate dimeglumine (Multi-Hance, MH), compared to a standard dose linear gadolinium chelate, gadodiamide (Omniscan, OM). Materials and Methods: This study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved. As per institution standardized contrast-enhanced magnetic resonance imaging (MRI) protocols, patients on dialysis were imaged using either MH, between 2/2007 to 9/2008, or OM between 10/2003 and 1/2007. Rates of NSF were compared using 95{\%} score-based confidence intervals (CI). The Wilcoxon rank sum test was used to test similarity/ difference between contrast doses given to each patient group. Results: Overall, 312 patients on dialysis received OM and eight (2.6{\%}) developed NSF (95{\%} CI: 1.30{\%}-4.98{\%}). In all, 784 patients on dialysis received MH at a mean cumulative dose of 0.11 mmol/kg (0.05-0.75 mmol/kg) and no cases of NSF were identified (upper 95{\%} confidence bound of 0.45{\%}). The mean cumulative dose of OM was 0.16 mmol/kg (0.1-0.9 mmol/kg) for all patients and 0.28 mmol/kg (0.1-0.8 mmol/kg) for the patients with NSF. The median OM dose was greater in patients who developed NSF (P = 0.03), and was greater than the median MH dose (P < 0.005).",
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AU - Sharma, Puneet

AU - Carew, John D.

AU - Martin, Phillip A.

AU - Chapman, Arlene B.

AU - Ray, Gaye L.

AU - Larsen, Christian P.

AU - Pearson, Thomas C.

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N2 - Purpose: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in patients on dialysis administered either a lower dose high-relaxivity linear gadolinium-chelate, gadobenate dimeglumine (Multi-Hance, MH), compared to a standard dose linear gadolinium chelate, gadodiamide (Omniscan, OM). Materials and Methods: This study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved. As per institution standardized contrast-enhanced magnetic resonance imaging (MRI) protocols, patients on dialysis were imaged using either MH, between 2/2007 to 9/2008, or OM between 10/2003 and 1/2007. Rates of NSF were compared using 95% score-based confidence intervals (CI). The Wilcoxon rank sum test was used to test similarity/ difference between contrast doses given to each patient group. Results: Overall, 312 patients on dialysis received OM and eight (2.6%) developed NSF (95% CI: 1.30%-4.98%). In all, 784 patients on dialysis received MH at a mean cumulative dose of 0.11 mmol/kg (0.05-0.75 mmol/kg) and no cases of NSF were identified (upper 95% confidence bound of 0.45%). The mean cumulative dose of OM was 0.16 mmol/kg (0.1-0.9 mmol/kg) for all patients and 0.28 mmol/kg (0.1-0.8 mmol/kg) for the patients with NSF. The median OM dose was greater in patients who developed NSF (P = 0.03), and was greater than the median MH dose (P < 0.005).

AB - Purpose: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in patients on dialysis administered either a lower dose high-relaxivity linear gadolinium-chelate, gadobenate dimeglumine (Multi-Hance, MH), compared to a standard dose linear gadolinium chelate, gadodiamide (Omniscan, OM). Materials and Methods: This study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved. As per institution standardized contrast-enhanced magnetic resonance imaging (MRI) protocols, patients on dialysis were imaged using either MH, between 2/2007 to 9/2008, or OM between 10/2003 and 1/2007. Rates of NSF were compared using 95% score-based confidence intervals (CI). The Wilcoxon rank sum test was used to test similarity/ difference between contrast doses given to each patient group. Results: Overall, 312 patients on dialysis received OM and eight (2.6%) developed NSF (95% CI: 1.30%-4.98%). In all, 784 patients on dialysis received MH at a mean cumulative dose of 0.11 mmol/kg (0.05-0.75 mmol/kg) and no cases of NSF were identified (upper 95% confidence bound of 0.45%). The mean cumulative dose of OM was 0.16 mmol/kg (0.1-0.9 mmol/kg) for all patients and 0.28 mmol/kg (0.1-0.8 mmol/kg) for the patients with NSF. The median OM dose was greater in patients who developed NSF (P = 0.03), and was greater than the median MH dose (P < 0.005).

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