Shima Aran MD, Presenter: Nothing to Disclose

Khalid Walid Shaqdan MD, Abstract Co-Author: Nothing to Disclose

Hani H. Abujudeh MD, MBA, Abstract Co-Author: Research Grant, Bracco Group Consultant, RCG HealthCare Consulting Author, Oxford University Press

The use of MRI gadolinium-based contrast agents (GBCAs) is associated with the risk of allergic adverse reactions. There is high variation in the reported allergic reactions between different institutions (0.07% to 2.4%). We investigated the incidence, severity and risk factors of allergic reaction to four GBCAs at a single large academic medical center.

IRB approved the retrospective study. Data in the electronic incident reporting system was searched between Jan-01-2007 to Jan-14-2014. These GBCAs were used: Gadopentetate Dimeglumine (Mag), Gadofosveset Trisodium (Abl), Gadoxetate Disodium (Eov) and Gadobenate Dimeglumine (Mul). The severity of the hypersensitivity reactions was classified into 3 categories of mild, moderate, and severe.

Of 194,400 injections, 204(0.1%) patients (mean age: 45.7±14.9) showed allergic reaction, consisted of 6/746 (0.80%), 10/3200 (0.31%), 14/6236 (0.22%) and 174/184218 (0.09%), for Abl, Eov, Mul and Mag, respectively (graph). A significant difference was found between different GBCAs regarding the total number of reactions (P<0.0001). When comparing the GBCAs, we found significant differences for Abl vs. Mag (p<.0001), Abl vs. Mul (p=0.0051), Eov vs. Mag (p<.0001) and Mag vs. Mul (p=0.0013). There was no significant difference between ages of patients receiving different GBCAs (p= 0.815). Rate of reaction was higher in females with significant difference for all GBCAs (table, p<0.0001). Significant differences were found when GBCAs were compared for emergency, inpatient, & outpatient groups (table, p<0.0001). Mild reactions were most common. There was a significant difference between GBCAs regarding the severity of reaction (p=0.0297). Significant differences were found regarding the patients outcome (table, p<0.0001), history of allergy (table, p<0.05) and different types of examinations (table, p<0.0001).

The overall rate of allergic adverse reaction in our study was 0.1%. The rates of allergic reaction to GBCAs in descending order are Abl, Eov, Mul and Mag. Allergic reactions to GBCAs are more common in females, outpatients, patient with history of reaction and patients undergoing abdomen-pelvis and thoracic images.

Knowledge of the rate, severity of reaction, and the symptom of allergic reaction associated with them raise the awareness of the physicians and technologist in administration of the appropriate GBCA.

Aran, S, Shaqdan, K, Abujudeh, H, Allergic Adverse Reactions to Gadolinium-based Contrast Agents: Experience with 194,400 Injections.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002685.html