Following completion of a European-level scientific review to investigate gadolinium retention in brain and other tissues, the MHRA has just issued following advice for healthcare professionals:
•linear gadolinium-containing contrast agents (GdCAs) are associated with higher retention of gadolinium in the brain than macrocyclic GdCAs.
•licences will be suspended for linear agents gadodiamide (Omniscan) and intravenous gadopentetic acid (Magnevist).
•suspended products will be recalled from 1 February 2018, by which time healthcare professionals are expected to have switched over to alternative GdCAs
•the authorised indication of the linear agents gadobenic acid (also known as gadobenate dimeglumine; MultiHance) and gadoxetic acid (Primovist) will be limited to delayed phase liver imaging.
•macrocyclic agents gadoteridol (Prohance), gadobutrol (Gadovist), and gadoteric acid (Dotarem) will remain authorised, as will gadopentetic acid for intra-articular use.
•use GdCAs only when diagnostic information is essential and not available with unenhanced magnetic resonance imaging (MRI); do not exceed the recommended dose per kilogram of body weight and use the lowest dose that is effective for diagnosis.