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RADIOLOGY INSIDER ARTICLES

GBCAs-Kidney-Disease

Gadovist® among agents with exceedingly low or non-existent risk of NSF according to CAR guidelines

The Canadian Association of Radiologists (CAR) has recently released a 2019 update to its clinical practice guideline regarding the use of gadolinium based contrast agents (GBCAs) in kidney disease. The purpose of this guideline is to address concerns about the use of GBCAs and the development of nephrogenic systemic fibrosis (NSF) …

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Better-Visualisation-lesion-enhancement

Better visualization and lesion enhancement in contrast-enhanced MRI of the brain with Gadovist® compared to gadoterate meglumine

There have been three intraindividual studies directly comparing Gadovist® and gadoterate meglumine for contrast-enhanced MRI of the central nervous system. In 2 out of 3 of these direct comparison trials, Gadovist® showed either…

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gadolinium-pediatric-brain-section

Gadolinium presence in the pediatric brain – Section 1

In this interview, Dr. Govind Chavhan sits down with Dr. Ravi Bhargava to discuss Dr. Bhargava’s recent investigation of gadolinium presence in the pediatric brain.

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Relaxivity of Gadovist<sup>®</sup> compared to the other macrocyclic agents

Relaxivity Matters: Which Macrocyclic agent has the highest relaxivity?

There are three macrocyclic gadolinium based contrast agents (GBCAs) available on the Canadian market. As macrocyclic agents, these three GBCAs all belong to the most stable class of MRI contrast media. Beyond stability, there are other differences in molecular structure that impact the relaxivity of these agents and thus their ability to enhance signal intensity on the MR image.

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10 Years of Nephrogenic Systemic Fibrosis (NSF) – What Conclusions Can Be Drawn From Report Numbers?

10 Years of Nephrogenic Systemic Fibrosis (NSF) – What Conclusions Can Be Drawn From Report Numbers?

The European Medicines Agency (EMA) and the European Society of Urogenital Radiology (ESUR) categorize all macrocyclic gadolinium-based contrast agents (GBCAs) as low risk for NSF development. A similar conclusion was drawn by the Canadian Association of Radiology (CAR) and the American College of Radiology (ACR). The NSF risk classification is largely based on single-agent NSF reports. However, different numbers of NSF reports are frequently cited…

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Pediatric-best-practices - Dr. Bhargava – Best practices in pediatric radiology

Best Practices in Pediatric Radiology - Section 4

In this final installment of “Best practices in pediatric radiology”, Dr. Bhargava discusses patient management strategies for the injection of small volumes, dealing with patient motion, and decreasing the need for sedation in pediatric patients.

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Relaxivity Matters - The influence of molecular structure on relaxivity

Relaxivity Matters - The influence of molecular structure on relaxivity

Two requirements of gadolinium based contrast agents (GBCAs) designed for use in MRI include high stability and high relaxivity. While molecular structure plays a large role in the stability of GBCAs, molecular structure also influences relaxivity, which is a prerequisite of technical efficacy of MRI contrast.

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Best practices in Pediatric Protocolling – Section 3

Best practices in Pediatric Protocolling – Section 3

In this video, Dr. Bhargava discusses the use of gadolinium based contrast agents (GBCAs) in children. This includes a summary of the types of non-allergic and allergic-like reactions that can occur, a review of nephrogenic systemic fibrosis (NSF), and the topic of gadolinium presence in the brain.

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Scientific Evidence of the Benefits of Power Injection

Scientific Evidence of the Benefits of Power Injection

To achieve successful contrast-enhanced MR procedures, accurate and repeatable contrast agent (e.g. gadobutrol) administration is necessary. In order to compare outcomes from power injection with MEDRAD MRXperion MR Injection System (MRXperion) versus manual injection, Bayer performed two studies.

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Gadolinium Presence in the Brain and Body

Gadolinium Presence in the Brain and Body

The first association of repeated gadolinium-based contrast agent administrations and increased signal intensity (SI) on non-contrast T1-weighted MR images in the dentate nucleus and globus pallidus brain areas was published by Kanda et al in 2014. This study stimulated intensive scientific investigations that aim to better understand the origin of this SI increase.

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Best practices in Pediatric Protocolling – Section 2

Best practices in Pediatric Protocolling – Section 2

Special considerations are required for optimizing MRI protocols and choosing hardware for imaging children. In this video, Dr. Bhargava discusses these considerations as well as the risks and benefits that must be considered when choosing an MRI contrast agent.

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CT Contrast Extravasation: Can it be Decreased?

CT Contrast Extravasation: Can it be Decreased?

CT has exploded in popularity since the early 2000s and has changed the game of medicine in many ways. Even though CT scans may have several benefits to diagnosis, contrast extravasations may carry downsides from compartment syndrome to tissue necrosis. In this video, Ryan K. Lee talks about CT contrast extravasation, its definition, implications, and tips and tricks to try to decrease extravasation.

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Macrocyclic Agent Relaxivity

Trust Gadovist® 1.0 for detection of very small lesions

Relaxivity can make a clinical difference particularly in small lesions that have a higher chance of being missed when using an agent with lower relaxivity.¹

Gadovist has the highest relaxivity of all macrocyclic gadolinium based contrast agents (GBCAs) available in Canada (Figure 1).

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Best practices in Pediatric Protocolling – Section 1

Best practices in Pediatric Protocolling – Section 1

Children are struck by a different set of diseases than adults, and pathology that varies with the age of the child. Performing effective examinations is critical, especially in young children who are unable to accurately describe their symptoms. Follow this link to see a presentation by Dr. Bhargava as he shares his experience and thoughts on best practices in pediatric MR protocolling.

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Technologist accommodating patient in the scanner

MRI potentially changes liver resection planning

Gadoxetic acid-enhanced MRI (EOB-MRI) is superior to contrast-enhanced CT (CECT) for the preoperative detection of small colorectal liver metastases (CRLM) in patients previously treated with chemotherapy, according to research published in the November 2017 issue of HPB. This finding also led to the conclusion that the improved diagnostic performance of EOB-MRI may alter the surgical plan in close to half of patients scheduled for liver resection.

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Kaplan-Meier Survival Curves

Delayed tumour enhancement may predict long-term survival post-hepatectomy

Delayed tumour enhancement of colorectal liver metastases (CRLM) on gadoxetate-enhanced MRI is associated with survival post-hepatectomy, according to results reported by researchers from Sunnybrook Health Sciences Centre.

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