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This chapter provides a comprehensive overview of gadolinium-based contrast agents (GBCAs) and their role in magnetic resonance imaging (MRI). It highlights the key pharmacodynamic properties of gadolinium, emphasizing its ability to reduce T1 and T2 relaxation times in adjacent protons, thus enhancing accuracy and confidence of lesion detection on MRI scans. The toxic nature of the trivalent cation Gd3+ is addressed, along with the necessity of administering it as a chelating agent to form GBCAs. The abstract underscores the value of GBCAs in MRI for their T1 shortening effect on protons near the chelated central Gd3+ atom, enabling the detection of subtle diseases that may not be easily recognized without contrast enhancement. Furthermore, this chapter acknowledges the limitations of GBCAs, emphasizing that they serve as a complementary tool rather than a substitute for clinical history and immunohistopathologic analysis. It presents specific case examples to illustrate the effectiveness of GBCAs in enhancing the visualization of pathologic lesions and guiding clinical decision-making. The importance of GBCA selection, considering factors such as thermodynamic stability, water solubility, elimination, and retention in patients with kidney disease, is also discussed. The chapter delves into the classification of gadolinium-chelating agents into macrocyclic and linear types, highlighting their respective properties and implications for clinical use. Additionally, it addresses the potential toxicity of GBCAs, emphasizing the influence of renal function on GBCA clearance and the deposition of Gd3+ in various organs. Animal studies are cited to underscore the histologic changes observed following gadolinium exposure, shedding light on the potential adverse effects associated with GBCAs. This chapter concludes by overviewing recent studies aimed at reconstructing the full-dose T1 from zero-dose and low-dose T1 images and briefly demonstrating clinical and quantitative imaging metrics of synthetic T1c. In conclusion, the abstract provides a comprehensive understanding of GBCAs in MRI, encompassing their pharmacodynamic properties, clinical utility, selection considerations, potential toxicity, and limitations. It serves as a valuable resource for healthcare professionals and researchers seeking to enhance their knowledge of contrast agents in the context of MRI.

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Advances in Gadolinium-Enhanced MRI: Pharmacodynamics, Clinical Applications, and AI Insights

  • 章节

  • 发表日期：

    2025年

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  • Mojtaba Safari,
  • Ramin Hamidi,
  • Xiaofeng Yang,
  • Ali Fatemi

摘要

This chapter provides a comprehensive overview of gadolinium-based contrast agents (GBCAs) and their role in magnetic resonance imaging (MRI). It highlights the key pharmacodynamic properties of gadolinium, emphasizing its ability to reduce T1 and T2 relaxation times in adjacent protons, thus enhancing accuracy and confidence of lesion detection on MRI scans. The toxic nature of the trivalent cation Gd3+ is addressed, along with the necessity of administering it as a chelating agent to form GBCAs. The abstract underscores the value of GBCAs in MRI for their T1 shortening effect on protons near the chelated central Gd3+ atom, enabling the detection of subtle diseases that may not be easily recognized without contrast enhancement. Furthermore, this chapter acknowledges the limitations of GBCAs, emphasizing that they serve as a complementary tool rather than a substitute for clinical history and immunohistopathologic analysis. It presents specific case examples to illustrate the effectiveness of GBCAs in enhancing the visualization of pathologic lesions and guiding clinical decision-making. The importance of GBCA selection, considering factors such as thermodynamic stability, water solubility, elimination, and retention in patients with kidney disease, is also discussed. The chapter delves into the classification of gadolinium-chelating agents into macrocyclic and linear types, highlighting their respective properties and implications for clinical use. Additionally, it addresses the potential toxicity of GBCAs, emphasizing the influence of renal function on GBCA clearance and the deposition of Gd3+ in various organs. Animal studies are cited to underscore the histologic changes observed following gadolinium exposure, shedding light on the potential adverse effects associated with GBCAs. This chapter concludes by overviewing recent studies aimed at reconstructing the full-dose T1 from zero-dose and low-dose T1 images and briefly demonstrating clinical and quantitative imaging metrics of synthetic T1c. In conclusion, the abstract provides a comprehensive understanding of GBCAs in MRI, encompassing their pharmacodynamic properties, clinical utility, selection considerations, potential toxicity, and limitations. It serves as a valuable resource for healthcare professionals and researchers seeking to enhance their knowledge of contrast agents in the context of MRI.