Honglei Zhang1, Giles H. Roditi2, Rochelle Morgan1, Martin R. Prince1,3
1Radiology, Weill Medical College of Cornell University, New York, NY, USA; 2Radiology, Glasgow Royal Infirmary, Glasgow, UK; 3Radiology, Columbia College of Physicians and Surgeons, New York, NY, USA
From 260 NSF patients in 59 published papers, this meta-analysis explores the risk factors and demonstrates how risk can be minimized. It appears that eliminating even a single risk factor, such as the use of high dose can reduce NSF incidence/risk at least 10-fold. Elimination of multiple risk factors for example by using single dose GBCA, dialyzing dialysis patients with 24 hours following GBCA administration, avoiding GBCA in acute renal failure, avoiding non-ionic GBCA in renal failure patients can reduce NSF risk by orders of magnitude thereby allowing safe GBCA enhanced MRI in most patients.