Feature | Contrast Media | July 18, 2019 | By Greg Freiherr

How To Manage Risk in the MR Suite

AHRA Talk To Focus on Risk Management of MR Contrast Media

Two brain metastases from primary lung cancer are contrast enhanced in the brain of a 61-year-old male. Speakers at AHRA 2019 will state that ProHance and other macrocyclic MR agents present a very low risk to patients. Images courtesy of Bracco

Two brain metastases from primary lung cancer are contrast enhanced in the brain of a 61-year-old male. Speakers at AHRA 2019 will state that ProHance and other macrocyclic MR agents present a very low risk to patients. Images courtesy of Bracco

Macrocyclic contrast agents have the best safety profile of all the magnetic resonance (MR) contrast media that are now commercially available, according to John Karis, M.D., director of neuroradiology at the Barrow Neurological Institute.

Their safety profile is so compelling that the Phoenix -based institute switched to using macrocyclics for the vast majority of its MR contrast-enhanced scans. The institute settled recently on a single macrocyclic agent, ProHance, Karis told Imaging Technology News.

“We switched initially to a different macrocyclic but then switched to ProHance based on hospital contract issues,” he said. Although ProHance currently is the “default” MR agent, “there are a few research situations where we might use some other agents,” said Karis, who noted that the three macrocylic agents currently on the market “all have extremely good safety profiles.”

At The Association for Medical Imaging Management (AHRA) 2019 meeting, on July 21 at 5:30 pm, he and Nicolas Argy, M.D., J.D., a Bracco consultant, are scheduled to describe ways to manage risks from MR contrast media. The goal, Karis said, is to give audience members “all the information they need to make intelligently formed decisions for their site about what would be the best agent to use and, if (they decide to make) a change, what is the best and most effective way to do it.”

The name of the AHRA symposium, “A New Perspective on Risk Management in MR Contrast,” is based on the short experience that physicians have with these agents, according to Karis. The first such gadolinium-based agent was commercialized in 1987, he said. Since then, millions of doses have been administered with “very, very few adverse outcomes.”

 

Patient Safety First

During the symposium, safety profiles of different MR contrast media will be presented, as well as the pharmacology underlying them. Also addressed, according to Karis, will be complications of MR contrast including NSF (nephrogenic systemic fibrosis); immediate adverse reactions such as allergies, vomiting and feelings of heat or cold; and issues surrounding gadolinium retention.

It was out of concern for patient safety that the Barrow Neurological Institute switched to macrocyclics, he said. Although these agents are more expensive than linear ones, their small cost differential can be offset by improved efficiency, according to Karis.

The switch at the institute did not happen suddenly. Because different workflows in the MR suite accompany different types of MR contrast agents, the Barrow Neurological Institute gradually transitioned to macrocyclics “to make sure that all our technologists and physicians were comfortable with the switch and bought into it,” he said.

Key considerations in transitioning to macrocyclics will be discussed at the symposium, in the context of ways to reduce risk from the use of MR contrast. Karis plans to caution attendees against the administration of any IV drugs unless their use is necessary.

 

Greg Freiherr is a contributing editor to Imaging Technology News. Over the past three decades, Freiherr has served as business and technology editor for publications in medical imaging, as well as consulted for vendors, professional organizations, academia, and financial institutions.

 

Editor’s note: This article is the third piece in a content series by Greg Freiherr covering The Association for Medical Imaging Management (AHRA) annual meeting in Denver. The first article, How Standardizing Protocols Can Save Time and Money, can be found here. The second article, How Artificial Intelligence Might Impact Radiology, can be found here.

 

Related content:

How Standardizing Protocols Can Save Time and Money

How Artificial Intelligence Might Impact Radiology

Gadolinium-Based Imaging Agent Boasts Safety, Reliability 

FDA Calls for Patient Education, More Clinical Studies for Gadolinium-based Contrast Agents (GBCAs) 

Gadolinium-Based MRI Contrast Agents Linked to Potentially Fatal Disease 

Related Content

New MRI Technique Captures Brain Changes in Near-real Time

Differences in stiffness between stimulus states. Image courtesy of Patz et al.

News | Neuro Imaging | August 19, 2019
An international team of researchers developed a new magnetic resonance imaging (MRI) technique that can capture an...
ADHD Medication May Affect Brain Development in Children

Images of regions of interest (colored lines) in the white matter skeleton representation. Data from left and right anterior thalamic radiation (ATR) were averaged. Image courtesy of C. Bouziane et al.

News | Neuro Imaging | August 16, 2019
A drug used to treat attention-deficit/hyperactivity disorder (ADHD) appears to affect development of the brain’s...
Profound Medical Receives U.S. FDA 510(k) Clearance for Tulsa-Pro
Technology | Interventional Radiology | August 16, 2019
Profound Medical Corp. announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) to...
Videos | Radiographic Fluoroscopy (RF) | August 09, 2019
Shimadzu displayed the FluoroSpeed X1 conventional radiographic fluoroscopy (RF) system at the Association for Medica
Shimadzu Medical Systems Receives FDA 510(k) for FluoroSpeed X1 RF System
Technology | Radiographic Fluoroscopy (RF) | August 09, 2019
Shimadzu Medical Systems USA, a subsidiary of Shimadzu Corp., announced they have received U.S. Food and Drug...
Synaptive Medical Launches Modus Plan With Automated Tractography Segmentation
Technology | Neuro Imaging | August 07, 2019
Synaptive Medical announced the U.S. launch and availability of Modus Plan featuring BrightMatter AutoSeg. This release...
Contrast Use in First Transthoracic Echocardiogram for Heart Failure Reduces Repeat Testing
News | Cardiovascular Ultrasound | August 07, 2019
Heart failure is the fourth most common cause for all admission to U.S. hospitals, and it is the most common reason for...
Canon Medical Introduces Encore Orian MR Upgrade Program
News | Magnetic Resonance Imaging (MRI) | August 06, 2019
Canon Medical Systems USA Inc. is helping to provide low-cost patient care solutions for its customers with the launch...
Bracco Receives FDA Approval for Varibar Thin Liquid for Oral Suspension
Technology | Contrast Media | August 05, 2019
Bracco Diagnostics Inc. announced U.S. Food and Drug Administration (FDA) approval for Varibar Thin Liquid (barium...