The extra miles on preventing nephrogenic systemic fibrosis

Since the first discovery for magnetic resonance imaging (MRI) and its clinical application for medical diagnostics, Gadolinium (Gd)-based contrast agents (GBCAs) are possibly the most important feature to improve the diagnostic yield of MRI. Although chelation of Gd significantly improved the safety profile of GBCAs, it was discovered that GBCAs may still pose a threat being one of the lanthanides with high toxicity (1). The heightened issue in GBCA safety for clinical application is centralized in possible adverse effect of Gd retention in human tissues, clinical manifestations that may be caused by this retention and whether vulnerable population will be more at risk.