Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents

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Pubblicato in:Insights into Imaging vol. 15, no. 1 (Dec 2024), p. 62
Autore principale: Dekker, Helena M.
Altri autori: Stroomberg, Gerard J., Van der Molen, Aart J., Prokop, Mathias
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Springer Nature B.V.
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022 |a 1869-4101 
024 7 |a 10.1186/s13244-024-01626-7  |2 doi 
035 |a 2938257053 
045 2 |b d20241201  |b d20241231 
084 |a 243131  |2 nlm 
100 1 |a Dekker, Helena M.  |u Radboud University Medical Center, Department of Medical Imaging, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382) 
245 1 |a Review of strategies to reduce the contamination of the water environment by gadolinium-based contrast agents 
260 |b Springer Nature B.V.  |c Dec 2024 
513 |a Journal Article 
520 3 |a Gadolinium-based contrast agents (GBCA) are essential for diagnostic MRI examinations. GBCA are only used in small quantities on a per-patient basis; however, the acquisition of contrast-enhanced MRI examinations worldwide results in the use of many thousands of litres of GBCA per year. Data shows that these GBCA are present in sewage water, surface water, and drinking water in many regions of the world. Therefore, there is growing concern regarding the environmental impact of GBCA because of their ubiquitous presence in the aquatic environment. To address the problem of GBCA in the water system as a whole, collaboration is necessary between all stakeholders, including the producers of GBCA, medical professionals and importantly, the consumers of drinking water, i.e. the patients. This paper aims to make healthcare professionals aware of the opportunity to take the lead in making informed decisions about the use of GBCA and provides an overview of the different options for action.In this paper, we first provide a summary on the metabolism and clinical use of GBCA, then the environmental fate and observations of GBCA, followed by measures to reduce the use of GBCA. The environmental impact of GBCA can be reduced by (1) measures focusing on the application of GBCA by means of weight-based contrast volume reduction, GBCA with higher relaxivity per mmol of Gd, contrast-enhancing sequences, and post-processing; and (2) measures that reduce the waste of GBCA, including the use of bulk packaging and collecting residues of GBCA at the point of application.Critical relevance statement This review aims to make healthcare professionals aware of the environmental impact of GBCA and the opportunity for them to take the lead in making informed decisions about GBCA use and the different options to reduce its environmental burden.Key points• Gadolinium-based contrast agents are found in sources of drinking water and constitute an environmental risk.• Radiologists have a wide spectrum of options to reduce GBCA use without compromising diagnostic quality.• Radiology can become more sustainable by adopting such measures in clinical practice. 
653 |a Drinking water 
653 |a Gadolinium 
653 |a Magnetic resonance imaging 
653 |a Surface water 
653 |a Environmental impact 
653 |a Contrast agents 
653 |a Health care 
653 |a Aquatic environment 
653 |a Medical personnel 
653 |a Decisions 
700 1 |a Stroomberg, Gerard J.  |u RIWA-Rijn – Association of River Water Works, Nieuwegein, The Netherlands (GRID:grid.10417.33) 
700 1 |a Van der Molen, Aart J.  |u Leiden University Medical Center, Department of Radiology, Leiden, The Netherlands (GRID:grid.10419.3d) (ISNI:0000 0000 8945 2978) 
700 1 |a Prokop, Mathias  |u Radboud University Medical Center, Department of Medical Imaging, Nijmegen, The Netherlands (GRID:grid.10417.33) (ISNI:0000 0004 0444 9382) 
773 0 |t Insights into Imaging  |g vol. 15, no. 1 (Dec 2024), p. 62 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/2938257053/abstract/embedded/L8HZQI7Z43R0LA5T?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/2938257053/fulltextPDF/embedded/L8HZQI7Z43R0LA5T?source=fedsrch