Abstract:
Introduction: The aim of this study is to identify current practice of administration of gadolinium-based
contrast agents (GBCAs) in Ghana.
Method: A total of 13 MRI (magnetic resonance imaging) facilities were sent a survey questionnaire to
request information on their current practice with the use of GBCAs.
Results: Gadodiamide, a high risk GBCA accounted for 67% of first line agents. 5 (42%) had a departmental
protocol on the administration of GBCAs with regards to its association with nephrogenic systemic
fibrosis (NSF). Of the 8 that use gadodiamide, 3 check kidney function in all patients, 2 check in selected
patients, and 3 do not check at all. All 3 that screen all patients do not use contrast if the patient has an
eGFR (estimated glomerular filtration rate) of 30e59 ml/min, 1 considers other modality; and if the
patient has an eGFR of <30 ml/min, 2 do not use contrast but consider other modality, however 1
continues with the high risk agent.
Conclusion: Gadodiamide is widely used, with varied practice in screening for renal function, and risk
factors associated with NSF. Current evidence shows that it is advisable to administer macrocyclic agents
in patients with compromised renal function. It is also imperative to establish local guidelines in line
with international guidelines in order to minimize the incidence of NSF.
