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Improved Contrast Agent Protocols Eliminate New Cases of Nephrogenic Systemic Fibrosis

By MedImaging International staff writers
Posted on 23 May 2011

A study revealed how one medical center implemented strict protocols for administering gadolinium-based contrast agents (GBCAs) before imaging that resulted in the elimination of new cases for nephrogenic system fibrosis (NSF). More...

Implementing this protocol is particularly important for patients with diminished kidney function, according to Dr. Ozden Narin, presenting author for this study. "In the past, we had some patients who developed NSF after they were given a gadolinium-based agent before imaging. We implemented this new policy to see if we could make any change in preventing this condition," she said.

In a retrospective review of 52,954 contrast-enhanced magnetic resonance imaging (MRI) scans at Massachusetts General Hospital (MGH; Boston, MA, USA) during a 2.5-year period after this protocol was enforced, no new cases of NSF were identified. After examining the findings from this study and recognizing that this protocol is undeniably effective for preventing NSF, Dr. Narin is hopeful that this procedure will continue to make a difference at her institution and other medical centers. She stated, "Now, we only use GBCAs in patients with decreased kidney function in emergent cases and we have procedures in place to pay special attention to those patients and to take all the necessary precautions."

Dr. Narin delivered the study's findings on May 3, 2011 at the 2011 American Roentgen Ray Society (ARRS) annual meeting in Chicago (IL, USA).

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67 (36.001205444336): select jos_google_plus.link from jos_google_plus where cat=10

68 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10

69 (41.961669921875): SELECT fid FROM jos_deeppockets WHERE id=294735178 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294735178 AND published='1' LIMIT 1

70 (36.001205444336): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

71 (370.97930908203): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (347.13745117188): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

74 (101.80473327637): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (91.791152954102): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (49.829483032227): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (88.930130004883): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

91 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

106 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

107 (56.028366088867): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735178 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735178 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

110 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

111 (53.167343139648): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294735178 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (547.17063903809): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294735178 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (571.96617126465): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (414.84832763672): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

115 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

116 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

117 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

118 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

119 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

120 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

121 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

122 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

123 (313.04359436035): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

124 (!!!!! 42684.078216553): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

125 (597.95379638672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735178 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735178 AND type='deeppockets_item' AND published='1' LIMIT 1

126 (!!!!! 22142.887115479): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (208.13941955566): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

128 (303.98368835449): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (188.11225891113): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

130 (190.01960754395): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (324.01084899902): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

132 (!!!!! 1216.8884277344): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (135.89859008789): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

134 (103.95050048828): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1211.1663818359): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

136 (508.06999206543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (455.85632324219): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (416.04042053223): SELECT name FROM jos_deeppockets WHERE id=211

139 (52.213668823242): SELECT name FROM jos_deeppockets WHERE id=211

140 (931.0245513916): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (709.05685424805): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (141.85905456543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

143 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

144 (!!!!! 11434.078216553): TRUNCATE TABLE jos_trademed_module

145 (200.98686218262): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735178 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (95.844268798828): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294735178 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (834.94186401367): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

150 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

151 (!!!!! 1738.0714416504): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

152 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

153 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

154 (40.769577026367): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294735178 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294735178 AND type='deeppockets_item' AND published='1' LIMIT 1

155 (36.001205444336): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (32.901763916016): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

157 (36.001205444336): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

158 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

159 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294735178 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294735178 AND published='1' LIMIT 1

160 (49.829483032227): select jos_twitters.link from jos_twitters where cat=10

161 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

162 (62.227249145508): select jos_google_plus.link from jos_google_plus where cat=10

163 (50.067901611328): select jos_linkedin.link from jos_linkedin where cat=10

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