Neurologist here, so I order lots of MRIs, sometimes with contrast. Also graduated near the top of my class, and I absolutely hear what you're saying about the person graduating at the bottom being also a doctor! Gadolinium itself is actually highly toxic, but in the MRI contrast form it's given in, it's highly chelated so gets largely peed out. Gadovist etc isn't intrinsically nephrotoxic unlike CT contrast. However, in setting of kidney failure e.g. eGFR less than 30, radiologists generally won't give it as you can't pee it out, then it comes off the chelating compound and causes NSF, which is an awful condition. A recent study out of University of New Mexico looked into risk factors for this. Anyway, good article. Thank you!
Neurologist here, so I order lots of MRIs, sometimes with contrast. Also graduated near the top of my class, and I absolutely hear what you're saying about the person graduating at the bottom being also a doctor! Gadolinium itself is actually highly toxic, but in the MRI contrast form it's given in, it's highly chelated so gets largely peed out. Gadovist etc isn't intrinsically nephrotoxic unlike CT contrast. However, in setting of kidney failure e.g. eGFR less than 30, radiologists generally won't give it as you can't pee it out, then it comes off the chelating compound and causes NSF, which is an awful condition. A recent study out of University of New Mexico looked into risk factors for this. Anyway, good article. Thank you!