A contrast agent containing gadolinium is often injected into the vein before an individual undergoes an MRI scan. Gadolinium is used to identify areas of active inflammation that can be associated with MS. There are several forms of gadolinium-based contrast agents (GBCSs) used. In people with MS or possible MS, GBCAs are frequently used to better identify active inflammation in the brain.
In December 2017, the U.S. Food and Drug Administration (FDA) updated a Safety Communication
indicating that small amounts of GBCAs may be retained in the brain in some people who have received multiple doses of GBCAs. More research is needed to establish if some GBCAs are more prone to cause deposits than others. There is currently no indication that these deposits are harmful, but the FDA has advised healthcare providers and patients against unnecessary use of gadolinium for routine MRI scans. The use of GBCAs are still considered essential for diagnosis and to help explain situations such as abnormal disease activity or rapid worsening.
In 2016, the Society convened a group of researchers, MS healthcare providers, radiologists, people with MS and other stakeholders to discuss the research needs regarding the initial GBCA safety communication and to develop recommendations so that people with MS and healthcare providers will have better information and guidance.
In 2017, The Consortium of MS Centers convened a group of experts, and included representatives from the MS Society, to review and revise their MRI Guidelines. The recommendation from the Consortium is for judicious use of gadolinium with the understanding that it remains important for diagnosis and ongoing monitoring of MS in certain situations, however, for routine ongoing monitoring gadolinium may not be needed.
The National MS Society recommends that people with MS and care partners should talk to their healthcare provider if they have questions about the use of gadolinium with MRIs.
Q: What should I do if my doctor prescribes an MRI?
A: Ask whether your doctor is aware of the FDA’s safety communication about gadolinium and whether using a gadolinium contrast agent is necessary for the purposes of the MRI scan which has been prescribed for you.
Q: What could happen to me if I have had numerous MRIs with gadolinium?
A: Health risks from any retained gadolinium are not known at this time. The FDA is working to understand how and why the gadolinium deposits occur and to identify any safety or health risks.