Scarciglia Angelo, Papi Chiara, Romiti Chiara, Leone Andrea, Di Gregorio Enza, Ferrauto Giuseppe
Department of Molecular Biotechnologies and Health Sciences University of Torino Via Nizza 52 Torino 10126 Italy.
Glob Chall. 2025 Jan 23;9(3):2400269. doi: 10.1002/gch2.202400269. eCollection 2025 Mar.
Gadolinium-based contrast agents (GBCAs) have revolutionized medical imaging, enhancing the accuracy and diagnostic value of magnetic resonance imaging (MRI). The increasing use of GBCAs has raised concerns about the release of gadolinium (Gd)(III) into the environment and potential risks for human health. Initially, multiple administrations of GBCAs were associated only with nephrogenic system fibrosis disease in individuals with impaired kidney function. Even if the Gd(III) retention in tissues has not yet been correlated with any specific disease, caution is required for the extensive use of GBCAs. The concerns related to the employment of GBCAs, due to the possible deposition and retention, should be extended also to healthy individuals without renal impairments. To ensure the well-being of patients, there is a need to develop even more stable and better-performing GBCAs, new MRI approaches requiring lower doses of GBCAs and, finally, innovative methods for recovering Gd(III) from both patients' urines and the environment. This can have strong advantages for human health and for environmental sustainability, also considering Gd(III) scarcity, being a rare earth element, and the shared guideline to reduce, as much as possible, the use of rare metals.
钆基造影剂（GBCAs）彻底改变了医学成像，提高了磁共振成像（MRI）的准确性和诊断价值。GBCAs使用的增加引发了人们对钆（Gd）（III）释放到环境中以及对人类健康潜在风险的担忧。最初，多次使用GBCAs仅与肾功能受损个体的肾源性系统纤维化疾病有关。即使组织中Gd（III）的潴留尚未与任何特定疾病相关联，但广泛使用GBCAs仍需谨慎。由于可能的沉积和潴留，与使用GBCAs相关的担忧也应扩展到无肾功能损害的健康个体。为确保患者的健康，需要开发更稳定、性能更好的GBCAs，需要较低剂量GBCAs的新MRI方法，以及最终从患者尿液和环境中回收Gd（III）的创新方法。考虑到Gd（III）作为稀土元素的稀缺性以及尽可能减少稀有金属使用的共同指导原则，这对人类健康和环境可持续性具有显著优势。
