NSF (Nephrogenic Systemic Fibrosis) - Gadoxetic Acid (Primovist)

Implications: Nephrogenic systemic fibrosis is becoming a severe problem for radiologist and industry as it may prevent physicians from using gadolinium containing contrast agents fearing that they induce nephrogenic systemic fibrosis even in patients without known kidney disease. A stable contrast agent with almost no release of gadolinium may be a solution: gadoxetic acid, sold in Europe and Asia as Primovist.

Analysis: Gadoxetic acid (Primovist) is a cyclic gadolinium containing MR contrast agent that is excreted via the bile as well as via kidney. Registration process with the FDA has been initiated. Gadoxetic acid has some protein binding which increases the relaxivity.

Therefore a reduced amount of gadolinium compared with Magnevist, the agent mentioned in the article, is needed for imaging. Having similar imaging properties as Magnevist, Omniscan, and Prohance gadoxetic acid may replace them in the coming years.