Studies examining the clinical histories of patients who developed nephrogenic systemic fibrosis after treatment at distinguished teaching hospitals in New York City and Vienna suggest that gadoliniumbased contrast dose and post-MRI hemodialysis are keys to controlling the rare but deadly skin disorder.
NSF is possibly associated with gadolinium-based MRI agents administered to kidney disease patients.
The first case was documented in early 1997. The International Center for Nephrogenic Fibrosing Dermopathy Research at Yale University had identified more than 300 confirmed cases as of January 2009.
It is not clear if any new cases were reported last year, according to Dr. Emanuel Kanal, a professor of radiology at the University of Pittsburgh.
Some medical device and pharmaceutical companies report that no new cases arose, he said in an interview, but NSF patients have said during online discussions that they are aware of new cases.
Studies presented at the 2008 RSNA meeting shed light on how to avoid NSF, according to Dr. Martin Prince, a professor of radiology at Weill Medical College of Cornell University.
“Though we don't fully understand NSF, we have learned enough to virtually eliminate it as a concern,” he said in an interview.
Prince presented results at RSNA 2008 from case reviews involving 83,121 patients at Columbia Presbyterian Medical Center and Cornell New York Hospital from January 1997 to July 2007.
Of 31 biopsy-confirmed NSF cases at the two hospitals, Prince identified 15 in which the patient received gadolinium contrast at one of the two facilities.
On the basis of that evaluation, Prince found that a single dose of gadolinium-based contrast media is safe. No NSF cases were associated with 74,124 patients who received a single dose.
