Edgy NSF article may have gone too far

February 1, 2009

I read with interest your article on nephrogenic systemic fibrosis and the “heavy collateraldamage” that radiologists face due to the off-label uses of gadoliniumagents and subsequent development of NSF in somepatients

To the editor:

I read with interest your article on nephrogenic systemic fibrosis and the “heavy collateral damage” that radiologists face due to the off-label uses of gadolinium agents and subsequent development of NSF in some patients (“Radiologists meet with heavy collateral damage,” December, page 23). While the points are largely difficult to dispute, I just want to note that there is a lot that we do in interventional radiology that is off-label, such as the way that stents are utilized (FDA concerns noted).

The rhetoric in the article is a bit inflammatory, suggesting that radiologists are to be shamed for ignorance or worse, when most are likely to be well educated and following standards of care that are taught by leaders and mentors in our fields. A similar type of discussion has been going on now for some time now regarding the uses of ionizing radiation in CT scans, with polarizing viewpoints that at times seem more like pointing fingers than actually facilitating constructive dialogue. A toning down of the accusatorial commentary may be appreciated by some of your readers.

Jason Smith, M.D., Assistant Professor, Department of Radiology
Loma Linda University, Loma Linda, CA