Gadoversetamide

Gadoversetamide is a gadolinium-based contrast agent (GBCA) used in magnetic resonance imaging (MRI) to improve visualization of internal structures and lesions. It is administered intravenously and operates by shortening T1 relaxation times, producing increased signal on T1-weighted images.

Chemically, gadoversetamide is a nonionic extracellular contrast agent. It is a chelate of gadolinium with a derivative of diethylenetriaminepentaacetic acid (DTPA), placing it in the class of linear GBCAs. Its pharmacokinetic properties include predominantly renal excretion and a plasma half-life that becomes prolonged in patients with reduced kidney function.

Indications for gadoversetamide include enhancement of lesions and vascular structures in the brain, spine, liver, pancreas, and other tissues to aid in the detection, characterization, and staging of pathology. It is used in various MRI protocols, including dynamic contrast-enhanced studies, depending on the clinical question.

Administration and safety considerations: typical dosing ranges from about 0.1 to 0.3 mmol per kilogram of body weight, adjusted to the clinical indication. Injection is usually performed by trained personnel in a radiology setting. Common adverse effects are generally mild, such as nausea or a warm sensation at the injection site, though hypersensitivity reactions can occur rarely. A major safety concern with gadoversetamide, as with other GBCAs, is the risk of nephrogenic systemic fibrosis (NSF) in patients with severe renal impairment. Consequently, renal function should be assessed prior to use, and the lowest effective dose should be used or alternative imaging strategies considered in high-risk patients.

Regulatory status: gadoversetamide is a prescription MRI contrast agent. Availability and labeling vary by country and over time, reflecting ongoing safety evaluations and regulatory guidance.