Minimizing Risk of Nephrogenic systemic fibrosis in Cardiovascular Magnetic Resonance

Table 4 The EMA guidelines (www.ema.europa.eu)

Patients with severely impaired renal function	high risk GBCAs are contraindicated
Patients with severely impaired renal function	medium and low risk GBCAs: use lowest possible dose, pause at least 7d between two GBCA enhanced procedures
Patients with moderately impaired renal function	High risk GBCAs: use single injection of minimum dose, pause of 7d between two GBCA enhanced procedures
Patients with moderately impaired renal function	Medium and low risk GBCAs: use minimum dose, pause of 7d between two GBCA enhanced procedures
Toddlers < 1yo	High, medium and low risk GBCAs: use single injection of minimum dose, pause of 7d between two GBCA enhanced procedures
Infants < 4wks	high risk GBCAs are contraindicated
Infants < 4wks	medium and low risk GBCAs: use lowest possible dose, pause at least 7d between two GBCA enhanced procedures
Breast feeding	High risk GBCAs: pause for 24 h
Breast feeding	Medium and low risk GBCAs: consider pause for 24 h
Perioperative phase of liver transplants	high risk GBCAs are contraindicated
Perioperative phase of liver transplants	medium and low risk GBCAs: use lowest possible dose, pause at least 7d between two GBCA enhanced procedures

ISSN: 1532-429X