The question often comes up: what is DTPA (in fact what are any chelators) doing with Gd? The answer is recreating in vivo (literally in life - in actually in one's body) a GBCA. A number of sufferers, most in fact, recoil in horror at the idea we are recreating a GBCA, the thing that made them sick to begin with, but now in their body. In deed it is like bringing the Gd back to life, taking it out of the tissue and creating the Frankenstein monster: another GBCA. Once recovering from the shock - here is the scientific and reassuring basis. Gd-DTPA is essentially Magnevist (the new life) and we are creating that. It turns out that these MR contrast agents are among (or the) most stable form

Shouldn't the description of the risks of GDD be told in advance to all patients undergoing MRI, and not just target those who have already developed subtle disease? Yes, I believe that more information should be provided to all patients. I have written several the peer-reviewed literature on the subject of providing informed consent to patients in Radiology. It's also important to acknowledge that effective change is almost always an incremental process. To push for too much all at once can be a recipe for opposition and rejection. I value a realistic and pragmatic approach to change. Ultimately, what is needed is a comprehensive and complete communication of risks in Radiology - a number o

Leaving patients high and dry and having to fend for themselves: one of the great wrongs committed by the allopathic medical community in the denial of Gadolinium Deposition Disease. There are many negative aspects to it. Of the myriad of problems due to the failure to recognize the disease, the one I will focus on here is that it leaves patients defenseless in having to fend for themselves. In having their disease denied, a number of patients have been further damaged by even more GBCA-enhanced MR studies, to investigate GDD. Others have been injured by a variety of unnecessary surgeries/ procedures/ treatments based on lack of knowledge of the disease, maybe the luckiest of the mismanaged

There appears to remain a general misunderstanding on chelators. In this post I will briefly address the relative strength of the bonds between Gd and the common chelators: DTPA, EDTA, DMSA, DMPS. As I reported in an early blog on the stability constants of these chelators looking at Gd (where available) and other heavy metals, DTPA has the highest stability constant for essentially Gd and all other heavy metals. What may not be generally understood is all these chelators will pick up what they are marketed to pick up (DMSA and lead) but also all the other metals, like Gd. Picking up metals is good, but redistribution is bad, and this is where individuals can have problems. All chelators wil

Can Symptoms of GDD be Aggravated with MRI Even Without GBCA Administration? This question has come up on a few occasions, and also a few individuals have remarked that they have experienced this. They were symptomatic with GDD and therefore underwent noncontrast MRI, but still had a worsening of symptoms afterwards. The entire subject of GDD is new, so this possibility is then ultra new. My initial thoughts are that it is difficult to explain how this could happen. There are two possibilities: 1. the magnetic field may cause the deposited Gd to show micromovement, perhaps torsion in the magnetic field. This would be on a microscopic scale as Gd is paramagnetic and not magnetic (iron is magn

For the longest time (meaning 2 years with GDD and 12 years with NSF) consideration was made that Gd presence in bone and skin represented simple deposition, simple replacement of Gd for Ca in bone, simple replacement of Gd for Na in sweat. Could it however be something more? At least something in addition to simple deposition. I relate this back to 2 points, and relate to a third: 1. what are circulating fibrocytes and other bone marrow-derived cells doing as part of the chronic immune reaction? 2. why are intact GBCAs of macrocyclic agents doing in bone, if atomic Gd is replacing atomic Ca in bone? 3. could this relate to the Ghon focus of primary Tb? Let us start with the Wrath of Ghon.

The immune system is a remarkably complex and interwoven system of various cells that serve either as action heroes, checks, and balances, the vast majority of these are classified together as the family of white blood cells. All components are essential to achieve health. Too much or too little of any can result in severe disease. The primary diseases that the immune system is involved in can be categorized globally into exogenous proliferative invaders, foreign invaders (infections); endogenous proliferative invaders, rebels (malignancies, cancer); and self-destructive actions, excess friendly fire (autoimmune diseases, GDD). In many respects it may be useful to think of the immune system

Having been the director of MR services for a major university medical center for 25 years, I am very familiar with the MRI Screening form, that all centers have patients complete prior to undergoing an MR exam. From that perspective, combined with the wisdom that comes with experience and thoughtful reflection, it is somewhat humorous/sad to think what is in the form as important and what is lacking. The slings and arrows of what is asked, and what is not. As with most other things in life, there is a certain randomness, and that randomness is often based on the artifact of anecdotal experience or anecdotal awareness, and lack of broad awareness. For example, one of my pet peeves is the tre