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SAGE, MAGI, IGOR - acronyms for feeling sick from Gd.

The love of acronyms I think probably began in the 20th century. Among the peaks of acronym generation is technology in MRI: GRASS, FLASH, FISP, STIR, STAR, FLARE, UFLARE, TurboFLASH, VIBE, HASTE. In MRI dictations I have used FLASH, VIBE, HASTE extensively. In many respects it has come to pass that if you don't have a good acronym, you don't got nothin'.

SAGE (Symptoms Associated with Gadolinium Exposure) has recently been coined in an article in Radiology by 3 highly regarded radiologists. I don't want to say too much about it, as one of my co-researchers thinks we need to write a response. The American College of Radiology has endorsed this concept. The one problem I have is that, as with CIN (an acronym I like- Contrast Induced nephropathy: now called Contrast Media Induced Acute Kidney Injury> CM- AKI - an acronym I don't like). The definition is a bump in sCr, with levels given, not important in this blog to know what the numbers are, but the big problem with CIN for decades and SAGE now, is that it does not reflect on the critical difference between transient SAGE (like saying a smart thing once in your life) vs persistent or durable SAGE (being generally smart most of the time). Another problem with SAGE is that almost simultaneously some other group has adopted it for another purpose- without looking it up, I think it may be a COVID group- then it becomes confusing: what SAGE are you talking about.

I have come up with a couple of alternatives:

MAGI > Manifestations Associated with Gadolinium Injection > I was going to post this blog at Christmas, but I was concerned some may consider it critical-of-Christians or making fun of Christians, which it is not (I am also a Christian).

But my favorite acronym is :

IGOAR > Injected Gadolinium Observed Adverse Reactions. Could drop or lower case the A and just have IGOR.

Who doesn't like Igor? Some may be thinking I am talking about the British PM but he is Boris not Igor.

In the end what makes the most sense for the long term/ durable/persistent condition is GDD, and if you are ok after GBCA, GSC.

Richard Semelka, MD


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