The Utility of Gadolinium Contrast Agents in Older Patients with Multiple Sclerosis after Cessation of Disease Modifying Therapy
du Preez, Liam Ulano, Adam
du Preez, Liam
Ulano, Adam
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Abstract
Gadolinium contrast agents are frequently administered during follow-up imaging obtained on patients with multiple sclerosis (MS), a complex autoimmune disease that affects the central nervous system. Recent literature details the deposition of gadolinium in various areas of the brain after long-term repeated exposure. While no negative effects have been documented as a result of gadolinium deposition, efforts are underway to identify patients for which these contrast agents could be safely withheld. MS often becomes quiescent in older patients, allowing cessation of disease modifying therapy (DMT). We hypothesized that encountering enhancing lesions in this cohort is uncommon to the extent that contrast may be unnecessary. We identified the cohort of patients at the University of Vermont Medical Center with a diagnosis of MS, age greater than 55, not on DMTs. We reviewed all of the MRI reports on for each patient performed after the cessation of DMTs provided the patient was older than 55 at the time of the MRI to determine: 1) the presence of new lesions, 2) the presence of enlarging lesions, and 3) the presence of enhancing lesions. Of all reports reviewed, less than 1% demonstrated an enhancing lesion.
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Date
2021-01-01