Gadolinium Contrast Information
Gad Quick Reference Sheet
Who Needs eGFR testing?
OutPatients
Routine scans done with Dotarem do not require renal function testing. Only patients receiving Eovist (A group III agent per ACR) that answers yes to questions 19-23 need eGFR testing as detailed below.
- eGFR Labs must be less than 6 weeks old and eGFR > 30
- If eGFR < 30 Radiologist needs to consent.
InPatients:
Routine scans done with Dotarem do not require renal function testing. Only patients receiving Eovist (A group III agent per ACR) that answers yes to questions 19-23 need eGFR testing as detailed below.
- eGFR must be less than 2 days old and > 30
- If eGFR is < 30 Radiologist needs to consent.
Patient getting higher than standard dose (ie. Double dosing) of group II/III agent (such as Dotarem or Eovist) per protocol (ex. Some Cardiac MRI exams, Gamma-Knife Met protocol brain MRI) require renal function screening as a larger dose of Gadolinium is being used.
Same policy for group III agents for in-patients and out-patients as above would apply in this setting.
What do we do with prior Gadolinium "allergic-like" event?
If a patient has had a prior reaction to a gadolinium agent but is approved to have a repeat scan with gadolinium (see pretreatment policy in contrast manual) effort should be made to determine which contrast agent the reaction occurred with.
If unknown, Dotarem can be used. If with Dotarem, then Multihance should be used as alternative agent to help decrease risk of repeat reaction.
Who needs a Hcg urine test?
All females getting gadolinium IV contrast who have started menses or are between ages 10-55 need pregnancy testing checked.
Adults (age 18+) can sign a waiver bypassing urine/serum testing, pediatric pateints (age 10-17) cannot sign waiver and need testing.
For full policy and exceptions please see: Policy Regarding Testing for Pregnancy.