Evidence map›Paper›PMID 40383774›Full record

ArticleNeurological research and practice2025

From routine to selective: how updated MRI guidelines reshape gadolinium use in Germany.

Marc Pawlitzki, Alexander Stahmann, Niklas Frahm, Mathia Kirstein, Melanie Peters, Peter Flachenecker, Tim Friede, Kerstin Hellwig, Dagmar Krefting, Michaela Mai and 3 more

Abstract readLetter
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurological research and practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Marc PawlitzkiDepartment of Neurology, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany. MarcGuenter.Pawlitzki@med.uni-duesseldorf.de.
Alexander StahmannGerman MS Register, MS Forschungs- und Projektentwicklungs- gGmbH (MS Research and Project Development gGmbH [MSFP]), Hannover, Germany.
Niklas FrahmGerman MS Register, MS Forschungs- und Projektentwicklungs- gGmbH (MS Research and Project Development gGmbH [MSFP]), Hannover, Germany.ORCID http://orcid.org/0000-0002-4655-774X
Mathia KirsteinGerman MS Register, MS Forschungs- und Projektentwicklungs- gGmbH (MS Research and Project Development gGmbH [MSFP]), Hannover, Germany.
Melanie PetersGerman MS Register, MS Forschungs- und Projektentwicklungs- gGmbH (MS Research and Project Development gGmbH [MSFP]), Hannover, Germany.
Peter FlacheneckerNeurological Rehabilitation Center Quellenhof, Bad Wildbad, Germany.
Tim FriedeDepartment of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany.
Kerstin HellwigDepartment of Neurology, St. Josef Hospital, Ruhr University, Bochum, Germany.
Dagmar KreftingDepartment of Medical Informatics, University Medical Center Göttingen, Göttingen, Germany.
Michaela MaiDeutsche Multiple Sklerose Gesellschaft, Bundesverband e.V. (German Multiple Sclerosis Society [DMSG]), Hannover, Germany.
Clemens WarnkeDepartment of Neurology, University Hospital of Gießen and Marburg, Marburg, Germany.
Uwe K ZettlDepartment of Neurology, Neuroimmunological Section, University Medical Center of Rostock, Rostock, Germany.
David EllenbergerGerman MS Register, MS Forschungs- und Projektentwicklungs- gGmbH (MS Research and Project Development gGmbH [MSFP]), Hannover, Germany.

Funding

Bristol-Myers Squibb Bristol-Myers SquibbMerck MerckNovartis Pharma Novartis PharmaRoche RocheTG Therapeutics TG Therapeutics
6 · The paper itself

Abstract

Magnetic resonance imaging (MRI) is a critical diagnostic tool and monitoring modality for multiple sclerosis (MS), frequently employing gadolinium-based contrast agents (Gd). However, concerns regarding the accumulation of Gd have prompted international guidelines (MAGNIMS-CMSC-NAIMS, 2021) to advocate for the limitation of Gd utilization. Consequently, we assessed of the impact of the 2021 guidelines on the use of Gd in MRI in MS patients in Germany by conducting a retrospective analysis of MRI data from 12,833 MS patients in the German MS Register (2019-2024). Generalized additive models were employed to analyze Gd use trends over time by MRI type (cranial, spinal, combined). From 2020 to 2024, a significant decline in Gd use was observed, with percentages dropping from 74.2 to 41.2% in cranial MRI, from 78.2 to 39.2% in spinal MRI and from 81.8 to 59.0% in combined MRI (p < 0.001). The most substantial decline occurred within the initial five years of MS. Gd use in MS MRI scans has significantly decreased in line with the updated guidelines. Nevertheless, its persistent utilization in over one-third of cases necessitates further examination.

Indexed as

Gadolinium-based contrastMagnetic resonance imagingRelapsing multiple sclerosis

Identifiers

PMID40383774
PMCPMC12087169

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.