Evidence mapPaperPMID 40608128Full record

ReviewArchives of toxicology2025

Gadolinium toxicity: mechanisms, clinical manifestations, and nanoparticle role.

Jose L Domingo, Richard C Semelka

Abstract readReview
In one paragraph

Review in Archives of toxicology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing 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

19 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Gadolinium-Based Contrast Agents and the Theater of Safety.Clinical journal of the American Society of Nephrology : CJASN · 2026
    Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Cerebral Accumulation of Gadolinium (GdTomography (Ann Arbor, Mich.) · 2026
    Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Lanthanide Nanotheranostics in Radiotherapy.International journal of molecular sciences · 2025
    Review
  18. Review
  19. Transmetalation in Cancer Pharmacology.International journal of molecular sciences · 2025
    Review
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

2 authors.

Jose L DomingoLaboratory of Toxicology and Environmental Health, School of Medicine, Universitat Rovira i Virgili, Sant Llorens 21, Catalonia, 43201, Reus, Spain. joseluis.domingo@urv.cat.ORCID 0000-0001-6647-9470
Richard C SemelkaConsulting. PLLC, Chapel Hill, NC, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Gadolinium-based contrast agents (GBCAs), essential for MRI, are facing renewed scrutiny due to gadolinium (Gd) retention and emerging toxicity profiles. While the link between less stable agents and Nephrogenic Systemic Fibrosis (NSF) in renal impairment is established, gadolinium (Gd) deposition is also observed in the brain, bone, and skin across all GBCA classes, even in patients with normal renal function. This finding has raised concerns and led to a concept of Gadolinium Deposition Disease (GDD). The present review synthesizes current evidence on clinical manifestations and underlying mechanisms. It highlights pathways beyond traditional transmetallation, particularly endogenous nanoparticle formation as a key mechanism for Gd release and retention, potentially challenging the stability assumptions for even macrocyclic agents. Structural factors (linear/macrocyclic; ionic/non-ionic) and stability parameters (thermodynamic log K; kinetic kobs) influencing risk are evaluated alongside regulatory responses. GBCAs should be viewed not as inert diagnostics but as agents with complex, cumulative biological interactions. Future research should focus on developing non-gadolinium alternatives, validating biomarkers for early detection of Gd retention, and conducting controlled trials on chelation therapy efficacy. Clinicians must balance the diagnostic benefits of GBCAs with potential long-term risks, ensuring informed patient consent and judicious use. Innovative approaches, such as Gd-grafted nanodiamonds with high relaxivity and enhanced safety via polyvinylpyrrolidone (PVP) coating, may offer alternatives to traditional GBCAs by reducing toxicity risks. Manganese-based contrast agents, such as Mn-PyC3A, show promise as safer alternatives due to efficient renal and hepatobiliary elimination, even in renal impairment, as demonstrated in rat models.

Indexed as

Contrast MediaGadoliniumNanoparticlesAnimalsHumansMagnetic Resonance ImagingNephrogenic Fibrosing DermopathyContrast MediaGadoliniumChelate stabilityGadolinium-based contrast agents (GBCA)Gadolinium depositionGadolinium toxicityNanoparticlesNephrogenic systemic fibrosis (NSF)

Identifiers

PMID40608128
PMCPMC12454587

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.