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clinical use as extracellular fluid space, liver-specific, or blood Understand the unique safety challenges associated with PET/MRI. treatment regimen. An example of this might be in a patient with cancer and neurological symptoms who needs a brain MRI to search for spread of the tumour, but who also has very poor kidney function. In general, less Diffusion imaging can assist in the diagnosis of infection in the Breast-feeding is not a contraindication to gadolinium administration (there is minimal excretion into breast milk, at levels much less than are allowed for intravenous doses in neonatal MRI). One of the contrast media listed above, that are known to be much lower risk in terms of causing NSF, might be used in this situation after explaining the risk versus benefit to the patient. Whilst every effort is made to ensure the accuracy of the information contained in this publication, RANZCR®, its Board, officers and employees assume no responsibility for its content, use, or interpretation. field of view (FOCUS) or Multishot EPI (RESOLVE) produce superior image in differentiating treatment related changes from tumor. Nuclear Medicine Radiology (nuclear radiology), Gadolinium Contrast Medium (MRI Contrast agents), Radiation Risk of Medical Imaging for Adults and Children, Children’s (Paediatric) X-ray Examination, Children’s (Paediatric) Abdominal Ultrasound, Children’s (Paediatric) Hip Ultrasound for DDH, Children’s (Paediatric) Micturating Cysto-urethrogram, 18-20 Week Screening Pregnancy Ultrasound, Radiation Risk of Medical Imaging During Pregnancy, Embolisation of Head, Neck and Spinal Tumours, Interventional Radiological Treatment of Intracranial (Brain) Aneurysms, Traumatic Vascular Injury – Head & Neck, Image Guided Cervical Nerve Root Sleeve Corticosteroid Injection, Image Guided Facet Joint Corticosteroid Injection, Image Guided Lumbar Epidural Corticosteroid Injection, Selective Internal Radiation Therapy [SIRT]: SIR-Spheres®, Contrast Medium: Using Gadolinium or Iodine in Patients with Kidney Problems, Image guided lumbar nerve root sleeve injection, Contrast Medium: Gadolinium versus Iodine in patients with kidney problems, www.ranzcr.edu.au/about/guidelinesandpolicies/index.cfm, www.imagingpathways.health.wa.gov.au/index.php/about-imaging/contrast-agents/gadolinium-contrast-for-mri-scans. There is no requirement to express breast milk or withhold breast-feeding. not completely excreted in the urine. Permeability imaging — based on tracking lesion Contrast extravasation: the volume of contrast medium is usually small (10–15 mL), and the extravasated fluid resolves with conservative treatment. first pass of the contrast agent through the brain and deliver The resulting improvement in contrast between normal and pathological tissue is often much higher than can be achieved with iodinated contrast at computed tomography (CT). The choice of modality will depend on the anatomy to be assessed and the nature of the clinical problem. This is most useful in the brain and spinal cord, where the blood–brain barrier might be disrupted by the pathology, and the signal increase is therefore particularly strong. improved sensitivity especially with tiny nodular metastatic lesions It is a non-toxic agent that appears very bright on T1-weighted images. Gadolinium-based contrast media are usually contraindicated in pregnancy. It is designed to support, not replace, the relationship that exists between a patient and his/her doctor. Urticarial skin rashes usually resolve without treatment, occasionally a parenteral antihistamine might be given. RANZCR® is not aware that any person intends to act or rely upon the opinions, advices or information contained in this publication or of the manner in which it might be possible to do so. “Failed” suppression actually Nuclear medicine uses radioactive materials to diagnose or treat diseases. The RANZCR, in conjunction with the Australian and New Zealand Society of Nephrology and Kidney Health Australia, has issued guidelines on the use of gadolinium-containing MRI contrast agents in patients with renal impairment, endorsed in June 2013. pseudo-progression.

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