This presentation provides a broad overview of tissue deposition of gadolinium, focused on the central nervous system. Preclinical studies provide evidence of the pattern and degree of gadolinium deposition across various agents, as well as some evidence regarding potential clinical and behavioral impact. Many clinical imaging studies provide indirect evidence of gadolinium deposition from T1 shortening, which varies substantially across different agents. Newer studies provide early, indirect evidence of washout. A number of clinical studies, predominantly retrospective, have failed to detect neurologic deficits. The syndrome of “Gadolinium Deposition Disease” is discussed, along with future areas for research and clinical management.

David F. Kallmes, M.D., is a Professor of Radiology at the Mayo Clinic in Rochester, MN. He completed his Fellowship in Diagnostic and Interventional Neuroradiology at UVA.