Conservative gadolinium administration to patients with Duchenne muscular dystrophy: decreasing exposure, cost, and time
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ORIGINAL PAPER
Conservative gadolinium administration to patients with Duchenne muscular dystrophy: decreasing exposure, cost, and time, without change in medical management Sean M. Lang1,2 · Tarek Alsaied1,2 · Ryan A. Moore1,2 · Mantosh Rattan3,4 · Thomas D. Ryan1,2 · Michael D. Taylor1,2 Received: 31 May 2019 / Accepted: 13 July 2019 © Springer Nature B.V. 2019
Abstract Cardiac MR (CMR) is increasingly used to assess for cardiac involvement in patients with Duchenne muscular dystrophy (DMD). The frequent use of gadolinium based contrast agents (GBCAs) has been called into question with reports of intracranial gadolinium deposition in patients receiving multiple administrations. We adopted a conservative GBCA administration policy, limiting the frequency of GBCA exposure in patients with previously documented late gadolinium enhancement. The aim of our study was to evaluate the clinical effects of this policy change. Data were retrospectively reviewed on 405 consecutive patients with DMD who underwent CMR evaluation. Patients were grouped into conservative GBCA administration or historical control. CMR reports were evaluated and clinical reports were reviewed to determine actionable changes. Ohio Medicaid reimbursements were used to estimate costs. A total of 187 patients comprised the conservative GBCA group and 218 patients the historical cohort. The conservative GBCA group had lower contrast administration rates (84% vs. 99%, p
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