# Gadolinium-based and other MRI contrast agents

Source: https://onco.cc/technologies/gadolinium-based-contrast-agents/  
OnCo record `gadolinium-based-contrast-agents` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The dyes injected into a vein during many MRI scans. They make tumours and inflamed tissue light up, which helps find cancers, measure them and check how they respond to treatment.

## Summary

Most MRI contrast agents contain gadolinium held in a chelate. The WHO groups them as paramagnetic contrast media (ATC V08CA), including gadoteric acid, gadodiamide, gadoteridol, gadobenic acid, gadobutrol, gadoxetic acid, gadopiclenol and gadoquatrane, and lists iron oxide nanoparticles separately (V08CB). In the United States every gadolinium agent's label carries a boxed warning on intrathecal use and nephrogenic systemic fibrosis. Most are general agents that show where the blood-brain barrier or vessels are abnormal; gadoxetate is taken up by liver cells and is used to characterise liver lesions; FeraBright, an iron agent, was approved in 2025 for brain MRI in people with known or suspected brain tumours.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-11-04
- Also known as: MRI contrast; MRI dye; Gadolinium contrast; GBCA; Gadolinium-based contrast agent
- Tags: contrast-agents-gaps-2026-11
- Principle: Paramagnetic gadolinium (or superparamagnetic iron) shortens the T1 or T2 relaxation of nearby water protons; where the agent accumulates, in leaky tumour vessels or in liver cells for hepatobiliary agents, the MRI signal changes.
- Since: 1992
- Strengths: Shows tumour extent and blood-brain barrier disruption; Liver-specific agents help characterise liver lesions
- Limitations: Boxed warnings on intrathecal use and nephrogenic systemic fibrosis; Allergic-type reactions occur

## Sources

- WHO ATC index V08CA: paramagnetic contrast media: https://atcddd.fhi.no/atc_ddd_index/?code=V08CA&showdescription=no
- WHO ATC index V08CB: superparamagnetic contrast media: https://atcddd.fhi.no/atc_ddd_index/?code=V08CB&showdescription=no

## Connected records

- cancers: [Breast cancer (all types)](https://onco.cc/cancers/breast-cancer/), [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/), [Hepatocellular carcinoma](https://onco.cc/cancers/hcc/)
- fronts: [Imaging](https://onco.cc/fronts/imaging/)
- technologies: [Breast MRI coils and abbreviated breast MRI](https://onco.cc/technologies/breast-mri-coils-abbreviated-mri/), [Iodinated and barium contrast for CT and X-ray](https://onco.cc/technologies/iodinated-contrast-media/), [MRI](https://onco.cc/technologies/mri/), [Ultrasound contrast agents (microbubbles)](https://onco.cc/technologies/ultrasound-contrast-agents/)
- drugs: [Ferumoxtran-10 (Sinerem, lymph node MRI contrast)](https://onco.cc/drugs/ferumoxtran-10/), [Ferumoxytol for brain MRI (FeraBright)](https://onco.cc/drugs/ferabright-ferumoxytol/), [Gadobenate dimeglumine](https://onco.cc/drugs/gadobenate-dimeglumine/), [Gadobutrol](https://onco.cc/drugs/gadobutrol/), [Gadodiamide](https://onco.cc/drugs/gadodiamide/), [Gadopiclenol](https://onco.cc/drugs/gadopiclenol/), [Gadoquatrane](https://onco.cc/drugs/gadoquatrane/), [Gadoterate meglumine](https://onco.cc/drugs/gadoterate-meglumine/), [Gadoteridol](https://onco.cc/drugs/gadoteridol/), [Gadoxetate disodium (liver-specific MRI contrast)](https://onco.cc/drugs/gadoxetate-disodium/), [Mangafodipir (withdrawn liver MRI contrast)](https://onco.cc/drugs/mangafodipir/)
- companies: [Bayer](https://onco.cc/companies/bayer/), [Bracco (Bracco Imaging and Bracco Diagnostics)](https://onco.cc/companies/bracco/), [GE HealthCare](https://onco.cc/companies/ge-healthcare/), [Guerbet](https://onco.cc/companies/guerbet/)

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