It is clear that gadolinium-based contrast agents (GBCA) for MRI improve detection (sensitivity), characterization (specificity), disease staging, and diagnostic confidence levels. It has also become clear that nephrogenic systemic fibrosis (NSF) is associated with their use in patients with preexisting kidney disease. For radiology, the challenge is to minimize the risk of NSF while retaining, when appropriate, the advantages of GBCA use.
