Gadolinium enhancement necessity?

[Aaron98]

I've always understood (perhaps incorrectly) that gadolinium enhancement was necessary in our annual MRIs to determine enhancing brain lesions. As I went to schedule my annual MRI this time, my local neurologist told me the following:

"Contrast is only slightly helpful and I often do without contrast imaging in follow-ups of most conditions where seeing progressive lesions (T2 / FLAIR) would preceed any contrast enhancing lesions. While contrast is not harmful at this time, repetitive frequent contrast use can stay around in the brain longer than expected and there is concern this may increase neurologic symptoms (tremors, movement disorders)."

What do the AMN specialists say about this? Does anyone know? Thank you!

[bluejadedwho]

I had just found out from a friend that contrast is important. I requested it, and they said it wasn’t necessary

[monkeybus]

I have an MRI every six months. My neurologist (who is only too happy to milk my insurance) only requestested the Gandolinium when he thought it looked like one of my brain lesions was growing.

That was a few a few years ago now. He has never mentioned it since. I had forgotten all about it until you mentioned it.

[3WheelWonder in reply to monkeybus]

Milk your insurance?? Never! 😁

[Mamring]

According to Dr. Troy Lund and his leukodystrophy team at University of Minnesota, gadolinium enhancement is imperative to proper brain MRIs for detecting lesions. My son went to Duke Medical Center for MRIs with no enhancement, and they immediately wanted him to have bone marrow transplant, because they misread the MRI.

[StevenSims]

It very important to have it has it shows that the disease is active!

[SongStream in reply to StevenSims]

I agree. Since I showed brain inflammation in 9/2020, the contrast shows an active lesion or inflammation and/or progression. Since then while on the Min-102 trial, (I was 1 of the 6 who developed adult cerebral ALD while on the placebo) I have had and will have an MRI every 3 mos until August. Prior to this, I always had an annual MRI with contrast as recommended. One should be concerned about contrast solution if one has kidney disease. No other warning has been advised and I have been fine since 2020, if ever so grateful. More information will be published at end of year concerning Min-102 and I have since been on the actual drug like all.