Before gadolinium-enhanced MRI, which precaution is routinely performed?

• A. Screen kidney function
• B. Ingest contrast orally
• C. Skip IV access
• D. Perform fasting anesthesia

Answer: (A)

The main safety step before gadolinium-enhanced MRI is to check kidney function. Gadolinium-based contrast is cleared by the kidneys, and in patients with reduced renal function there is a risk of nephrogenic systemic fibrosis, a serious complication. By testing serum creatinine and estimating the glomerular filtration rate (eGFR), clinicians identify those at higher risk and decide whether to proceed with contrast, adjust the approach, or use a non-contrast study.

Oral ingestion isn’t how the contrast is given— gadolinium is administered intravenously, so IV access is required. Fasting or anesthesia isn’t a standard precaution for routine gadolinium administration in MRI.