Evaluation of the safety profile of CT and MRI contrast agents based on iodine and gadolinium

Objectives: The purpose of the study was to investigate the safety of contrast agents in the field of medical radiology. Methods: We conducted a comprehensive literature review through databases such as PubMed, Google Scholar, Scopus, and ScienceDirect, with the selection of relevant articles based on keywords, publication in English, study design, and publication criteria from 2020 to 2024. Results: In the course of the study, we determined that iodine containing contrast agents are often used in medical imaging, but their safety is a concern, especially in patients with renal impairment and a tendency to allergic reactions. It is recommended to observe a 4-12 hours interval between procedures to minimise the risk of contrast-induced nephropathy. Iodised contrasts are more likely to cause adverse reactions compared to gadolinium-based contrasts, but serious cases such as anaphylaxis remain rare (0.06%). Low concentration iodine-containing contrasts for cerebral angiography have shown high safety, reducing toxic effects. Barium contrast agents have demonstrated a high level of safety when used in diagnostics, including procedures such as oral barium test. Special attention was paid to reducing radiation exposure and compliance with safety protocols during the COVID-19 pandemic, which prevented the spread of infections. Contrast agents based on linear gadolinium more often contribute to its deposition, which could be associated with potential long-term risks, although their clinical consequences have not been fully examined. In contrast, macrocyclic gadolinium chelates show better stability and less often cause such effects, which makes them preferable in clinical practice. Conclusions: The introduction of strict recommendations on the use of gadolinium-containing contrast agents has reduced the incidence of nephrogenic systemic fibrosis, but further studies on their accumulation in the body remain relevant.