Gadolinium-based contrast agents in pediatric MRI: renal safety, risk mitigation, and emerging alternatives

or kidney injury is suspected, minimizing cumulative lifetime exposure, and managing special populations such as neonates and children with prior allergic-like reactions. The review also outlines the growing role of alternative contrast agents, particularly ferumoxytol. By synthesizing current evidence and guideline recommendations, this article provides a comprehensive framework to support safe, effective, and judicious contrast-enhanced MRI in children while emphasizing areas where further pediatric-specific research is needed.