ContrastConnect has released a guide on ACR’s guidelines on gladolinium-based contrast agent (GBCA) classifications and CA-AKI protocols as outlined in the 2025 ACR Manual on Contrast Media, which introduced revised safety parameters and the corresponding precautions imaging teams must take during patient screening and imaging procedures.
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Per ContrastConnect’s guide, ACR has reclassified many GBCAs based on clinical data pertaining to nephrogenic systemic fibrosis (NSF) risk. "Group I" agents, which include gadodiamide (Omniscan), gadopentetate dimeglumine (Magnevist), and gadoversetamide (OptiMARK), are contraindicated by the FDA for high-risk patients; "Group II" agents, including gadobutrol (Gadavist) and gadoteric acid (Dotarem and Clariscan), are considered lower risk by the ACR Committee and do not require assessment of renal function or laboratory testing before intravenous administration.
For patients with an eGFR between 30 and 44 mL/min/1.73 m2, "Group II" agents pose little significant risk; however, guidelines say that facilities should still be equipped to evaluate and treat adverse reactions and closely monitor patients post-administration.
For the revised CA-AKI guidelines, ContrastConnect’s guide says that ACR has made major changes to renal function assessment: medical teams are now recommended to perform targeted assessment based on specific risk factors, rather than employ universal screening protocols; this is especially true for individuals with a history of renal disease. For high-risk patients, prophylaxis regimens should be considered on an individual basis, with regimen duration based on patient need.
ContrastConnect adds that contrast media protocols in pregnant or breastfeeding women, pediatric cases, geriatric cases, and patients with multiple allergies now have additional considerations. Regardless of the demographic, all contrast studies must be documented, including pre-procedure assessment of risk factors, contrast type, volume administered, and adverse reactions observed.
The new guidelines necessitate more rigorous oversight during higher-risk contrast studies, which ContrastConnect acknowledges may be difficult to manage for imaging teams struggling with the ongoing radiologist shortage. To alleviate the strain on understaffed facilities, the company offers a virtual supervision platform that connects teams with licensed radiologists trained to remotely supervise contrast administration in real time. HIPAA- and HITECH-compliant technology is provided to partners, allowing facilities to satisfy CMS direct supervision requirements without a radiologist on site.
More information is available at http://www.contrast-connect.com/