Since the introduction of MRI, we have seen a significant development in both anatomic and functional imaging procedures, as well as tremendous technological breakthroughs. At the same time, there's also been the important development of gadolinium contrast media for the evaluation of both structure and function with MRI. In the last decade, since the introduction of the gadolinium chelates, there has been a tremendous increase in the use of these agents, which has also presented some challenges.

The physicians using these agents need to understand what dose to use, what injection rate to use, and what the clinical indications are for their use. They must also learn some of the techniques for perfusion imaging, anatomic imaging, and functional imaging. These all increase the complexity of using these contrast agents in humans.

This focus group was designed to discuss these areas and the use of gadolinium agents. We asked each of the speakers to target a specific anatomic area of interest that is under significant change, and address how high-dose contrast agents are being used.

There were several objectives of our discussion. First, we wanted to review the current use of gadolinium contrast agents for MRI, and particularly those applications that use either high-dose contrast media or high injection rate contrast infusions, or have some other nuance related to the media itself. We also reviewed some of the similarities and differences in how the various physicians active in MRI use these agents and how they incorporate them into their clinical practice. Finally, we wanted each participant to determine through their clinical experience and demonstrate exactly how these tools, both the advanced imaging tools and the available contrast media, fit into their approach to patients. I would like to make specific mention of the distinguished panel of experts who participated in this focus group.

Dr. David Bluemke is experienced in all aspects of body MRI, and has been involved in the development of these techniques for some time. He's currently the Clinical Director of MRI at Johns Hopkins University, Baltimore, MD.

Dr. Nola Hylton is an Assistant Professor of Radiology at the University of California at San Francisco. She is a leader in the role of MR in breast imaging.

Dr. Larry Kramer is the director of MRI at Memorial Herman Hospital in Houston, TX and is a very active practitioner of MRI. He has performed body and contrast-enhanced MRI procedures for quite some time, and has incorporated those into his clinical practice, which is a combination of academic and community practice.

Dr. Russell Low is in practice in San Diego and has been developing contrast-enhanced MRI procedures in the abdomen for some time in a private practice setting, with extraordinary results.

Dr. Martin Prince is really credited with bringing forward the use of 3D contrast-enhanced MRA procedures and the use of high-dose contrast media for evaluation of the vascular system anatomy. Many consider him the pioneer of contrast-enhanced MRA. Dr. Prince is currently a Professor of Radiology at the Weill Medical College of Cornell University.

Dr. David Roberts is an Assistant Professor of Radiology at the University of Pennsylvania Medical Center, Philadelphia, PA. He is a recognized leader in MR.

Dr. Howard Rowley is a Professor of Radiology at the University of Wisconsin in Madison and is Chief of Neuroradiology there. Dr. Rowley has specific interests in MR perfusion imaging for CNS evaluation.

Dr. Richard Semelka from the University of North Carolina-Chapel Hill. Dr. Semelka has been a pioneer in the use of abdominal imaging with MR, and is credited with many developments in the use of gadolinium-enhanced imaging, with particular emphasis on the liver.

This focus group offered valuable information on how these leading radiologists in the field of MRI use high-dose contrast in their practices. This supplement shares their experience, articulate presentations, and insightful discussions with the readers of Applied Radiology.