Green MRI approach reduces gadolinium use in brain tumor follow-up

Review finds non-contrast MRI sequences suffice for surveillance of many extra-axial brain tumors (meningiomas, schwannomas, macroadenomas), reducing environmental and patient safety risks of gadolinium. For intra-axial tumors, a 'non-contrast-first' strategy may be viable in in…

• Narrative review summarizing evidence on reducing gadolinium-based contrast agents (GBCAs) in neuro-oncologic MRI.
• Advanced non-contrast techniques (arterial spin labeling, CEST, diffusion-weighted imaging) and deep learning-based virtual contrast synthesis are emerging alternatives.
• Limitation: For high-grade gliomas and metastases, contrast-enhanced MRI remains gold standard; no quantitative meta-analysis performed.

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