Single-Center Retrospective Analysis of Breakthrough Allergic-Like Reactions to Gadobutrol
Bibliographic record
Abstract
OBJECTIVE: The purpose of this study was to assess the rate and severity of breakthrough allergic-like reactions to gadobutrol. MATERIALS AND METHODS: Under a waiver from our institutional review board, we performed a key word search of our institutional PACS (Picture Archiving and Communication System) database to identify all allergic-like reactions, which occurred in the setting of gadobutrol administration between December 2009 and August 2018, encompassing approximately 25,000 gadobutrol injections. Patients with an index allergic-like reaction who underwent a subsequent gadobutrol-enhanced magnetic resonance imaging after a standard 13-hour corticosteroid and antihistamine premedication protocol before repeat injection were identified. Patient characteristics, volume of gadobutrol injected, and severity of index and breakthrough reactions were recorded and compared by χ test, t test, and Spearman correlation. RESULTS: The index allergic-like reaction rate to gadobutrol was 0.28% (69/25000). Of the patients who had an index allergic-like reaction, 45% (31/69) had a subsequent magnetic resonance imaging with gadobutrol injection and premedication with a breakthrough reaction rate of 35% (11/31). Most index reactions were mild in severity (91% [63/69]), and most breakthrough reactions were also typically mild (91% [10/11]). One patient escalated from a mild index reaction to a moderate breakthrough reaction despite premedication. There was no correlation between volume of gadobutrol injected (ρ = -0.004, P = 0.98) or association with age (P = 0.74), although female patients had higher breakthrough reaction rates (P = 0.007). CONCLUSIONS: Allergic-like reactions to gadobutrol are rare; however, breakthrough reactions occur with moderate frequency despite premedication, and although generally of mild severity, in our series, one breakthrough reaction escalated in severity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".