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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".