Abstract
The scientific rationale for this review stems from the increasing global use of gadolinium-based contrast agents in medical imaging and the concerns over the long-term environmental accumulation of gadolinium waste, which may pose biological risks. The primary objective was to determine whether gadolinium exposure induces genetic damage in mammalian cells, regardless of the assay method used, and to assess the quality of the studies available in the literature. Genotoxicity was measured through assays such as the micronucleus test, comet assay, chromosomal aberration, and sister chromatid exchange. A total of 17 studies were included being 11 studies (out of 17) with positive genotoxic effects, suggesting that gadolinium can induce DNA damage. Most of the studies (12 out of 17) were rated as "strong" or "moderate" in quality, providing reliable evidence for these findings. This review advances the current understanding of gadolinium's potential health risks by highlighting its genotoxic effects.