Can gadolinium be used as an alternative to iodinated contrast for CT angiography during the current pandemic-related contrast shortage?

The Corona Virus (COVID-19) pandemic has brought profound disruptions to the health care systems globally. One of the serious consequences of the Covid-19 pandemic is a global scarcity of Iodinated Contrast Agents (ICA) due to the recent government-mandated lockdown in Shanghai, China. This halted the production of a water-soluble iodine contrast at a major General Electric factory (of the GE Healthcare subsidiary). Many elective diagnostic tests and procedures are being delayed because of this, which has a huge impact on patient health care. Initially, Gadolinium-based Computed tomography Angiography (GbCTA) was proved as a good alternative diagnostic test, especially in patients for whom MRI with gadolinium contrast is not feasible or CTA with iodinated contrast is contraindicated due to iodine-related issues. But due to the concerns of nephrogenic systemic fibrosis and the cost of gadolinium, this alternative option did not become popular. Currently, the scarcity of iodinated contrast once again highlighted the need of using the gadolinium-based CTA. Advancements in CT technology, availability of new data on more stable gadolinium agents, and methods to reduce the contrast dose showed that Gb-CTA studies are possible.