Figure. Tissue Localization and Cellular Response to Gadolinium Deposition.

Cellular localization of gadolinium using transmission electron microscopy (TEM) on tissue samples stained with 0.2% lead citrate are shown for the dentate nuclei of control patient 1 (A) and gadodiamide-exposed patient 3 (B) at 10 000-fold magnification. X-ray spectra of a selected electron dense foci (black arrowheads) are shown in the inset of each respective panel on a selected electron dense foci; gadolinium peaks in the spectra are indicated by red color overlay. Light microscopy images of hematoxylin-eosin–stained dentate nuclei samples (original magnification × 100) are shown for control patient 1 (C) and gadodiamide-exposed patients 3 and 1 (D and E). F, Neurofilament-immunostained dentate nuclei samples (original magnification × 200) for gadodiamide-exposed patient 1. Arrowheads indicate axonal spheroids. C indicates carbon; ca, calcium; gd, gadolinium; ni, nickel; o; oxygen; and pb, lead.