Since 50% of the excretion is by the liver - I would think this is the ideal contrast for any patient with renal compromise. I know there is currently a clinical trial for this. however as in all cases the science and the prelimiary data seems so promising that I think this needs to be considered for the renal impaired patients. There are many patients who need contrast who have renal failure. The fact that this cojntrast is already 1/4 dose regular contrast and you could use this 1/2 dose at 3T for renal impaired patients would for me be perfectly acceptable if this finds the small liver met or small brain met which could not be detected otherwise. Benefits vs risks are what we balance every day. I am happy to hear your comments on this.