According to new research performed at the Mayo Clinic, iodine-based contrast material injected intravenously to enhance computed tomography (CT) images can be safely used in most patients. The study appears online in the journal Radiology.
Of the 80 million or more CT scans performed each year in the United States, iodine-based contrast material is used in at least half to enhance computed tomography (CT) images, according to researcher Robert J. McDonald, M.D., Ph.D., a radiology resident at the Mayo Clinic in Rochester, Minn.
According to Dr. McDonald, a small number of case reports from the 1950s and, more recently, retrospective studies lacking appropriate control groups causally linked the use of iodine-based contrast CTs to kidney damage, a condition called contrast-induced nephropathy.
"For nearly 60 years, physicians have worried about contrast-induced nephropathy when using iodinated contrast material, particularly for patients with impaired kidney function," Dr. McDonald said. "Emerging evidence now suggests these concerns are likely vastly overestimated."
Armed with sophisticated informatics tools, Dr. McDonald and a team of researchers analyzed information on patients who underwent abdominal, pelvic and thoracic CT scans at the Mayo Clinic between 2000 and 2010. A study group of 21,346 patients included 10,673 patients who each underwent a contrast-enhanced CT exam and 10,673 patients who underwent a similar CT without intravenous contrast.
The two groups were closely matched by demographic and clinical characteristics, including gender, race and pre-existing conditions such as diabetes, congestive heart failure and acute renal disease.
The researchers analyzed the patient data for adverse events following the CT scans, including acute kidney injury, the need for emergency renal dialysis (in patients with no prior history of dialysis) and death within 30 days of contrast exposure.
The analysis revealed no significant difference in the rate of acute kidney injury between patients in the contrast group (4.8 percent, or 515 of 10,673) and the non-contrast group (5.1 percent or 544 of 10,673). More importantly, the rates of emergency dialysis and death in the 30-day window following CT examination were not significantly different between patients exposed to contrast and those who were not exposed.
These results were also observed among patients with compromised kidney function and high-risk conditions, such as congestive heart failure and diabetes, which are assumed to predispose a patient to kidney injury.
"These results challenge long-held assumptions regarding the presumed nephrotoxic risk of intravenous contrast material," Dr. McDonald said. "We hope that our findings will help refine the safety profile of these contrast agents."
"Intravenous Contrast Material Exposure Is Not an Independent Risk Factor for Dialysis or Mortality" Collaborating with Dr. McDonald were Jennifer S. McDonald, Ph.D., Rickey E. Carter, Ph.D., Robert P. Hartman, M.D., Richard W. Katzberg, M.D., David F. Kallmes, M.D., and Eric E. Williamson, M.D.
Radiology is edited by Herbert Y. Kressel, M.D., Harvard Medical School, Boston, Mass., and owned and published by the Radiological Society of North America, Inc.
RSNA is an association of more than 53,000 radiologists, radiation oncologists, medical physicists and related scientists promoting excellence in patient care and health care delivery through education, research and technologic innovation. The Society is based in Oak Brook, Ill.
For patient-friendly information on contrast materials, visit RadiologyInfo.org.
Linda Brooks | Eurek Alert!
Amputees can learn to control a robotic arm with their minds
28.11.2017 | University of Chicago Medical Center
The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig
DNA molecules that follow specific instructions could offer more precise molecular control of synthetic chemical systems, a discovery that opens the door for engineers to create molecular machines with new and complex behaviors.
Researchers have created chemical amplifiers and a chemical oscillator using a systematic method that has the potential to embed sophisticated circuit...
MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.
Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...
Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
15.12.2017 | Power and Electrical Engineering
15.12.2017 | Materials Sciences
15.12.2017 | Life Sciences