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!
The Great Unknown: Risk-Taking Behavior in Adolescents
19.01.2017 | Max-Planck-Institut für Bildungsforschung
A sudden drop in outdoor temperature increases the risk of respiratory infections
11.01.2017 | University of Gothenburg
A Swedish-German team of researchers has cleared up a key process for the artificial production of silk. With the help of the intense X-rays from DESY's...
For the first time ever, a cloud of ultra-cold atoms has been successfully created in space on board of a sounding rocket. The MAIUS mission demonstrates that quantum optical sensors can be operated even in harsh environments like space – a prerequi-site for finding answers to the most challenging questions of fundamental physics and an important innovation driver for everyday applications.
According to Albert Einstein's Equivalence Principle, all bodies are accelerated at the same rate by the Earth's gravity, regardless of their properties. This...
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
19.01.2017 | Event News
10.01.2017 | Event News
09.01.2017 | Event News
24.01.2017 | Physics and Astronomy
24.01.2017 | Life Sciences
24.01.2017 | Health and Medicine