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Radiocontrast Media: Adverse Reactions and Side Effects

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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (31 March 2022) | Viewed by 10991

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Special Issue Editor

Dr. Filippo Fassio

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Guest Editor

San Giovanni di Dio Hospital, Azienda USL Toscana Centro, 50143 Florence, Italy
Website editor, European Academy of Allergy and Clinical Immunology (EAACI), 8050 Zürich, Switzerland
Interests: drug allergy; anaphylaxis; food allergy; venom allergy; allergy diagnosis

Special Issue Information

Dear Colleagues,

Radiocontrast media (RCM) are widely used around the world and generally well tolerated. However, adverse reaction (both immediate and delayed) and side effects are not uncommon.
In recent years, new evidence has emerged regarding pathogenetic mechanisms, risk factors, prevention and management of reactions and adverse events to RCM. It should also be emphasized that the most recent contrast media have hugely different characteristics from older ones (e.g., iodinated ionic and hyper-osmolar RCMs), and knowledge about the use of the latter cannot be applied to the newer compounds.

The topic of adverse reactions to RCM has a double interest in diagnostics: it is of interest to radiologists, who use RCM on a daily basis and are faced with adverse reactions themselves, and also to prescribers, because a correct management of the risk of adverse reaction starts from the moment of the patient evaluation and the prescription of the investigation that includes the use of RCM. In summary, the problem of adverse reactions to RCM affects anyone who prescribes or performs an investigation that involves RCM use.

The objective of this Special Issue would be to provide the clinician with the most current evidence on adverse reactions to RCMs—both of the immune-mediated and non-immune-mediated types—with a particular focus on diagnosis and risk stratification.

Dr. Filippo Fassio
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Drug adverse reactions
Drug allergy
Adverse reaction to radiographic contrast agent
Iodinated contrast media
MRI contrast agent
Contrast-induced nephropathy
Risk factors
Risk stratification
Prevention of adverse reactions to contrast agents

Published Papers (4 papers)

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Research

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12 pages, 1819 KiB

Open AccessArticle

The Image Quality and Diagnostic Performance of CT with Low-Concentration Iodine Contrast (240 mg Iodine/mL) for the Abdominal Organs

by Moon-Hyung Choi, Young-Joon Lee and Seung-Eun Jung

Diagnostics 2022, 12(3), 752; https://doi.org/10.3390/diagnostics12030752 - 19 Mar 2022

Cited by 2 | Viewed by 2215

Abstract

Purpose: To evaluate the difference between CT examinations using 240 mgI/mL contrast material (CM) and 320 mgI/mL CM in the contrast enhancement of the abdominal organs and the diagnostic performance for focal hepatic lesions. Materials and methods: This retrospective study included 422 CT examinations, using 240 mgI/mL iohexol (Group A, 206 examinations) and 320 mgI/mL ioversol (Group B, 216 examinations), performed between April 2019 and May 2020. Two CT scanners (single-source CT (machine A) and dual-source CT (machine B)) were used to obtain CT images. Two radiologists independently drew regions of interest (ROIs) in the liver, pancreas, spleen, kidney, aorta, portal vein, and paraspinal muscle. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated for each organ. They evaluated the degree of subjective enhancement of the organs and detected/differentiated focal hepatic lesions. Results: The SNR, CNR, and subjective enhancement of most organs were significantly higher in Group B than in Group A (p < 0.05). The sensitivity and specificity for cysts and malignancy were higher than 85.0% in both groups. The sensitivity for hemangioma was lower in Group B (<75%) than in Group A. In Group A, the SNR and CNR were significantly higher in most organs with machine B than with machine A. Conclusion: Although the SNR and CNR of the abdominal organs were lower with 240 mgI/mL CM than with 320 mgI/mL CM, 240 mgI/mL CM was feasible for evaluating the liver. A CT scanner with more advanced specifications may be beneficial for examinations with 240 mgI/mL CM by using lower tube voltage. Full article

(This article belongs to the Special Issue Radiocontrast Media: Adverse Reactions and Side Effects)

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10 pages, 2454 KiB

Open AccessArticle

The Role of Ferrous Ion in the Effect of the Gadolinium-Based Contrast Agents (GBCA) on the Purkinje Cells Arborization: An In Vitro Study

by Achmad Adhipatria Perayabangsa Kartamihardja, Winda Ariyani, Hirofumi Hanaoka, Ayako Taketomi-Takahashi, Noriyuki Koibuchi and Yoshito Tsushima

Diagnostics 2021, 11(12), 2310; https://doi.org/10.3390/diagnostics11122310 - 8 Dec 2021

Cited by 2 | Viewed by 2110

Abstract

Gadolinium deposition in the brain has been observed in areas rich in iron, such as the dentate nucleus of the cerebellum. We investigated the role of Fe²⁺ in the effect of gadolinium-based contrast agents (GBCA) on thyroid hormone-mediated Purkinje cell dendritogenesis in a cerebellar primary culture. The study comprises the control group, Fe²⁺ group, GBCA groups (gadopentetate group or gadobutrol group), and GBCA+Fe²⁺ groups. Immunocytochemistry was performed with an anti-calbindin-28K (anti-CaBP28k) antibody, and the nucleus was stained with 4′,6-diamidino-2-phenylindole (DAPI). The number of Purkinje cells and their arborization were evaluated with an analysis of variance with a post-hoc test. The number of Purkinje cells was similar to the control groups among all treated groups. There were no significant differences in dendrite arborization between the Fe²⁺ group and the control groups. The dendrite arborization was augmented in the gadopentetate and the gadobutrol groups when compared to the control group (p < 0.01, respectively). Fe²⁺ significantly increased the effect of gadopentetate on dendrite arborization (p < 0.01) but did not increase the effect of gadobutrol. These findings suggested that the chelate thermodynamic stability and Fe²⁺ may play important roles in attenuating the effect of GBCAs on the thyroid hormone-mediated dendritogenesis of Purkinje cells in in vitro settings. Full article

(This article belongs to the Special Issue Radiocontrast Media: Adverse Reactions and Side Effects)

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8 pages, 233 KiB

Open AccessArticle

Clinical Uses and Short-Term Safety Profile of Ethiodized Poppy Seed Oil Contrast Agent in the Diagnosis and Treatment of Vascular Anomalies and Tumors

by Robert K. Clemens, Tim Sebastian, Cindy Kerr and Ahmad I. Alomari

Diagnostics 2021, 11(10), 1776; https://doi.org/10.3390/diagnostics11101776 - 27 Sep 2021

Cited by 1 | Viewed by 1446

Abstract

Background: There is a sparsity of data on the use of ethiodized poppy seed oil (EPO) contrast agent (Lipiodol) in patients. We investigated the safety of EPO in children, adolescents, and some adults for diagnostic and therapeutic interventions. Methods: All patients who underwent procedures with EPO between 1995 and 2014 were retrospectively included. Demographic characteristics, diagnosis, dose, route of administration, preparation of EPO in combination with other agents, and complications were recorded. Results: In 1422 procedures, EPO was used for diagnostic or treatment purposes performed in 683 patients. The mean patient age was 13.4 years (range: 2 months–50 years); 58% of patients were female. Venous malformations (n = 402, 58.9%) and arteriovenous malformations (n = 60, 8.8%) were the most common diagnosis. Combined vascular anomalies included capillary–lymphatic–venous malformations, fibroadipose vascular anomalies (n = 54, 7.9%), central conducting lymphatic anomalies (n = 31, 4.5%), lymphatic malformations (n = 24, 3.5%), aneurysmal bone cysts (n = 22, 3.2%), and vascularized tumors (n = 11, 1.6%). In 1384 procedures (96%), EPO was used in various combinations with sclerosing and embolization agents, including sodium tetradecyl sulfate, ethanol, and glue. The mean volume of EPO used in interventions was 3.85 mL (range: 0.1–25 mL) per procedure with a mean patient weight of 45.9 kg (range: 3.7–122.6 kg) and a weight-adjusted dose of 0.12 mL/kg (range: 0.001–1.73 mL/kg). In 56 procedures (4%), EPO was used as a single agent for diagnostic lymphangiography. The mean volume was 4.8 mL (range: 0.3–13 mL) per procedure with a mean patient weight of 27.4 kg (range: 2.4–79.3 kg) and a weight-adjusted dose of 0.2 mL/kg (range: 0.04–0.54 mL/kg). Procedural-related complications occurred in 25 (1.8%) procedures. The 20 minor and 5 major complications were related to the primary treatment agents. None of them were directly related to EPO. No allergic reactions were noted. Conclusion: The use of an ethiodized poppy seed oil contrast agent in children, adolescents, and adults for diagnostic or therapeutic purposes is safe. Full article

(This article belongs to the Special Issue Radiocontrast Media: Adverse Reactions and Side Effects)

Review

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21 pages, 763 KiB

Open AccessReview

The Pathophysiology and the Management of Radiocontrast-Induced Nephropathy

by Eunjung Cho and Gang-Jee Ko

Diagnostics 2022, 12(1), 180; https://doi.org/10.3390/diagnostics12010180 - 12 Jan 2022

Cited by 16 | Viewed by 4341

Abstract

Contrast-induced nephropathy (CIN) is an impairment of renal function that occurs after the administration of an iodinated contrast medium (CM). Kidney dysfunction in CIN is considered transient and reversible in most cases. However, it is the third most common cause of hospital-acquired acute kidney injury and is associated with increased morbidity and mortality, especially in high-risk patients. Diagnostic and interventional procedures that require intravascular CM are being used with increasing frequency, especially among the elderly, who can be particularly susceptible to CIN due to multiple comorbidities. Therefore, identifying the exact mechanisms of CIN and its associated risk factors is crucial not only to provide optimal preventive management for at-risk patients, but also to increase the feasibility of diagnostic and interventional procedure that use CM. CM induces kidney injury by impairing renal hemodynamics and increasing the generation of reactive oxygen species, in addition to direct cytotoxicity. Periprocedural hydration is the most widely accepted preventive strategy to date. Here, we review the latest research results on the pathophysiology and management of CIN. Full article

(This article belongs to the Special Issue Radiocontrast Media: Adverse Reactions and Side Effects)

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