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Diagnostics
Volume 16
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10.3390/diagnostics16101507
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Review

Iodinated Contrast Media in Oncologic CT: A Narrative Review of Safety, Risk Stratification, and Practical Considerations

by
Sabina-Oana Vasii
1,2,
Florin-Gabriel Crișan
2,
Sandra-Monica Lazăr
3,4,
Claudiu Ioniță
5,6,
Dan Iliescu
5,
Ioana Ioniță
3,4,7,
Daniel-Claudiu Malița
8,
Mirela Voicu
9,10,*,
Adrian Voicu
9 and
Lucreția Udrescu
1,11,*
1
Center for Drug Data Analysis, Cheminformatics, and the Internet of Medical Things, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
2
Doctoral School, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
3
First Department of Internal Medicine, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
4
Department of Hematology, Emergency Municipal Hospital, 300254 Timişoara, Romania
5
Department IX–Surgery I, Discipline Surgical Semiology I and Thoracic Surgery, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
6
Department of General Surgery I, Emergency Municipal Hospital, 300254 Timişoara, Romania
7
Multidisciplinary Research Center for Malignant Hemopathies, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
8
Department XV-Orthopedics-Traumatology, Urology, Radiology and Medical Imaging, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
9
Department II–Pharmacology, Physiology and Physiopathology, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
10
Research Center for Experimental Pharmacology and Drug Design (X-Pharm Design), Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
11
Department I–Clinical Pharmacy and Drug Analysis, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania
 
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Diagnostics 2026, 16(10), 1507; https://doi.org/10.3390/diagnostics16101507
Submission received: 6 April 2026 / Revised: 28 April 2026 / Accepted: 13 May 2026 / Published: 15 May 2026
(This article belongs to the Special Issue Clinical Applications of CT and MRI)
Versions Notes

Abstract

Background: Iodinated contrast media are essential for oncologic imaging but raise specific safety concerns because cancer patients are often exposed to repeated contrast-enhanced computed tomography, nephrotoxic drugs, immune-modulating therapies, and, in selected cases, radioiodine-dependent diagnostic or therapeutic pathways. Methods: We performed a narrative review based on an exploratory search followed by a focused search targeting iodinated contrast use in oncology-related settings. Studies were included if they addressed renal risk and post-contrast acute kidney injury, hypersensitivity and acute adverse reactions, or thyroid dysfunction with radioiodine-related implications. We also considered clinically relevant studies on drug interactions, isotope studies, and laboratory confounding. Results: The evidence base was methodologically heterogeneous, with renal safety as the predominant domain. Kidney injury after contrast-enhanced imaging in cancer patients appeared frequently multifactorial, supporting the broader concept of post-contrast acute kidney injury rather than automatic attribution to contrast alone. Hypersensitivity reactions to modern nonionic iodinated contrast media were generally uncommon, with severe reactions rare, although immune-modulating therapies may alter risk. Thyroid-related effects were usually transient but relevant in patients with thyroid autonomy and in differentiated thyroid carcinoma, where contrast exposure may affect scintigraphy and radioiodine planning. Conclusions: In oncology, iodinated contrast use requires individualized, field-specific risk stratification instead of reflexive avoidance.
Keywords: post-contrast acute kidney injury; contrast-induced nephropathy; hypersensitivity reactions; immune checkpoint inhibitors; thyroid dysfunction; differentiated thyroid carcinoma; drug interactions post-contrast acute kidney injury; contrast-induced nephropathy; hypersensitivity reactions; immune checkpoint inhibitors; thyroid dysfunction; differentiated thyroid carcinoma; drug interactions

Share and Cite

MDPI and ACS Style

Vasii, S.-O.; Crișan, F.-G.; Lazăr, S.-M.; Ioniță, C.; Iliescu, D.; Ioniță, I.; Malița, D.-C.; Voicu, M.; Voicu, A.; Udrescu, L. Iodinated Contrast Media in Oncologic CT: A Narrative Review of Safety, Risk Stratification, and Practical Considerations. Diagnostics 2026, 16, 1507. https://doi.org/10.3390/diagnostics16101507

AMA Style

Vasii S-O, Crișan F-G, Lazăr S-M, Ioniță C, Iliescu D, Ioniță I, Malița D-C, Voicu M, Voicu A, Udrescu L. Iodinated Contrast Media in Oncologic CT: A Narrative Review of Safety, Risk Stratification, and Practical Considerations. Diagnostics. 2026; 16(10):1507. https://doi.org/10.3390/diagnostics16101507

Chicago/Turabian Style

Vasii, Sabina-Oana, Florin-Gabriel Crișan, Sandra-Monica Lazăr, Claudiu Ioniță, Dan Iliescu, Ioana Ioniță, Daniel-Claudiu Malița, Mirela Voicu, Adrian Voicu, and Lucreția Udrescu. 2026. "Iodinated Contrast Media in Oncologic CT: A Narrative Review of Safety, Risk Stratification, and Practical Considerations" Diagnostics 16, no. 10: 1507. https://doi.org/10.3390/diagnostics16101507

APA Style

Vasii, S.-O., Crișan, F.-G., Lazăr, S.-M., Ioniță, C., Iliescu, D., Ioniță, I., Malița, D.-C., Voicu, M., Voicu, A., & Udrescu, L. (2026). Iodinated Contrast Media in Oncologic CT: A Narrative Review of Safety, Risk Stratification, and Practical Considerations. Diagnostics, 16(10), 1507. https://doi.org/10.3390/diagnostics16101507

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