ABSTRACT
The purpose of this study was to determine the influence of two different iodine concentrations of the non-ionic contrast agent, Iomeprol, on contrast enhancement in multislice CT (MSCT) of the pancreas. To achieve this MSCT of the pancreas was performed in 50 patients (mean age 57+/-14 years) with suspected or known pancreatic tumours. The patients were randomly assigned to group A (n=25 patients) or group B (n=25 patients). There were no statistically significant differences in age, height or weight between the patients of the two groups. The contrast agent, Iomeprol, was injected with iodine concentrations of 300 mg ml(-1) in group A (130 ml, injection rate 5 ml s(-1)) and 400 mg ml(-1) in group B (98 ml, injection rate 5 ml s(-1)). Arterial and portal venous phase contrast enhancement (HU) of the vessels, organs, and pancreatic masses were measured and a qualitative image assessment was performed by two independent readers. In the arterial phase, Iomeprol 400 led to a significantly greater enhancement in the aorta, superior mesenteric artery, coeliac trunk, pancreas, pancreatic carcinomas, kidneys, spleen and wall of the small intestine than Iomeprol 300. Portal venous phase enhancement was significantly greater in the pancreas, pancreatic carcinomas, wall of the small intestine and portal vein with Iomeprol 400. The two independent readers considered Iomeprol 400 superior over Iomeprol 300 concerning technical quality, contribution of the contrast agent to the diagnostic value, and evaluability of vessels in the arterial phase. No differences were found for tumour delineation and evaluability of infiltration of organs adjacent to the pancreas between the two iodine concentrations. In conclusion the higher iodine concentration leads to a higher arterial phase contrast enhancement of large and small arteries in MSCT of the pancreas and therefore improves the evaluability of vessels in the arterial phase.
Subject(s)
Contrast Media , Iodine Radioisotopes , Iodine/administration & dosage , Iopamidol/analogs & derivatives , Pancreatic Neoplasms/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Aged , Cohort Studies , Contrast Media/chemistry , Female , Humans , Iopamidol/chemistry , Male , Middle AgedABSTRACT
RATIONALE AND OBJECTIVES: To evaluate iomeprol, a new nonionic iodinated contrast medium, as a contrast agent for myelography and to compare it with iopamidol, iohexol, and iotrolan. METHODS: An extensive clinical program was conducted on more than 600 patients to assess iomeprol's pharmacokinetics, tolerability, safety, and efficacy after intrathecal injection. RESULTS: Pharmacokinetics study results showed that after intrathecal administration iomeprol is completely absorbed from the cerebrospinal fluid compartment; once absorbed into the systemic circulation, it is rapidly excreted, unmetabolized, by glomerular filtration. Dose-finding studies showed that the opacification produced by iomeprol depends on the injected dose. Although a dose-dependent increase in efficacy was observed, no differences in neurotolerability and safety were detected between the doses tested. Doses of iomeprol greater than 3 g I did not cause a greater incidence of adverse events and produced significantly better contrast efficacy. Comparative clinical trials showed that iomeprol and iopamidol, iohexol, and iotrolan always provided adequate opacification of the subarachnoid space, both in conventional myelography and myelo-CT, with adequate delineation of normal structures and pathologic processes. No serious adverse events occurred up to a total dose of 4.5 g I. No differences between the agents with regard to tolerance, adverse events, and effects on vital signs, physical examination, and neurologic examination were observed. CONCLUSIONS: Iomeprol is safe and effective and can be recommended for myelography and myelo-CT.
Subject(s)
Contrast Media , Iohexol , Iopamidol/analogs & derivatives , Myelography , Tomography, X-Ray Computed , Triiodobenzoic Acids , Adult , Aged , Double-Blind Method , Humans , Iopamidol/pharmacokinetics , Male , Middle Aged , Pilot ProjectsABSTRACT
PURPOSE: To assess the tolerability of the newly developed nonionic contrast medium Iomeprol in pediatric patients. MATERIAL AND METHODS: A total of 438 patients (1 day-17 years) were enrolled in open-label phase III studies with Iomeprol in the most important radiologic, urologic, and cardiologic indications. Iomeprol was tested in five concentrations ranging from isotonic solutions of 150 mg iodine/ml up to 400 mg iodine/ml. Half of the patients were younger than 3 years. RESULTS: Apart from the mostly slight sensations of heat, pain, and taste, the following adverse events were observed independently of a causal relationship to the test compound: vomiting (1.8%), rise in blood pressure (1.8%), and restlessness (1.1%). The respective incidence of all other adverse events was below 1%. CONCLUSION: Iomeprol is a suitable and well-tolerated nonionic contrast medium for use in pediatric examinations.
