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Ultra-low iodine concentrations iso-attenuating with diagnostic 0.5M gadolinium in endovascular procedures to minimize the risk of contrast nephropathy: A phantom study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
2015 (English)In: European Journal of Radiology, ISSN 0720-048X, E-ISSN 1872-7727, Vol. 84, no 6, 1068-1074 p.Article in journal (Refereed) Published
Abstract [en]

PURPOSE:

To establish the concentrations of iodine contrast media (I-CM) iso-attenuating with 0.5M gadolinium contrast media (Gd-CM), regarded diagnostic in catheter angiography and vascular interventions in azotemic patients, at various X-ray tube potentials with correlation to skin radiation dose.

MATERIALS AND METHOD:

20-mL syringes filled with 30, 40, 50, 70 and 90mgI/mL, 0.5M Gd-CM and air were placed in a water-equivalent phantom and exposed at about 50, 60, 70, 80 and 90kV in an X-ray angiographic system. Relative contrast between the contrast materials and the background phantom material was measured on a PACS workstation. Radiation entrance dose, measured with a dose meter and estimated from the dose-area-product (DAP), was adjusted for radiation backscatter to simulate absorbed skin dose.

RESULT:

The iodine concentrations 30, 40, 50, 70 and 90mg/mL resulted in the same relative contrast as 0.5M gadolinium at 53, 57, 62, 71 and 85kVp, respectively. Air had lower relative contrast than all iodine concentrations at all kVp-settings except for 30mgI/mL above 84kVp. The measured skin radiation dose was less than 1mGy per exposure at all kVp-settings, and around 25-30% lower than the dose estimations derived from the angiographic system's in-built DAP meter.

CONCLUSION:

Low-kilovoltage X-ray technique and ultra-low concentrations of I-CM iso-attenuating with 0.5M Gd-CM may be utilizable in peripheral arteriography and endovascular interventions, to minimize the total CM-dose to avoid CIN in azotemic patients.

Place, publisher, year, edition, pages
2015. Vol. 84, no 6, 1068-1074 p.
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-251297DOI: 10.1016/j.ejrad.2015.03.014ISI: 000354027400009PubMedID: 25842009OAI: oai:DiVA.org:uu-251297DiVA: diva2:805253
Available from: 2015-04-15 Created: 2015-04-15 Last updated: 2017-12-04Bibliographically approved

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Swanberg, JakobNyman, Rickard S

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