Toxicity of MRI and CT contrast agents

Expert Opinion on Drug Metabolism and Toxicology

Volumn 5, Issue 4, 2009, Pages 403-416

  Hasebroock, Kendra M ^a   Serkova, Natalie J ^a  

^a UNIVERSITY OF COLORADO   (United States)

Author keywords

Chronic kidney disease; Contrast induced nephropathy; CT; Estimated glomerular filtration rate; Gadolinium; Iodinated contrast agents; MRI; Nephrogenic systemic fibrosis

Indexed keywords

ACETAZOLAMIDE; ACETYLCYSTEINE; AMINOPHYLLINE; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CISPLATIN; CONTRAST MEDIUM; CYCLOSPORIN; DIURETIC AGENT; FUROSEMIDE; GADOBENATE DIMEGLUMINE; GADODIAMIDE; GADOLINIUM; GADOLINIUM CHELATE; GADOLINIUM PENTETATE; GADOTERATE MEGLUMINE; GADOTERIDOL; GENTAMICIN; HYDRALAZINE; INTERFERON; IODINATED CONTRAST MEDIUM; IODIXANOL; IOHEXOL; IOMEPROL; IOPAMIDOL; IRINOTECAN; NONSTEROID ANTIINFLAMMATORY AGENT; RADIOACTIVE IODINE; SPIRONOLACTONE; THEOPHYLLINE; UNINDEXED DRUG; VANDETANIB;

CLINICAL TRIAL; COMPUTER ASSISTED TOMOGRAPHY; CONTRAST ENHANCEMENT; CONTRAST INDUCED NEPHROPATHY; DRUG EXCRETION; DRUG HALF LIFE; DRUG TUMOR LEVEL; HUMAN; INCIDENCE; NEPHROGENIC SYSTEMIC FIBROSIS; NONHUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; PHYSICAL CHEMISTRY; RECOMMENDED DRUG DOSE; REVIEW; RISK ASSESSMENT;

ANIMALS; CONTRAST MEDIA; HUMANS; MAGNETIC RESONANCE IMAGING; RISK FACTORS; TOMOGRAPHY, X-RAY COMPUTED;

EID: 67649250007     PISSN: 17425255     EISSN: None     Source Type: Journal    
DOI: 10.1517/17425250902873796     Document Type: Review

References (88)

1. Vaughan CL, Mayosi BM. Origins of computed tomography. Lancet 2007;369:1168 (Pubitemid 46527874)
2. Bragg DG, Rubin P, Hricak H. "Imaging strategies for oncologic diagnosis and multidisciplinary treatment" in "Oncologic Imaging". Second Edition. Bragg, Rubin, Hricak, W.B. Saunders Company, Philadelphia, 2002. p. 3-8
3. Weissleder R, Mahmood U. Molecular imaging. Radiology 2001;219:316-333 • This is an excellent review which gives a detailed report on novel scientific applications and technological advances in the area of radiological sciences and imaging modalities. (Pubitemid 32336342)
4. Tidwell AS, Jones JC. Advanced imaging concepts: a pictorial glossary of CT and MRI technology. Clin Tech Small Anim Pract 1999;14:65-111
5. Hylton N. Dynamic contrast-enhanced magnetic resonance imaging as an imaging biomarker. J Clin Oncol 2006;24:3293-3298 • Principles of dynamic contrast-enhanced MRI, pharmacokinetic modeling and the application for anti-vascular targeted therapies in oncology are discussed in this review. (Pubitemid 46622069)
6. Choyke PL, Kobayashi H. Functional magnetic resonance imaging of the kidney using macromolecular contrast agents. Abdom Imaging 2006;31:224-231
7. Miles KA, Young H, Chica SL, Esser PD. Quantitative contrast-enhanced computed tomography: is there a need for system calibration? Eur Radiol 2007;17:919-926
8. Bisdas S, Medov L, Baghi M, et al. A comparison of tumor perfusion assessed by deconvolution-based analysis of dynamic contrast-enhanced CT and MR imaging in patients with squamous cell carcinoma of the upper aerodigetsive tract. Eur Radiol 2008;18:843-850
9. Bolondi L, Correas JM, Lencioni R, et al. New perspectives for the use of contrast-enhanced liver ultrasound in clinical practice. Dig Liver Dis 2007;39:187-195 (Pubitemid 46117926)
10. Burrell SC, Van den Abbeele AD. 2-Deoxy-2-[F-18]fluoro-D-glucose-positron emission tomography of the head and neck: an atlas of normal uptake and variants. Mol Imaging Biol 2005;7:244-256 (Pubitemid 41348867)
11. Crawford EJ, Christman D, Atkins H, et al. Scintigraphy with positron-emitting compounds - I. Carbon-11 labeled thymidine and thymidylate. Int J Nucl Med Biol 1978;5:61-69 (Pubitemid 9031127)
12. Nelson SJ. Magnetic resonance spectroscopic imaging. IEEE Eng Med Biol Magn 2004;23:30-39 (Pubitemid 39545965)
13. Glunde K, Serkova NJ. Therapeutic targets and biomarkers identified in cancer choline phospholipid metabolism. Pharmacogenomics 2006;7:1109-1123 (Pubitemid 44644788)
14. Beer AJ, Grosu AL, Carlsen J, et al. [18F] Galacto-RGD positron emission tomography for imaging of alphavbeta3 expression on the neurovasculature in patients with squamous cell carcinoma of the head and neck. Clin Cancer Res 2007:13:6610-6616 (Pubitemid 350206795)
15. Artemov D, Mori N, Okollie B, Bhujwalla ZM. MR molecular imaging of her-2/neu receptor in breast cancer cells using targeted iron oxide nanoparticles. Magn Reson Med 2003;49:403-408 (Pubitemid 36262806)
16. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function - measured and estimated glomerular filtration rate. N Engl J Med 2006;354:2473-2483 • Basics of mathematic and physiological interpretations of kidney functions are provided (Pubitemid 43855050)
17. Thomsen HS. Imaging patients with chronic kidney disease: CIN or NSF? Radiol Med 2007;112:621-625 •• An excellent guide for practicing radiologists, clinicians and medical physicists in conducting contrast-enhanced CT and MRI studies in renally impaired patients.
18. Tumlin J, Stacul F, Adam A, et al. Pathophysiology of contrast-induced nephropathy. Am J Cardiol 2006;98:14K-20K •• Principles and mechanisms of iodinated contrast agent nephrotoxicity are discussed. (Pubitemid 44292090)
19. Thomsen HS, Morcos SK, Barrett BJ. Contrast-induced nephropathy: the wheel has turned 360 degrees. Acta Radiol 2008;49:646-657 •• A detailed overview on adverse effects of Gd-enhanced MRI.
20. Thomsen HS, Marckmann, Logager VB. Enhanced computed tomography or magnetic resonance imaging: a choice between contrast medium-induced nephropathy and nephrogenic systemic fibrosis? Acta Radiol 2007;48:593-596 • Provides pro- and contra- for use of iodinated versus Gd-based clinical protocols in renally compromised patients.
21. Knopp EA, Cowper SE. Nephrogenic systemic fibrosis: early recognition and treatment. Semin Dial 2008;21:123-128
22. Davidson CJ, Laskey WK, Hermiller JB, et al. Randomized trial of contrast media utilization in high-risk PTCA: the COURT trial. Circulation 2000;101:2172-2177 (Pubitemid 30253046)
23. Aspelin P, Aubry P, Fransson SG, et al. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med 2003;348:491-499 (Pubitemid 36159884)
24. Solomon RJ, Natarajan MK, Doucet S, et al. Cardiac angiography in renally impaired patients (CARE) study: a randomized double-blind trial of contrast-induced nephropathy in patients with chronic kidney disease. Circulation 2007;115:3189-3196 (Pubitemid 47012233)
25. Esplugas E, Cequier A, Gomez-Hospital JA, et al. Comparative tolerability of contrast media used for coronary interventions. Drug Saf 2002;25:1079-1098 (Pubitemid 36009060)
26. Mansfield P. Snapshot magnetic resonance imging (Nobel lecture). Angew Chem Int Ed Engl 2004;43:5456-5464 (Pubitemid 39486659)
27. Thomassin-Naggara I, Bazot M, Darai E, et al. Epithelial ovarian tumors: values of dynamic contrast-enhanced MR imaging and correlation with tumor angiogenesis. Radiology 2008;248:148-159
28. Zahara MA, Hollingsworth KG, Sala E, et al. Dynamic contrast-enhanced MRI as a predictor of tumor response to radiotherapy. Lancet Oncol 2007;8:63-74 (Pubitemid 44943092)
29. Troiani T, Serkova NJ, Gustafson DL, et al. Investigation of two dosing schedules of Vandetanib (ZD6474), an inhibitor of VEGFR and EGFR signaling, in combination with Irinotecan in a human colon cancer xenograft model. Clin Cancer Res 2007;13:6450-6458
30. Boss A, Martirosian P, Gehrmann M, et al. Quantitative assessment of glomerular filtration rat with gadolinium slope clearance measurements: a Phase I trial. Radiology 2007;242:783-790 (Pubitemid 46310091)
31. Mendichovszky I, Pedersen M, Frokiaer J, et al. How accurate is dynamic contrast-enhanced MRI in the assessment of renal glomerular filtration rate? A critical appraisal. J Magn Reson Imaging 2008;27:925-931 • This article described physiological principles of Gd kinetics to assess kidney functions.
32. Dawson P. Functional imaging in CT. Eur J Radiol 2006;60:331-340 (Pubitemid 44779076)
33. Thomsen HS, Morcos AK. Risk of contrast-medium0induced nephropathy in high risk patients undergoing MDCT - a pooled analysis of two randomized trials. Eur Radiol 2008[Epub ahead of print] •• This retrospective study compares various contrast agent formulations for the risk of developing nephropathy.
34. Thomsen HS, Morcos SK and members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Contrast media and metformin. Guidelines to distinguish the risk of lactic acidosis in non-insulin dependent diabetics after administration of contrast media. Eur Radiol 1999;9:738-740
35. Singh J, Daftary A. Iodinated contrast media and their adverse reactions. J Nucl Med Technol 2008;36:69-74 (Pubitemid 351879833)
36. Solomon R, DuMouchel W. Contrast media and nephropathy. Finding from systematic analysis and Food and Drug Administration reports of adverse effects. Invest Radiol 2006;41:651-660
37. Nguyen S, Suranyi P, Ravenel JG, et al. Iso-osmolarity versus low-osmolarity iodinated contrast medium at intravenous contrast-enhanced CT: effect on kidney function. Radiology 2008;248:97-105 • Comparison of physiochemical properties of CT contrast agents and their nephrotoxic potential.
38. Wang CL, Cohan RH, Ellis JH, et al. Frequency, management, and outcome of extravasation of nonionic iodinated contrast medium in 69,657 intravenous injections. Radiology 2007;243:80-87 (Pubitemid 46579697)
39. Thomsen HS, Morcos SK, and the Investigators in the Abdominal Computed Tomography (ACTIVE) trials. The ACTIVE trial: comparison of the effects on renal function of iomeprol-400 and iodixanol-320 in patients with chronic kidney disease undergoing abdominal computed tomography. Invest Radiol 2008;43:170-178
40. Solomon R. The role of osmolarity in the incidence of contrast-induced nephropathy: a systematic review of angiographic contrast media at high risk patients. Kidney Int 2005;68:2256-2263 •• Another systematic comparison of physiochemical properties of CT contrast agents and their nephrotoxic potential. (Pubitemid 43117802)
41. Liss P, Persson PB, Hansell P, Lagerqvist B. Renal failure in 57,925 patients undergoing coronary procedures using iso-osmolas or low-osmolar contrast media. Kidney Int 2006;70:1811-1817 (Pubitemid 44684813)
42. Kuhn MJ, Chen N, Sahani DV, et al. The PREDICT study: a randomized double-blind comparison of contrast-induced nephropathy after low- or isoosmolar contrast agent exposure. Am J Roentgenol 2008;191:151-157 (Pubitemid 351955220)
43. Weisbord SD, Mor MK, Resnick AL, et al. Incidence and outcomes of contrast-induced AKI following computed tomography. Clin J Am Soc Nephrol 2008;3:1274-1281
44. Davidson C, Stacul F, McCullough PA, et al. Contrast medium use. Am J Cardiol 2006;98:42K-58K (Pubitemid 44292093)
45. Duan S, Zhou X, Liu F, et al. Comparative cytotoxicity of high-osmolar and low-osmolar contrast media on HKCs in vitro. J Nephrol 2006;19:717-724 (Pubitemid 46415975)
46. Haller C, Hizoh I. The cytotxicity of iodinated radiocontrast agents on renal cells in vitro. Invest Radiol 2004;39:149-154 (Pubitemid 38263921)
47. Morcos SK, Thomsen HS. Adverse reactions to iodinated contrast media. Eur Radiol 2001;11:1267-1275 (Pubitemid 32755608)
48. Cochran ST. Anaphylactoid reactions to radiocontrast media. Curr Allergy Asthma Rep 2005;5:28-31 (Pubitemid 40310254)
49. Cochran ST, Bomyea K, Sayre JW. Trends in adverse events after iv administration of contrast media. Am J Roentgenol 2001;176:1385-2001 (Pubitemid 32510247)
50. Wang CL, Cohan RH, Ellis JH, et al. Frequency, outcome, and appropriateness of treatment of nonionic iodinated contrast media reactions. Am J Roentgenol 2008;191:409-415
51. Dillman JR, Strouse PJ, Ellis JH, et al. Incidence and severity of acute allergic-like reactions to iv nonionic iodinated contrast material in children. Am J Roentgenol 2007;188:1643-1647 (Pubitemid 46866870)
52. Dawson P. "Pharmacokinetics of water-soluble iodinated X-ray contrast agents" in "Textbook of Contrast Media". First Edition. Dawson, Cosgrove, Grainger, W.B. by Isis Medical Media Ltd, Oxford, 1999. p. 61-74
53. Morcos SK, Thomsen HS, Exley CM, and Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR). Contrast media: interactions with other drugs and clinical tests. Eur Radiol 2005;15:1463-1468
54. Bagshaw SM, Culleton BF. Contrast-induced nephropathy: epidemiology and prevention. Minerva Cardioangiol 2006;54:109-129 (Pubitemid 43343117)
55. Van Praet JT, DeVriese AS. Prevention of contrast-induced nephropathy: a clinical review. Curr Opin Nephrol Hypertens 2007;16:336-347 • Treatment options to prevent and treat CIN are discussed. (Pubitemid 46944332)
56. Pannu N, Wiebe N, Tonelli M, et al. Prophylaxis strategies for contrast-induced nephropathy. JAMA 2006;295:2765-2779 (Pubitemid 43920730)
57. Budhiraja P, Chen Z, Popovtzer M. Sodium bicarbonate versus normal saline for protection against contrast nephropathy. Ren Fail 2009;31:118-123
58. Pannu N, Manns B, Lee H, Tonelli M. Systematic review of the impact of N-acetylcysteine on contrast nephropathy. Kidney Int 2004;65:1366-1374 (Pubitemid 38406975)
59. Bagshaw SM, Ghali WA. Acetylcysteine for prevention of contrast-induced nephropathy after intravascular angiography: a systematic review and meta-analysis. BMC Med biol 2004;2:38-50 (Pubitemid 40251694)
60. Bagshaw SM, Ghali WA. Theophylline for prevention of contrast-induced nephropathy. Arch Intern Med 2005;165:1087-1093
61. Ix JH, McCulloch CE, Chertow GM. Theophylline for the prevention of radiocontrast nephropathy: a meta-analysis. Nephrol Dial Transplant 2004;19:2747-2753 (Pubitemid 39480968)
62. Cruz DN, Perazella MA, Bellomo R, et al. Extracorporeal blood purification therapies for prevention of radiocontrast-induced nephropathy: a systematic review. Am J Kidney Dis 2006;48:361-371 (Pubitemid 44262427)
63. La Manna G, Pancaldi L, Dalmastri V, et al. Post-coronography application of continuous veno-venous hemofiltration in the prevention of contrast nephropathy in patients with complex multisystem deficiency. In Vivo 2008;22:123-129
64. Marckmann P, Skov L, Rossen K, et al. Nephrogenic systemic fibrosis: suspected causative role of gadodiamide used for contrast-enhanced magnetic resonance imaging. J Am Soc Nephrol 2006;17:2359-2362 (Pubitemid 44300951)
65. Colletti PM. Nephrogenic systemic fibrosis and gadolinium: a perfect storm. Am J Roentgenol 2008;191:1-4
66. Bellin MF, Van Der Molen AJ. Extracellular gadolinium-based contrast media: an overview. Eur J Radiol 2008;66:160-167 • Physiochemical properties of Gd chelates are provided.
67. Hermann P, Kotek J, Kubicek V, Lukes I. Gadolinium (III) complexes as MRI contrats agents: ligand design and properties of the complexes. Dalton Trans 2008;23:3027-3047
68. Pierrard JC, Rimbault J, Aplincourt M, et al. New synthesis of a high molecular weight ligand derived from dota: thermodynamic stability of the MRI contrast agent formed with gadolinium. Contrast Media Mol Imaging 2008;3:243-252
69. Bongartz G. Imaging in the time of NFD/ NSF: do we have to change our routines concerning renal insufficiency? MAGMA 2007;20:57-62
70. Runge VM. Safety of magnetic resonance contrast media. Top Magn Reson Imaging 2001;12:309-314 (Pubitemid 33031400)
71. Idee JM, Port M, Raynal I, et al. Clinical and biological consequences of transmetallation induced by contrast agents for magnetic resonance imaging: a review. Fund Clin Pramacol 2006;20:563-576 (Pubitemid 44760175)
72. Perazella MA, Radby RA. Gadolinium use in patients with kidney disease: a cause for concern. Semin Dial 2007;20:179-185
73. Reilly RF. Risk for nephrogenic systemic fibrosis with gadoteridol (ProHance) in patients who are on long-term hemodialysis. Clin J Am Soc Nephrol 2008;3:747-751
74. Wertman R, Altun E, Martin DR, et al. Rick of nephrogenic systemic fibrosis: evaluation of gadolinium chelate contrast agents at four American universities. Radiology 2008;248:799-806
75. Thomsen HS, Marckmann P, Logager VB. Nephrogenic systemic fibrosis (NSF): a late adverse reaction to some of the gadolinium based contrast agents. Cancer Imaging 2007;7:130-137 (Pubitemid 47570591)
76. Kanal E, Broome DR, Martin DR, Thomsen HS. Response to the FDA's May 23, 2007, nephrogenic systemic fibrosis update. Radiology 2008;246:11-14
77. Rydahl C, Thomsen HS, Marckmann P. High prevalence of nephrogenic systemic fibrosis in chronic failure patients exposed to gadodiamide, a gadolinium-containing magnetic resonance contrast agent. Invest Radiol 2008;43:141-144
78. Peak AS, Sheller A. Risk factors for developing gadolinium-induced nephrogenic systemic fibrosis. Ann Pharmacother 2007;41:1481-1485 (Pubitemid 47311368)
79. Wiginton CD, Kelly B, Oto A, et al. Gadolinium-based ccontrast exposure, nephrogenic systemic fibrosis, and gadolinium detection in tissue. Am J Roentgenol 2008;190:1060-1068 (Pubitemid 351571526)
80. Shellock FG, Spinazzi A. MRI safety update 2008: part 1, MRI contrast agents and nephrogenic systemic fibrosis. Am J Roentgenol 2008;191:1-11 •• An excellent review on NSF prevalence in various Gd-based contrast agents.
81. Shellock FG, Spinazzi A. MRI safety update 2008: part 2, screening patients for MRI. Am J Roentgenol 2008;191:1-10
82. Dillman JR, Ellis JH, Cohan RH, et al. Allergic-like breakthrough reactions to gadolinium contrast agents after corticosteroid and antihistamine premedication. Am J Roentgenol 2008;190:187-190
83. Dillman JR, Ellis JH, Cohan RH, et al. Frequency and severity of acute allergic-like reactions to gadolinium-containing iv contrast media in children and adults. Am J Roentgenol 2007;189:1533-1538 (Pubitemid 350174833)
84. Thomsen HS. Is NSF only the tip of the "gadolinium toxicity: iceberg. J Magn Reson Imaging 2008;28:284-6
85. Li A, Wong CS, Wong NK, et al. Acute adverse reactions to magnetic resonance contrast media-gadolinium chelates. Br J Radiol 2006;79:368-371 (Pubitemid 43676338)
86. Linfert DR, Schell JO, Fine DM. Treatment of nephrogenic systemic fibrosis: limited options but hope for the future. Semin Dial 2008;21:155-159
87. Kadiyala D, Roer DA, Perazella MA. Nephrogenic systemic fibrosis associated with gadoversetamid e exposure: Treatment with sodium thiosulfate. Am J Kidney Dis 2009;53:133-137
88. Chung L, Fiorentino DF, BenBarak MJ, et al. Molecular framework for response to imatinib mesylate in systemic sclerosis. Arthritis Rheum 2009;60:584-591