Multicenter comparison of high concentration contrast agent iomeprol-400 with iso-osmolar iodixanol-320

Contrast enhancement and heart rate variation in coronary dual-source computed tomographic angiography

Cristoph R. Becker, Angelo Vanzulli, Christian Fink, Daniele De Faveri, Stefano Fedeli, Roberto Dore, Pietro Biondetti, Alex Kuettner, Martin Krix, Giorgio Ascenti

Research output: Contribution to journalArticle

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Abstract

Objectives: To compare a contrast agent with high iodine concentration with an iso-osmolar contrast agent for coronary dual-source computed tomography angiography (DS-CTA), and to assess whether the contrast agent characteristics may affect the diagnostic quality of coronary DS-CTA. Materials and Methods: Patients were randomized to receive either 80 mL of iodixanol-320 (Visipaque, GE Healthcare, Chalfont St. Giles, United Kingdom) or iomeprol-400 (Iomeron, Bracco Imaging SpA, Milan, Italy) at 5 mL/s. Mean, minimum, maximum heart rate, and its variation (max-min) were assessed during calcium scoring scan and coronary DS-CTA. Three off-site readers independently evaluated the image sets in terms of technical adequacy, reasons for inadequacy, vessel visualization, diagnostic confidence (based on a 5-point scale), and arterial contrast opacification in Hounsfield units (HUs). Results: Ninety-six patients were included in the final evaluation. No significant differences were observed for pre-and postdose heart rate values for iomeron-400 compared with iodixanol-320, and changes in heart rate variation were also not significantly different (-2.3 ± 11.7 vs.-2.5 ± 7.3 bpm, P > 0.1). Contrast measurements in all analyzed vessels were significantly higher for iomeprol-400 (mean, 391.5-441.4 HU) compared with iodixanol-320 (mean, 332.3-365.5 HU, all P ≤ 0.0038). There was no significant difference in qualitative visualization of coronary arteries (mean scores, 4.3-4.5 for iomeprol, 4.1-4.3 for iodixanol, P = 0.15-0.28), or in diagnostic confidence scores. HU were inversely correlated with the number of insufficiently opacified segments (all readers P ≤ 0.0006). Conclusions: The high-iodine concentration contrast medium iomeprol-400 demonstrated significant benefit for coronary arterial enhancement compared with the iso-osmolar contrast medium iodixanol-320 when administered at identical flow rates and volumes for coronary DS-CTA. In addition, higher enhancement levels were found to be associated with lower numbers of inadequately visualized segments. Finally, observed mean heart rate changes after intravenous contrast injection were generally small during the examination and comparable for both agents.

Original languageEnglish
Pages (from-to)457-464
Number of pages8
JournalInvestigative Radiology
Volume46
Issue number7
DOIs
Publication statusPublished - Jul 2011

Fingerprint

Contrast Media
Angiography
Heart Rate
Iodine
Intravenous Injections
Italy
iomeprol
iodixanol
Coronary Vessels
Calcium
Delivery of Health Care
Computed Tomography Angiography

Keywords

  • Coronary arteries
  • Dual-source computed tomography
  • Heart rate
  • Hounsfield units (HU)
  • Iodixanol
  • Iomeprol

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Multicenter comparison of high concentration contrast agent iomeprol-400 with iso-osmolar iodixanol-320 : Contrast enhancement and heart rate variation in coronary dual-source computed tomographic angiography. / Becker, Cristoph R.; Vanzulli, Angelo; Fink, Christian; De Faveri, Daniele; Fedeli, Stefano; Dore, Roberto; Biondetti, Pietro; Kuettner, Alex; Krix, Martin; Ascenti, Giorgio.

In: Investigative Radiology, Vol. 46, No. 7, 07.2011, p. 457-464.

Research output: Contribution to journalArticle

Becker, Cristoph R. ; Vanzulli, Angelo ; Fink, Christian ; De Faveri, Daniele ; Fedeli, Stefano ; Dore, Roberto ; Biondetti, Pietro ; Kuettner, Alex ; Krix, Martin ; Ascenti, Giorgio. / Multicenter comparison of high concentration contrast agent iomeprol-400 with iso-osmolar iodixanol-320 : Contrast enhancement and heart rate variation in coronary dual-source computed tomographic angiography. In: Investigative Radiology. 2011 ; Vol. 46, No. 7. pp. 457-464.
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abstract = "Objectives: To compare a contrast agent with high iodine concentration with an iso-osmolar contrast agent for coronary dual-source computed tomography angiography (DS-CTA), and to assess whether the contrast agent characteristics may affect the diagnostic quality of coronary DS-CTA. Materials and Methods: Patients were randomized to receive either 80 mL of iodixanol-320 (Visipaque, GE Healthcare, Chalfont St. Giles, United Kingdom) or iomeprol-400 (Iomeron, Bracco Imaging SpA, Milan, Italy) at 5 mL/s. Mean, minimum, maximum heart rate, and its variation (max-min) were assessed during calcium scoring scan and coronary DS-CTA. Three off-site readers independently evaluated the image sets in terms of technical adequacy, reasons for inadequacy, vessel visualization, diagnostic confidence (based on a 5-point scale), and arterial contrast opacification in Hounsfield units (HUs). Results: Ninety-six patients were included in the final evaluation. No significant differences were observed for pre-and postdose heart rate values for iomeron-400 compared with iodixanol-320, and changes in heart rate variation were also not significantly different (-2.3 ± 11.7 vs.-2.5 ± 7.3 bpm, P > 0.1). Contrast measurements in all analyzed vessels were significantly higher for iomeprol-400 (mean, 391.5-441.4 HU) compared with iodixanol-320 (mean, 332.3-365.5 HU, all P ≤ 0.0038). There was no significant difference in qualitative visualization of coronary arteries (mean scores, 4.3-4.5 for iomeprol, 4.1-4.3 for iodixanol, P = 0.15-0.28), or in diagnostic confidence scores. HU were inversely correlated with the number of insufficiently opacified segments (all readers P ≤ 0.0006). Conclusions: The high-iodine concentration contrast medium iomeprol-400 demonstrated significant benefit for coronary arterial enhancement compared with the iso-osmolar contrast medium iodixanol-320 when administered at identical flow rates and volumes for coronary DS-CTA. In addition, higher enhancement levels were found to be associated with lower numbers of inadequately visualized segments. Finally, observed mean heart rate changes after intravenous contrast injection were generally small during the examination and comparable for both agents.",
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T2 - Contrast enhancement and heart rate variation in coronary dual-source computed tomographic angiography

AU - Becker, Cristoph R.

AU - Vanzulli, Angelo

AU - Fink, Christian

AU - De Faveri, Daniele

AU - Fedeli, Stefano

AU - Dore, Roberto

AU - Biondetti, Pietro

AU - Kuettner, Alex

AU - Krix, Martin

AU - Ascenti, Giorgio

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N2 - Objectives: To compare a contrast agent with high iodine concentration with an iso-osmolar contrast agent for coronary dual-source computed tomography angiography (DS-CTA), and to assess whether the contrast agent characteristics may affect the diagnostic quality of coronary DS-CTA. Materials and Methods: Patients were randomized to receive either 80 mL of iodixanol-320 (Visipaque, GE Healthcare, Chalfont St. Giles, United Kingdom) or iomeprol-400 (Iomeron, Bracco Imaging SpA, Milan, Italy) at 5 mL/s. Mean, minimum, maximum heart rate, and its variation (max-min) were assessed during calcium scoring scan and coronary DS-CTA. Three off-site readers independently evaluated the image sets in terms of technical adequacy, reasons for inadequacy, vessel visualization, diagnostic confidence (based on a 5-point scale), and arterial contrast opacification in Hounsfield units (HUs). Results: Ninety-six patients were included in the final evaluation. No significant differences were observed for pre-and postdose heart rate values for iomeron-400 compared with iodixanol-320, and changes in heart rate variation were also not significantly different (-2.3 ± 11.7 vs.-2.5 ± 7.3 bpm, P > 0.1). Contrast measurements in all analyzed vessels were significantly higher for iomeprol-400 (mean, 391.5-441.4 HU) compared with iodixanol-320 (mean, 332.3-365.5 HU, all P ≤ 0.0038). There was no significant difference in qualitative visualization of coronary arteries (mean scores, 4.3-4.5 for iomeprol, 4.1-4.3 for iodixanol, P = 0.15-0.28), or in diagnostic confidence scores. HU were inversely correlated with the number of insufficiently opacified segments (all readers P ≤ 0.0006). Conclusions: The high-iodine concentration contrast medium iomeprol-400 demonstrated significant benefit for coronary arterial enhancement compared with the iso-osmolar contrast medium iodixanol-320 when administered at identical flow rates and volumes for coronary DS-CTA. In addition, higher enhancement levels were found to be associated with lower numbers of inadequately visualized segments. Finally, observed mean heart rate changes after intravenous contrast injection were generally small during the examination and comparable for both agents.

AB - Objectives: To compare a contrast agent with high iodine concentration with an iso-osmolar contrast agent for coronary dual-source computed tomography angiography (DS-CTA), and to assess whether the contrast agent characteristics may affect the diagnostic quality of coronary DS-CTA. Materials and Methods: Patients were randomized to receive either 80 mL of iodixanol-320 (Visipaque, GE Healthcare, Chalfont St. Giles, United Kingdom) or iomeprol-400 (Iomeron, Bracco Imaging SpA, Milan, Italy) at 5 mL/s. Mean, minimum, maximum heart rate, and its variation (max-min) were assessed during calcium scoring scan and coronary DS-CTA. Three off-site readers independently evaluated the image sets in terms of technical adequacy, reasons for inadequacy, vessel visualization, diagnostic confidence (based on a 5-point scale), and arterial contrast opacification in Hounsfield units (HUs). Results: Ninety-six patients were included in the final evaluation. No significant differences were observed for pre-and postdose heart rate values for iomeron-400 compared with iodixanol-320, and changes in heart rate variation were also not significantly different (-2.3 ± 11.7 vs.-2.5 ± 7.3 bpm, P > 0.1). Contrast measurements in all analyzed vessels were significantly higher for iomeprol-400 (mean, 391.5-441.4 HU) compared with iodixanol-320 (mean, 332.3-365.5 HU, all P ≤ 0.0038). There was no significant difference in qualitative visualization of coronary arteries (mean scores, 4.3-4.5 for iomeprol, 4.1-4.3 for iodixanol, P = 0.15-0.28), or in diagnostic confidence scores. HU were inversely correlated with the number of insufficiently opacified segments (all readers P ≤ 0.0006). Conclusions: The high-iodine concentration contrast medium iomeprol-400 demonstrated significant benefit for coronary arterial enhancement compared with the iso-osmolar contrast medium iodixanol-320 when administered at identical flow rates and volumes for coronary DS-CTA. In addition, higher enhancement levels were found to be associated with lower numbers of inadequately visualized segments. Finally, observed mean heart rate changes after intravenous contrast injection were generally small during the examination and comparable for both agents.

KW - Coronary arteries

KW - Dual-source computed tomography

KW - Heart rate

KW - Hounsfield units (HU)

KW - Iodixanol

KW - Iomeprol

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