Waiting times between examinations with intravascularly administered contrast media: a review of contrast media pharmacokinetics and updated ESUR Contrast Media Safety Committee guidelines.

Aart J van der Molen, Ilona A Dekkers, Remy W F Geenen, Marie-France Bellin, Michele Bertolotto, Torkel B Brismar, Jean-Michel Correas, Gertraud Heinz-Peer, Andreas H Mahnken, Carlo C Quattrocchi, Alexander Radbruch, Peter Reimer, Giles Roditi, Laura Romanini, Carmen Sebastià, Fulvio Stacul, Olivier Clement

Journal: European radiology 2024;34(4):2512-2523

PMID: 37823923

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Abstract

The pharmacokinetics of contrast media (CM) will determine how long safe waiting intervals between successive CT or MRI examinations should be. The Contrast Media Safety Committee has reviewed the data on pharmacokinetics of contrast media to suggest safe waiting intervals between successive contrast-enhanced imaging studies in relation to the renal function of the patient. CLINICAL RELEVANCE STATEMENT: Consider a waiting time between elective contrast-enhanced CT and (coronary) angiography with successive iodine-based contrast media administrations in patients with normal renal function (eGFR > 60 mL/min/1.73 m) of optimally 12 h (near complete clearance of the previously administered iodine-based contrast media) and minimally 4 h (if clinical indication requires rapid follow-up). KEY POINTS: • Pharmacokinetics of contrast media will guide safe waiting times between successive administrations. • Safe waiting times increase with increasing renal insufficiency. • Iodine-based contrast media influence MRI signal intensities and gadolinium-based contrast agents influence CT attenuation.

Address: Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.; Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands.; Department of Radiology, University Paris Saclay, AP-HP, University Hospital Bicêtre, BioMaps, Le Kremlin-Bicêtre, France.; Department of Radiology, University Hospital Trieste, Trieste, Italy.; Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden.; AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Université de Paris, Paris, France.; Department of Radiology, Landesklinikum St Pölten, St Pölten, Austria.; Department of Diagnostic and Interventional Radiology, Marburg University Hospital, Marburg, Germany.; Centre for Medical Sciences - CISMed, University of Trento, Trento, Italy.; Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany.; Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany.; Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK.; Department of Radiology, ASST Cremona, Cremona, Italy.; Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain.; Department of Radiology, Ospedale Maggiore, Trieste, Italy.; AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Université de Paris, 20 Rue LeBlanc, 75015, Paris, France. [email protected].

DOI: 10.1007/s00330-023-10085-5