A comparison of the efficacy and safety of iopamidol-370 and iodixanol-320 in patients undergoing multidetector-row computed tomography

Dushyant V. Sahani, Gilles Soulez, Ke Min Chen, Luigi Lepanto, Jian Rong Xu, Rendon C. Nelson, Luigi Grazioli, Angelo Vanzulli, Jay Heiken

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

OBJECTIVES: To prospectively compare the effects on heart rate (HR) and contrast enhancement efficacy of iopamidol-370 and iodixanol-320 in contrast-enhanced, multidetector-row computed tomography (CE-MDCT). METHODS: IMPACT is a multicenter, double-blind study involving 166 patients undergoing CE-MDCT of the liver (n = 121) or peripheral arteries (n = 45) randomized to receive equi-iodine doses (40 gI) of iopamidol-370 or iodixanol-320 intravenous at 4 mL/s. CE-MDCT was performed using 16-MDCT scanners according to predefined imaging protocols. HR was measured with the patient in the supine position before and continuously for 5 minutes after contrast medium administration. Mean and peak increases in HR and the proportion of subjects with predefined HR increases (>5 to <10, 10 to <15, 15 to <20, >20 bpm) were compared in the 2 populations. Liver images were assessed by 2 independent, blinded readers for contrast enhancement [Hounsfield unit (HU)], using predefined regions-of-interest during the arterial and portal-venous phase of enhancement. RESULTS: Effects on HR: Eighty-four subjects received iopamidol-370 whereas 82 received iodixanol-320. Mean age, gender distribution, weight, total iodine dose, dose/body weight, concomitant medications and use of β-blockers were comparable in the 2 groups. Mean baseline HR was similar in the 2 groups (iopamidol-370: 72.3 ± 12.5 bpm; iodixanol-320: 74.5 ± 11.9 bpm). Mean changes from baseline to peak postdose were similar in the 2 groups (8.0 ± 9.3 bpm after iopamidol-370 and 8.4 ± 14.7 after iodixanol-320, P = 0.72). The proportion of subjects in each group having increases of <5, >5 to <10, 10 to <15, 15 to <20, or >20 bpm was comparable (P = 0.87). Two subjects experienced postcontrast tachycardia (HR increase >70 bpm, peak HR of 146 and 164 bpm), both in the iodixanol-320 group (2.4%). Contrast Enhancement: Of the 121 patients undergoing liver CT, 60 received iopamidol-370 whereas 61 received iodixanol-320. Mean age, gender distribution, weight, total iodine dose, and dose/body weight were comparable in the 2 groups. Iopamidol-370 provided significantly higher HU values in abdominal aorta during the arterial phase of enhancement for both readers [R1: 301.3 ± 80.2 vs. 273.6 ± 65.9 HU, 95% confidence interval (6.1-56.8), P = 0.02; R2: 302.0 ± 73.6 vs. 275.1 ± 62.9 HU, 95% confidence interval (2.3-51.3), P = 0.03]. No significant difference was observed between the 2 contrast medium during the portal venous phase of enhancement. CONCLUSIONS: When the same injection rate and iodine dose is used, the effects on HR of bolus intravenous injections of iopamidol-370 and iodixanol-320 were similar. Iopamidol-370 provides significantly greater enhancement during the arterial phase and similar enhancement during the portal venous phase compared with iodixanol-320.

Original languageEnglish (US)
Pages (from-to)856-861
Number of pages6
JournalInvestigative Radiology
Volume42
Issue number12
DOIs
StatePublished - Dec 1 2007
Externally publishedYes

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Iopamidol
Multidetector Computed Tomography
Heart Rate
Safety
Iodine
Age Distribution
Contrast Media
Liver
Body Weight
Confidence Intervals
iodixanol
Weights and Measures
Supine Position
Abdominal Aorta
Double-Blind Method
Tachycardia
Intravenous Injections
Arteries

Keywords

  • Computed tomography (CT)
  • Contrast media
  • Heart rate
  • Liver enhancement

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

A comparison of the efficacy and safety of iopamidol-370 and iodixanol-320 in patients undergoing multidetector-row computed tomography. / Sahani, Dushyant V.; Soulez, Gilles; Chen, Ke Min; Lepanto, Luigi; Xu, Jian Rong; Nelson, Rendon C.; Grazioli, Luigi; Vanzulli, Angelo; Heiken, Jay.

In: Investigative Radiology, Vol. 42, No. 12, 01.12.2007, p. 856-861.

Research output: Contribution to journalArticle

Sahani, Dushyant V. ; Soulez, Gilles ; Chen, Ke Min ; Lepanto, Luigi ; Xu, Jian Rong ; Nelson, Rendon C. ; Grazioli, Luigi ; Vanzulli, Angelo ; Heiken, Jay. / A comparison of the efficacy and safety of iopamidol-370 and iodixanol-320 in patients undergoing multidetector-row computed tomography. In: Investigative Radiology. 2007 ; Vol. 42, No. 12. pp. 856-861.
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TY - JOUR

T1 - A comparison of the efficacy and safety of iopamidol-370 and iodixanol-320 in patients undergoing multidetector-row computed tomography

AU - Sahani, Dushyant V.

AU - Soulez, Gilles

AU - Chen, Ke Min

AU - Lepanto, Luigi

AU - Xu, Jian Rong

AU - Nelson, Rendon C.

AU - Grazioli, Luigi

AU - Vanzulli, Angelo

AU - Heiken, Jay

PY - 2007/12/1

Y1 - 2007/12/1

N2 - OBJECTIVES: To prospectively compare the effects on heart rate (HR) and contrast enhancement efficacy of iopamidol-370 and iodixanol-320 in contrast-enhanced, multidetector-row computed tomography (CE-MDCT). METHODS: IMPACT is a multicenter, double-blind study involving 166 patients undergoing CE-MDCT of the liver (n = 121) or peripheral arteries (n = 45) randomized to receive equi-iodine doses (40 gI) of iopamidol-370 or iodixanol-320 intravenous at 4 mL/s. CE-MDCT was performed using 16-MDCT scanners according to predefined imaging protocols. HR was measured with the patient in the supine position before and continuously for 5 minutes after contrast medium administration. Mean and peak increases in HR and the proportion of subjects with predefined HR increases (>5 to <10, 10 to <15, 15 to <20, >20 bpm) were compared in the 2 populations. Liver images were assessed by 2 independent, blinded readers for contrast enhancement [Hounsfield unit (HU)], using predefined regions-of-interest during the arterial and portal-venous phase of enhancement. RESULTS: Effects on HR: Eighty-four subjects received iopamidol-370 whereas 82 received iodixanol-320. Mean age, gender distribution, weight, total iodine dose, dose/body weight, concomitant medications and use of β-blockers were comparable in the 2 groups. Mean baseline HR was similar in the 2 groups (iopamidol-370: 72.3 ± 12.5 bpm; iodixanol-320: 74.5 ± 11.9 bpm). Mean changes from baseline to peak postdose were similar in the 2 groups (8.0 ± 9.3 bpm after iopamidol-370 and 8.4 ± 14.7 after iodixanol-320, P = 0.72). The proportion of subjects in each group having increases of <5, >5 to <10, 10 to <15, 15 to <20, or >20 bpm was comparable (P = 0.87). Two subjects experienced postcontrast tachycardia (HR increase >70 bpm, peak HR of 146 and 164 bpm), both in the iodixanol-320 group (2.4%). Contrast Enhancement: Of the 121 patients undergoing liver CT, 60 received iopamidol-370 whereas 61 received iodixanol-320. Mean age, gender distribution, weight, total iodine dose, and dose/body weight were comparable in the 2 groups. Iopamidol-370 provided significantly higher HU values in abdominal aorta during the arterial phase of enhancement for both readers [R1: 301.3 ± 80.2 vs. 273.6 ± 65.9 HU, 95% confidence interval (6.1-56.8), P = 0.02; R2: 302.0 ± 73.6 vs. 275.1 ± 62.9 HU, 95% confidence interval (2.3-51.3), P = 0.03]. No significant difference was observed between the 2 contrast medium during the portal venous phase of enhancement. CONCLUSIONS: When the same injection rate and iodine dose is used, the effects on HR of bolus intravenous injections of iopamidol-370 and iodixanol-320 were similar. Iopamidol-370 provides significantly greater enhancement during the arterial phase and similar enhancement during the portal venous phase compared with iodixanol-320.

AB - OBJECTIVES: To prospectively compare the effects on heart rate (HR) and contrast enhancement efficacy of iopamidol-370 and iodixanol-320 in contrast-enhanced, multidetector-row computed tomography (CE-MDCT). METHODS: IMPACT is a multicenter, double-blind study involving 166 patients undergoing CE-MDCT of the liver (n = 121) or peripheral arteries (n = 45) randomized to receive equi-iodine doses (40 gI) of iopamidol-370 or iodixanol-320 intravenous at 4 mL/s. CE-MDCT was performed using 16-MDCT scanners according to predefined imaging protocols. HR was measured with the patient in the supine position before and continuously for 5 minutes after contrast medium administration. Mean and peak increases in HR and the proportion of subjects with predefined HR increases (>5 to <10, 10 to <15, 15 to <20, >20 bpm) were compared in the 2 populations. Liver images were assessed by 2 independent, blinded readers for contrast enhancement [Hounsfield unit (HU)], using predefined regions-of-interest during the arterial and portal-venous phase of enhancement. RESULTS: Effects on HR: Eighty-four subjects received iopamidol-370 whereas 82 received iodixanol-320. Mean age, gender distribution, weight, total iodine dose, dose/body weight, concomitant medications and use of β-blockers were comparable in the 2 groups. Mean baseline HR was similar in the 2 groups (iopamidol-370: 72.3 ± 12.5 bpm; iodixanol-320: 74.5 ± 11.9 bpm). Mean changes from baseline to peak postdose were similar in the 2 groups (8.0 ± 9.3 bpm after iopamidol-370 and 8.4 ± 14.7 after iodixanol-320, P = 0.72). The proportion of subjects in each group having increases of <5, >5 to <10, 10 to <15, 15 to <20, or >20 bpm was comparable (P = 0.87). Two subjects experienced postcontrast tachycardia (HR increase >70 bpm, peak HR of 146 and 164 bpm), both in the iodixanol-320 group (2.4%). Contrast Enhancement: Of the 121 patients undergoing liver CT, 60 received iopamidol-370 whereas 61 received iodixanol-320. Mean age, gender distribution, weight, total iodine dose, and dose/body weight were comparable in the 2 groups. Iopamidol-370 provided significantly higher HU values in abdominal aorta during the arterial phase of enhancement for both readers [R1: 301.3 ± 80.2 vs. 273.6 ± 65.9 HU, 95% confidence interval (6.1-56.8), P = 0.02; R2: 302.0 ± 73.6 vs. 275.1 ± 62.9 HU, 95% confidence interval (2.3-51.3), P = 0.03]. No significant difference was observed between the 2 contrast medium during the portal venous phase of enhancement. CONCLUSIONS: When the same injection rate and iodine dose is used, the effects on HR of bolus intravenous injections of iopamidol-370 and iodixanol-320 were similar. Iopamidol-370 provides significantly greater enhancement during the arterial phase and similar enhancement during the portal venous phase compared with iodixanol-320.

KW - Computed tomography (CT)

KW - Contrast media

KW - Heart rate

KW - Liver enhancement

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