Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Iohexol-380 and Iohexol-350 for Coronary CT Angiography: A Multicenter, Randomized, Double-Blind Phase 3 Trial

  • Park, Eun-Ah (Department of Radiology, Seoul National University Hospital) ;
  • Lee, Whal (Department of Radiology, Seoul National University Hospital) ;
  • Kang, Doo Kyoung (Department of Radiology, Ajou University School of Medicine) ;
  • Kim, Sung Jin (Department of Radiology, Chungbuk National University Hospital) ;
  • Kim, Young-Ju (Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital) ;
  • Kim, Yookyung (Department of Radiology, Ewha Womans University Mokdong Hospital) ;
  • Sung, Yon Mi (Department of Radiology, Gachon University Gil Medical Center) ;
  • Song, Soon-Young (Department of Radiology, Hanyang University Seoul Hospital) ;
  • Oh, Yu-Whan (Department of Radiology, Korea University Anam Hospital) ;
  • Yong, Hwan Seok (Department of Radiology, Korea University Guro Hospital) ;
  • Lee, Heon (Department of Radiology, Soonchunhyang University Bucheon Hospital) ;
  • Jeon, Eui-Yong (Department of Radiology, Hallym University Sacred Heart Hospital) ;
  • Jin, Gong-Yong (Department of Radiology, Chonbuk National University Medical School and Hospital, Institute of Medical Science, Research Institute of Clinical Medicine and Biomedical Research Institute) ;
  • Choi, Byoung Wook (Department of Radiology, Severance Hospital, Yonsei University Health System) ;
  • Choi, Sang-Il (Department of Radiology, Seoul National University Bundang Hospital)
  • Received : 2015.08.17
  • Accepted : 2016.02.13
  • Published : 2016.06.01
⟨ Previous Next ⟩

Abstract

Objective: This multi-center, randomized, double-blind, phase 3 trial was conducted to compare the safety and efficacy of contrast agents iohexol-380 and iohexol-350 for coronary CT angiography in healthy subjects. Materials and Methods: Volunteers were randomized to receive 420 mgI/kg of either iohexol-350 or iohexol-380 using a flow rate of 4 mL/sec. All adverse events were recorded. Two blinded readers independently reviewed the CT images and conflicting results were resolved by a third reader. Luminal attenuations (ascending aorta, left main coronary artery, and left ventricle) in Hounsfield units (HUs) and image quality on a 4-point scale were calculated. Results: A total of 225 subjects were given contrast media (115 with iohexol-380 and 110 with iohexol-350). There was no difference in number of adverse drug reactions between groups: 75 events in 56 (48.7%) of 115 subjects in the iohexol-380 group vs. 74 events in 51 (46.4%) of 110 subjects in the iohexol-350 group (p = 0.690). No severe adverse drug reactions were recorded. Neither group showed an increase in serum creatinine. Significant differences in mean density between the groups was found in the ascending aorta: $375.8{\pm}71.4HU$ with iohexol-380 vs. $356.3{\pm}61.5HU$ with iohexol-350 (p = 0.030). No significant differences in image quality scores between both groups were observed for all three anatomic evaluations (all, p > 0.05). Conclusion: Iohexol-380 provides improved enhancement of the ascending aorta and similar attenuation of the coronary arteries without any increase in adverse drug reactions, as compared with iohexol-350 using an identical amount of total iodine.

Keywords

Acknowledgement

Supported by : Central Medical Service (CMS)

References

  1. Kim YJ, Yong HS, Kim SM, Kim JA, Yang DH, Hong YJ; Korean Society of Radiology; Korean Society of Cardiology. Korean guidelines for the appropriate use of cardiac CT. Korean J Radiol 2015;16:251-285 https://doi.org/10.3348/kjr.2015.16.2.251
  2. Yoon YE, Lim TH. Current roles and future applications of cardiac CT: risk stratification of coronary artery disease. Korean J Radiol 2014;15:4-11 https://doi.org/10.3348/kjr.2014.15.1.4
  3. Pugliese F. Which contrast agent for coronary ct angiography? RAD Magazine. 2008 October
  4. Cademartiri F, Mollet NR, Lemos PA, Saia F, Midiri M, de Feyter PJ, et al. Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography. AJR Am J Roentgenol 2006;187:W430-W433 https://doi.org/10.2214/AJR.05.1406
  5. Becker CR, Hong C, Knez A, Leber A, Bruening R, Schoepf UJ, et al. Optimal contrast application for cardiac 4-detector-row computed tomography. Invest Radiol 2003;38:690-694 https://doi.org/10.1097/01.rli.0000084886.44676.e4
  6. Fleischmann D. Use of high concentration contrast media: principles and rationale-vascular district. Eur J Radiol 2003;45 Suppl 1:S88-S93 https://doi.org/10.1016/S0720-048X(02)00365-0
  7. Herman S. Computed tomography contrast enhancement principles and the use of high-concentration contrast media. J Comput Assist Tomogr 2004;28 Suppl 1:S7-S11 https://doi.org/10.1097/01.rct.0000120855.80935.2f
  8. Bae KT. Peak contrast enhancement in CT and MR angiography: when does it occur and why? Pharmacokinetic study in a porcine model. Radiology 2003;227:809-816 https://doi.org/10.1148/radiol.2273020102
  9. Cademartiri F, de Monye C, Pugliese F, Mollet NR, Runza G, van der Lugt A, et al. High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography: iopromide 370 versus iomeprol 400. Invest Radiol 2006;41:349-353 https://doi.org/10.1097/01.rli.0000191369.76521.09
  10. Kim EY, Yeh DW, Choe YH, Lee WJ, Lim HK. Image quality and attenuation values of multidetector CT coronary angiography using high iodine-concentration contrast material: a comparison of the use of iopromide 370 and iomeprol 400. Acta Radiol 2010;51:982-989 https://doi.org/10.3109/02841851.2010.509740
  11. Lim J, Park EA, Lee W, Shim H, Chung JW. Image quality and radiation reduction of 320-row area detector CT coronary angiography with optimal tube voltage selection and an automatic exposure control system: comparison with body mass index-adapted protocol. Int J Cardiovasc Imaging 2015;31 Suppl 1:23-30 https://doi.org/10.1007/s10554-015-0594-1
  12. Tsai IC, Lee T, Tsai WL, Chen MC, Wu MJ, Lee WL, et al. Contrast enhancement in cardiac MDCT: comparison of iodixanol 320 versus iohexol 350. AJR Am J Roentgenol 2008;190:W47-W53 https://doi.org/10.2214/AJR.07.2541
  13. Cademartiri F, Mollet NR, van der Lugt A, McFadden EP, Stijnen T, de Feyter PJ, et al. Intravenous contrast material administration at helical 16-detector row CT coronary angiography: effect of iodine concentration on vascular attenuation. Radiology 2005;236:661-665 https://doi.org/10.1148/radiol.2362040468
  14. Brink JA. Use of high concentration contrast media (HCCM): principles and rationale--body CT. Eur J Radiol 2003;45 Suppl 1:S53-S58 https://doi.org/10.1016/S0720-048X(02)00362-5
  15. Rist C, Nikolaou K, Kirchin MA, van Gessel R, Bae KT, von Ziegler F, et al. Contrast bolus optimization for cardiac 16-slice computed tomography: comparison of contrast medium formulations containing 300 and 400 milligrams of iodine per milliliter. Invest Radiol 2006;41:460-467 https://doi.org/10.1097/01.rli.0000208239.34723.5d
  16. Bae KT, Heiken JP. Scan and contrast administration principles of MDCT. Eur Radiol 2005;15 Suppl 5:E46-E59 https://doi.org/10.1007/s10406-005-0165-y
  17. Cademartiri F, van der Lugt A, Luccichenti G, Pavone P, Krestin GP. Parameters affecting bolus geometry in CTA: a review. J Comput Assist Tomogr 2002;26:598-607 https://doi.org/10.1097/00004728-200207000-00022
  18. Behrendt FF, Pietsch H, Jost G, Sieber MA, Keil S, Plumhans C, et al. Intra-individual comparison of different contrast media concentrations (300mg, 370mg and 400mg iodine) in MDCT. Eur Radiol 2010;20:1644-1650 https://doi.org/10.1007/s00330-010-1717-7
  19. Faggioni L, Neri E, Sbragia P, Pascale R, D'Errico L, Caramella D, et al. 80-kV pulmonary CT angiography with 40mL of iodinated contrast material in lean patients: comparison of vascular enhancement with iodixanol (320mg I/mL)and iomeprol (400mg I/mL). AJR Am J Roentgenol 2012;199:1220-1225 https://doi.org/10.2214/AJR.11.8122
  20. Han JK, Kim AY, Lee KY, Seo JB, Kim TK, Choi BI, et al. Factors influencing vascular and hepatic enhancement at CT: experimental study on injection protocol using a canine model. J Comput Assist Tomogr 2000;24:400-406 https://doi.org/10.1097/00004728-200005000-00008

Cited by

  1. High-Pitch Coronary CT Angiography at 70 kVp Adopting a Protocol of Low Injection Speed and Low Volume of Contrast Medium vol.18, pp.5, 2017, https://doi.org/10.3348/kjr.2017.18.5.763
  2. Incidence of Breakthrough Reaction in Patients with Prior Acute Allergic-Like Reactions to Iodinated Contrast Media according to the Administration Route vol.19, pp.2, 2016, https://doi.org/10.3348/kjr.2018.19.2.352
  3. Impact of Contrast Media Concentration on Low-Kilovolt Computed Tomography Angiography: A Systematic Preclinical Approach vol.53, pp.5, 2016, https://doi.org/10.1097/rli.0000000000000437
  4. A Glimpse on Trends and Characteristics of Recent Articles Published in the Korean Journal of Radiology vol.20, pp.12, 2019, https://doi.org/10.3348/kjr.2019.0928
  5. Facile Synthesis of Holmium-Based Nanoparticles as a CT and MRI Dual-Modal Imaging for Cancer Diagnosis vol.11, pp.None, 2016, https://doi.org/10.3389/fonc.2021.741383