Abdominal Imaging

, Volume 31, Issue 2, pp 131–140 | Cite as

ESUR guidelines on contrast media

Article

Abstract

Since 1996 the Contrast Media Safety Committee of the European Society of Urogenital Radiology has released 15 guidelines regarding safety in relation to the use of radiographic, ultrasonographic, and magnetic resonance contrast media. The guidelines have been well received by the radiologic community in Europe and all over the world and comprise current standards for good practice at many institutions. The present report is an overview of the work accomplished by the European Society of Urogenital Radiology over the past 8 years. The committee has covered renal and nonrenal adverse events and other aspects of contrast media.

Keywords

Contrast media Adverse reactions Safety issues Guidelines 

References

  1. 1.
    Morcos SK, Thomsen HS, Webb JAW, Members of Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR). Contrast media induced nephrotoxicity: a consensus report. Eur Radiol 1999;9:1602–1613PubMedCrossRefGoogle Scholar
  2. 2.
    Hou SH, Bushinsky DA, Wish JB, et al. Hospital acquired renal insufficiency: a prospective study. Am J Med 1983;74:243–248PubMedCrossRefGoogle Scholar
  3. 3.
    Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002;39:930–936PubMedCrossRefGoogle Scholar
  4. 4.
    Solomon R. Contrast medium-induced acute renal failure. Kidney Int 1998;53:230–242PubMedCrossRefGoogle Scholar
  5. 5.
    Gruberg L, Mintz GS, Mehran R, et al. The prognostic implications of further renal function deterioration with 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency. J Am Coll Cardiol 2000;36:1542–1548PubMedCrossRefGoogle Scholar
  6. 6.
    McCullough PA, Wolyn R, Rocher LL, et al. Acute renal failure after coronary intervention: incidence, risk factors and relationship to mortality. Am J Med 1997;103:368–375PubMedCrossRefGoogle Scholar
  7. 7.
    Rudnik MR, Goldfarb S, Wexler L, et al. Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. Kidney Int 1995;47:254–261Google Scholar
  8. 8.
    Blaufox MD, Aurell M, Bubeck B, et al. Report of the Radionuclide in Nephrourology Committee on renal clearance. J Nucl Med 1996;37:1883–1890PubMedGoogle Scholar
  9. 9.
    Bostrom AG, Kronenberg F, Ritz E. Predictive performance of renal function equations for patients with chronic kidney disease and normal serum creatinine levels. J Am Soc Nephrol 2002;13:2140–2144Google Scholar
  10. 10.
    Couchoud C, Pozet N, Labeeuw M, Pouteil-Noble C. Screening early renal failure: cut-off values for serum creatinine as an indicator of renal impairment. Kidney Int 1999;55:1878–1884PubMedCrossRefGoogle Scholar
  11. 11.
    Thomsen HS, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). In which patients should serum-creatinine be measured before contrast medium administration? Eur Radiol 2005;15:749–754PubMedCrossRefGoogle Scholar
  12. 12.
    Thomsen HS. Contrast nephropathy. In: Thomsen HS, Muller RN, Mattrey RF, eds. Trends in contrast media. Berlin: Springer-Verlag, 1999:103–116Google Scholar
  13. 13.
    Morcos SK. Prevention of contrast media nephrotoxicity—the story so far. Clin Radiol 2004;59:381–389PubMedGoogle Scholar
  14. 14.
    Solomon R, Werner C, Mann D, et al. Effects of saline, mannitol and furosemide on acute decreases in renal function induced by radiocontrast agents. N Engl J Med 1994;331:1416–1420PubMedGoogle Scholar
  15. 15.
    Allaqaband S, Tumuluri R, Malik AM, et al. Prospective randomized study of N-aceyltylcysteine, fenoldopam and saline for prevention of radiocontrast-induced nephropathy. Catheter Cardiovasc Intervent 2002;57:279–283Google Scholar
  16. 16.
    Mueller C, Burkle G, Buerkle HJ, et al. Prevention of contrast media-associated nephropathy. Randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med 2002;162:329–336PubMedGoogle Scholar
  17. 17.
    Trivedi HS, Moore H, Nasr S, et al. A randomized prospective trial to assess the role of saline hydration on the development of contrast nephrotoxicity. Nephron Clin Pract 2003;93:c29–c34PubMedCrossRefGoogle Scholar
  18. 18.
    Merten GJ, Burgess WP, Gray LV, et al. Prevention of contrast-induced nephropathy with sodium bicarbonate. A randomized controlled trial. JAMA 2004;291:2328–2334PubMedCrossRefGoogle Scholar
  19. 19.
    Morcos SK, Thomsen HS. Webb JAW, Members of the Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Dialysis and contrast media. Eur Radiol 2002;12:3026–3030PubMedGoogle Scholar
  20. 20.
    Dehnarts T, Keller E, Gondolf K, et al. Effect of haemodialysis after contrast medium administration in patients with renal insufficiency. Nephrol Dial Transplant 1998;13:358–362Google Scholar
  21. 21.
    Vogt B, Ferrari P, Schonholzer C, et al. Pre-emptive haemodialysis after radiocontrast media in patients with renal insufficiency is potentially harmful. Am J Med 2001;111:692–698PubMedCrossRefGoogle Scholar
  22. 22.
    Frank H, Werner D, Lorusso V, et al. Simultaneous hemodialysis during coronary angiography fails to prevent radiocontrast-induced nephropathy in chronic renal failure. Clin Nephrol 2003;60:176–182PubMedGoogle Scholar
  23. 23.
    Huber W, Jeschke B, Kreymann B, et al. Haemodialysis of the prevention of contrast-induced nephropathy. Outcome of 31 patients with severely impaired renal function, comparison with patients at similar risk and review. Invest Radiol 2002;37:471–481PubMedCrossRefGoogle Scholar
  24. 24.
    Marenzi G, Marana I, Lauri G, et al. The prevention of radiocontrast-agent–induced nephropathy by hemofiltration. N Engl J Med 2003;349:1333–1340PubMedCrossRefGoogle Scholar
  25. 25.
    Thomsen HS, Almén T, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Gadolinium-containing contrast media for radiographic examinations: a position paper. Eur Radiol 2002;12:2600–2605PubMedGoogle Scholar
  26. 26.
    Sam AD II, Morasch MD, Collins J, et al. Safety of gadolinium contrast angiography in patients with chronic renal insufficiency. J Vasc Surg 2003;38:313–318PubMedGoogle Scholar
  27. 27.
    Spinosa DJ, Angle JF, Hagspiel KD, et al. Lower extremity arteriography with use of iodinated contrast material or gadodiamide to supplement CO2 angiography in patients with renal insufficiency. J Vasc Interv Radiol 2000;11:35–43PubMedGoogle Scholar
  28. 28.
    Gemmete JJ, Forauer AR, Kazanjian S, et al. Safety of large volume gadolinium angiography (abstract). J Vasc Interv Radiol 2001;12(pt 2):S 28Google Scholar
  29. 29.
    Schenker MP, Solomon JA, Roberts DA. Gadolinium arteriography complicated by acute pancreatitis and acute renal failure (letter). J Vasc Interv Radiol 2001;12:393PubMedGoogle Scholar
  30. 30.
    Terzi C, Sokmen S. Acute pancreatitis induced by magnetic-resonance-imaging contrast agent. Lancet 1999;354:1789–1790PubMedCrossRefGoogle Scholar
  31. 31.
    Elmståhl B, Nyman U, Leander P, et al. Gadolinium contrast media are more nephrotoxic than a low osmolar iodine medium employing doses with equal X-ray attenuation in renal arteriography: an experimental study in pigs. Acta Radiol 2004;11:1219–1228Google Scholar
  32. 32.
    Thomsen HS, Morcos SK, and Members of Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR). Contrast media and metformin. Guidelines to diminish the risk of lactic acidosis in non–insulin dependent diabetics after administration of contrast media. Eur Radiol 1999;9:738–740PubMedCrossRefGoogle Scholar
  33. 33.
    Lasser EC, Berry CC, Talner LB, et al. Pretreatment with corticosteroids to alleviate reactions to intravenous contrast material. N Engl J Med 1987;317:845–849PubMedGoogle Scholar
  34. 34.
    Katayama H, Yamaguchi K, Kozuka T, et al. Adverse reactions to ionic and nonionic contrast media. Radiology 1990;175:621–628PubMedGoogle Scholar
  35. 35.
    Lasser EC, Berry CC, Mishkin MM, et al. Pretreatment with corticosteroids to prevent adverse reactions to non-ionic contrast media. AJR 1994;162:523–526PubMedGoogle Scholar
  36. 36.
    Dawson P, Sidhu PS. Is there a role for corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents? Clin Radiol 1993;48:225–226PubMedGoogle Scholar
  37. 37.
    Lasser EC. Corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents (letter). Clin Radiol 1994;49:582–583PubMedGoogle Scholar
  38. 38.
    Dore C, Sidhu PS, Dawson P. Corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents (letter). Clin Radiol 1994;49:583–584Google Scholar
  39. 39.
    Lasser EC, Berry CC. Corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents (letter). Clin Radiol 1994;49:584Google Scholar
  40. 40.
    Dore CJ, Sidhu PS, Dawson P. Corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents (letter). Clin Radiol 1995;50:198–199PubMedGoogle Scholar
  41. 41.
    Lasser EC. Corticosteroid prophylaxis in patients at increased risk of adverse reactions to intravascular contrast agents (letter). Clin Radiol 1995;50:199Google Scholar
  42. 42.
    Seymour R, Halpin SF, Hardman JA, et al. Corticosteroid prophylaxis for patients with increased risk of adverse reactions to intravenous contrast agents: a survey of current practice in the UK. Clin Radiol 1994;49:791–795PubMedGoogle Scholar
  43. 43.
    Morcos SK, Thomsen HS, Webb JAW, Contrast Media Safety Committee of the European Society of Urogenital Radiology. Prevention of generalized reactions to contrast media: a consensus report and guidelines. Eur Radiol 2001;11:1720–1728PubMedCrossRefGoogle Scholar
  44. 44.
    Thomsen HS, Bush WH. Treatment of the adverse effects of contrast media. Acta Radiol 1998;39:212–218PubMedGoogle Scholar
  45. 45.
    Dunnick NR, Cohan RH. Cost, corticosteroids, and contrast media. AJR 1994;162:527–529PubMedGoogle Scholar
  46. 46.
    Cohan RH, Ellis JH, Dunnick NR. Use of low-osmolar agents and premedication to reduce the frequency of adverse reactions to radiographic contrast media: a survey of the Society of Uroradiology. Radiology 1995;194:357–364PubMedGoogle Scholar
  47. 47.
    Thomsen HS, Dorph S. High-osmolar and low-osmolar contrast media. An update on frequency of adverse drug reactions. Acta Radiol 1993;34:205–209PubMedGoogle Scholar
  48. 48.
    Thomsen HS, Bush WH Jr. Adverse effects of contrast media. Incidence, prevention and management. Drug Safety 1998;19:313–324PubMedCrossRefGoogle Scholar
  49. 49.
    Shehadi WH. Death following intravascular administration of contrast media. Acta Radiol Diagn 1985;26:457–461Google Scholar
  50. 50.
    Bush WH, Swanson DP. Acute reactions to intravascular contrast media: types, risk factors, recognition, and specific treatment. AJR 1991;157:1153–1161PubMedGoogle Scholar
  51. 51.
    Gillenberger P, Halwig TM, Patterson R, et al. Emergency administration of a radiocontrast media in high risk patients. J Allergy Clin Immunol 1986;77:630–635Google Scholar
  52. 52.
    Bush WH, McClennan BL, Swanson DP. Contrast media reactions: prediction, prevention, and treatment. Postgrad Radiol 1993;13:137–147Google Scholar
  53. 53.
    Cohan RH, Leder RA, Ellis JH. Treatment of adverse reactions to radiographic contrast media in adults. Radiol Clin North Am 1996;34:1055–1060PubMedGoogle Scholar
  54. 54.
    Emergency Cardiac Care Committee, Subcommittees of the American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiac care III: adult advanced cardiac life support. JAMA 1992;268:2199–2241Google Scholar
  55. 55.
    Webb JAW, Stacul F, Thomsen HS, Morcos SK, Members of the Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR). Late adverse reactions to intravascular iodinated contrast media. Eur Radiol 2003;13:181–184PubMedGoogle Scholar
  56. 56.
    Bellin M-F, Jakobsen JÅ, Tomassin I, et al, Members of the Contrast Media Safety Committee of the European Society of Urogenital Radiology (ESUR). Contrast medium extravasation injury: guidelines for prevention and management. Eur Radiol 2002;12:2807–2812PubMedCrossRefGoogle Scholar
  57. 57.
    Molen AJvd, Thomsen HS, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Effect of iodinated contrast media on thyroid function in adults. Eur Radiol 2004;14:902–906PubMedGoogle Scholar
  58. 58.
    Webb JAW, Thomsen HS, Morcos SK, Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR) (2005) The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol 15: 1234–1240PubMedCrossRefGoogle Scholar
  59. 59.
    Morcos SK, Thomsen HS, Exley CM (2005) Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Contrast media: interaction with other drugs and clinical tests. Eur Radiol 15:1463–1468PubMedCrossRefGoogle Scholar
  60. 60.
    Jakobsen JA, Oyen R, Thomsen HS, Morcos SK (2005) Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Safety of ultrasound contrast agents. Eur Radiol 15:941–945PubMedCrossRefGoogle Scholar
  61. 61.
    Kirchin MA, Runge VM. Contrast agents for magnetic resonance imaging: safety update. Top Magn Reson Imaging 2003;14:426–435PubMedGoogle Scholar
  62. 62.
    Bluemke DA, Weber TM, Rubin D, et al. Hepatic MR imaging with ferumoxides: multicenter study of safety and effectiveness of direct injection protocol. Radiology 2003;228:457–464PubMedGoogle Scholar
  63. 63.
    Marti-Bonmati L, Fog AF, Op de Beeck B, et al. Safety and efficacy of mangafodipir trisodium in patients with liver lesions and cirrhosis. Eur Radiol 2003;13:1685–1692PubMedGoogle Scholar
  64. 64.
    Ros PR, Freeny PC, Harms SE, et al. Hepatic MR imaging with ferumoxides: a multicenter clinical trial of the safety and efficacy in the detection of focal hepatic lesions. Radiology 1995;196:481–488PubMedGoogle Scholar
  65. 65.
    Kopp AF, Laniado M, Dammann F, et al. MR imaging of the liver with Resovist: safety, efficacy, and pharmacodynamic properties. Radiology 1997;204:749–756PubMedGoogle Scholar
  66. 66.
    Spinazzi A, Lorusso V, Pirovano G, Kirchin M. Safety, tolerance, biodistribution MR imaging enhancement of the liver with Gd-BOPTA: results of clinical pharmacologic and pilot imaging studies in non-patient and patient volunteers. Acad Radiol 1999;6:282–291PubMedCrossRefGoogle Scholar
  67. 67.
    Bellin MF, Vasile M, Morel-Precetti S. Currently used non-specific extracellular MR contrast media. Eur Radiol 2003;13:2688–2698PubMedCrossRefGoogle Scholar
  68. 68.
    Bellin MF, Zaim S, Auberton E, et al. Liver metastases: safety and efficacy of detection with superparamagnetic iron oxide in MR imaging. Radiology 1994;193:657–663PubMedGoogle Scholar
  69. 69.
    Kehagias DT, Gouliamos AD, Smyrniotis V, Vlahos LJ. Diagnostic efficacy and safety of MRI of the liver with superparamagnetic iron oxide particles (SHU 555 A). J Magn Reson Imaging 2001;14:595–601PubMedCrossRefGoogle Scholar
  70. 70.
    Reimer P, Balzer T. Ferucarbotran (Resovist), a new clinically approved RES-specific contrast agent for contrast-enhanced MRI of the liver: properties, clinical development, and applications. Eur Radiol 2003;13:1266–1276PubMedGoogle Scholar
  71. 71.
    Bellin M-F, Webb JAW, Molen AJvd, et al. (2005) Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). Safety of MR liver specific contrast media. Eur Radiol 15:1607–1614PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  1. 1.Department of Diagnostic RadiologyCopenhagen University Hospital at HerlevHerlevDenmark
  2. 2.Department of Diagnostic ImagingNorthern General Hospital, Sheffield Teaching Hospitals NHS TrustSheffieldUnited Kingdom

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