Contrast Media Flashcards
3 molecular/functional imaging
scintigraphy, PET, SPECT
limitations of molecular/functional imaging
inability to accurately measure gross/structural changes
longest waves
radiowaves
shortest waves
gamma rays
who first documented x-ray imaging using an opaque contrast
Eduard Haschek and Otto Theodor Lindenthal
oral bismuth subnitrate was used for?
for visualization of GIT
Barium sulfate is used for?
as an oral radiopaque contrast
2% Collargol (colloidal silver) used in?
cystography
for retrograde pyelography but eventually causing toxicity/deaths
5% Collargol
Use of silver iodide for
retrograde pyelography
First attempt to use sodium iodide for?
renography
Use of 25% sodium and potassium iodide
for ___ →later modified to ___
renography, 13.5%
it replaced colloidal silver as the contrast medium of choice for retrograde pyelography but failed as a contrast medium in excretory urography
10% sodium iodide solution
Pyelognost
(co-intravenous administration of sodium iodide and urea) for pyelography
was the use of selectan (54.1% I) as a contrast medium for excretory urography successful?
no
was the use of uroselectan as a contrast medium for excretory urography successful?
yes
Iopax
uroselectan
Neo-Iopax
Uroselectan B
Diodrast
Diodone
became the standard IV contrast media
for urography for the next 20 years
Neo-Iopax (Uroselectan B) and Diodrast (Diodone)
Neo-Iopax (Uroselectan B) and Diodrast (Diodone) was later replaced by 3 1st gen agents. What are these?
Urokon (Acetrizoate)
Hypaque (Diatrizoate)
Conray (Iothalamate)
what is the osmolality of Urokon (Acetrizoate), Hypaque (Diatrizoate), Conray (Iothalamate)
high osmolality contrast media (HOCM)
what is Lipiodol?
iodinated poppy seed oil, developed in 1901 by Guerbet and Lafay
it is used foer bronchography and myelography→was later replaced by bronchoscopy and CT scan
lipiodol
Successful image of a dog’s heart through ___ but ___ resulted in death
IV injection of lipiodol to the femoral vein, intraarterial injection to the femoral artery
Berberich and Hirsch
First angiography on a living human using 20% strontium bromide
First angiography on a living human using ___
20% strontium bromide
First arteriography done in living humans using ___
25% sodium iodide to the internal carotid artery
he discovered that osmolality of contrast media is directly proportional to its toxicity
Torsten Almén
developed the first non-ionic iodine contrast media
Torsten Almén
the first non-ionic iodine contrast media
Amipaque (metrizamide, 48% I)
Amipaque was found to be not useful in ___ due to its poor solubility
urography
it was used as prototype of highly soluble 2nd gen agents
Amipaque (metrizamide)
highly soluble 2nd gen agents (related to amipaque)
Omnipaque (iohexol)
Isovue (iopamidol)
Optiray (ioversol)
Amipaque was repurposed as the first non- ionic iodine contrast intended for ___
coronary angiography
Hippuran
iodohippurate sodium, 38.8% I
who developed Hippuran?
Moses Swick
developed as an alternative radiopaque contrast media to Neo-Iopax and Diodrast
Hippuran (iodohippurate sodium)
the compound had low iodine content and less tolerated at higher doses
Hippuran (iodohippurate sodium
Hippuran (iodohippurate sodium) was redeveloped to become ___ which is among the common renal tubular function agents in nuclear medicine
[131-I] hippuran
what is the technetium-labeled analog of [131I]hippuran
[99mTc]MAG3
Isovist
Iotrolan (iso-osmolar, non-ionic, dimers)
Visipaque
iodixanol (iso-osmolar, non-ionic, dimers)
Iosmin
iosimenol (iso-osmolar, non-ionic, dimers)
Omnipaque
iohexol (Low-osmolar non-ionic monomers)
Isovue
iopamidol (Low-osmolar non-ionic monomers)
Optiray
ioversol (Low-osmolar non-ionic monomers)
Diatrizoate
High-osmolar ionic monomers
iothalamic acid
High-osmolar ionic monomers
ioxitalamic acid
High-osmolar ionic monomers
metrizoic acid
High-osmolar ionic monomers
Ioxaglic acid/ioxaglate
Low-osmolar ionic dimers
Iobitridol
Low-osmolar non-ionic monomers
iohexol
Low-osmolar non-ionic monomers
iomeprol
Low-osmolar non-ionic monomers
iopamidol
Low-osmolar non-ionic monomers
iopentol
Low-osmolar non-ionic monomers
iopromide
Low-osmolar non-ionic monomers
ioversol
Low-osmolar non-ionic monomers
ioxilan
Low-osmolar non-ionic monomers
Iodixanol
Iso-osmolar non-ionic dimers
iosimenol
Iso-osmolar non-ionic dimers
iotrolan
Iso-osmolar non-ionic dimers
associated with side effects
Osmolality
low osmolality agents are associated with side effects (T or F)
False - higher
affects injection rate
Viscosity
allows the production of highly concentrated
contrast media
Water solubility
affects image opacity (higher Z – stronger contrast)
Iodine content
specific to ionic agents
Electrical charge
the more concentrated the contrast, the
denser it is hence the higher its absorption capacity
Specific gravity/density
The osmolality of contrast agents affects the incidence of side-effects, particularly
above ___
800 mOsm/kg
High osmolal agents
greater than 1500 mOsm/kg
Low osmolal agents
600–700 mOsm/kg – set as the osmolality threshold
value: what is set as the osmolality threshold?
600–700 mOsm/kg
Iso-osmolal agents
290 mOsm/kg
Indication of the osmolality of an agent is given by the ___
contrast agent ratio
Number of iodine atoms / Number of particles in solution
Contrast agent ratio
what is the osmolality of ionic monomers
1.5
what is the osmolality of non-ionic monomers
3
what is the osmolality of ionic dimers
3
what is the osmolality of non-ionic dimers
6
they have the highest viscosity
Non-ionic dimers
they have the lowest viscosity
ionic monomers
Employ preheating to prior to administration of viscous agents
viscosity
The higher the ___, the opaquer the contrast becomes
iodine content
Free iodide ions affect above all the ___ but also other organs and tissues
thyroids
USP specification for free iodide should be no more than
0.02%
pharmacokinetics of iodinated contrasts is characterized by ___
extracellular distribution followed by renal excretion by glomerular filtration
Iodinated (aromatic) contrast agents are also very stable or unstable?
stable
they are not metabolised and are excreted unchanged
Iodinated (aromatic) contrast agents
what is the terminal halflife of iodinated contrast agents?
approx. 1.5 h
An overview of the existing data on pharmacokinetics of X-ray contrast media in humans has been given by ___
Bourin et al.
Low osmolar non-ionic monomers in the Philippine National Formulary
- Iohexol
- Iopamidol
- Iopromide
- Ioversol
Iso-osmolar non-ionic dimer in the Philippine National Formulary
- Iodixanol
Non-iodinated contrast inthe Philippine National Formulary
- Barium sulfate