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Analytical Interference by Contrast Agents in Biochemical Assays.

Sigrid Otnes1, Niels Fogh-Andersen2, Janne Rømsing1

  • 1Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

Contrast Media & Molecular Imaging
|November 4, 2017
PubMed
Summary

This study examined how five contrast agents used in imaging affect 29 common blood tests. Researchers added these agents to blood samples and measured how they changed test results. They found that iodixanol and iomeprol had the biggest impact, affecting levels of calcium, potassium, and magnesium. Some agents increased values while others decreased them. These changes could lead to incorrect interpretations if not accounted for. The study recommends that doctors consider these effects when reviewing lab results after contrast use. This helps ensure more accurate diagnoses and treatment decisions.

Keywords:
biochemical assayscontrast agent effectsclinical lab interferenceanalytical accuracy

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Area of Science:

  • Clinical laboratory diagnostics
  • Pharmacological interference
  • Analytical chemistry in medical testing

Background:

Current clinical practice relies on accurate biochemical assays to interpret patient health. However, contrast agents used in imaging procedures may interfere with these assays. Prior research has shown that contrast agents can affect analyte measurements, but the extent of interference varies by agent and test. This gap motivated a comprehensive study of five common contrast agents and their effects on 29 biochemical assays. No prior work had resolved the full range of interference patterns across different agents and analytes. Understanding these effects is essential for accurate diagnosis post-contrast administration. The study aimed to identify which agents and analytes are most affected. This knowledge helps clinicians interpret lab results more reliably after contrast use. The findings contribute to better diagnostic accuracy in clinical settings.

Purpose Of The Study:

This study aimed to assess how five contrast agents affect 29 biochemical assays. The agents included iodinated and gadolinium-based compounds. Researchers wanted to determine which assays are most vulnerable to interference. They focused on clinically relevant concentrations of each agent. The motivation was to improve diagnostic reliability after contrast administration. The study tested plasma, serum, and whole blood samples. Researchers used statistical methods to evaluate interference effects. The goal was to guide clinicians in interpreting lab results accurately.

Main Methods:

The study used five contrast agents: iodixanol, iomeprol, gadoxetate disodium, and two gadolinium agents. Researchers spiked plasma, serum, and whole blood with each agent at clinically relevant concentrations. They tested 29 biochemical assays in these samples. The agents were tested at full, half, and quarter concentrations. A paired Student’s t-test evaluated statistical significance. The study compared baseline and spiked sample results. Researchers focused on clinically important analytes like calcium and potassium. The approach ensured a comprehensive assessment of interference patterns.

Main Results:

Iodixanol caused negative interference in bicarbonate and lactate dehydrogenase assays. It also increased albumin, calcium, and potassium levels. Iomeprol reduced magnesium and bicarbonate but increased calcium and potassium. Gadoxetate disodium lowered iron and zinc but raised sodium. These effects were statistically significant with p-values below 0.0001 in many cases. The interference patterns varied by agent and analyte. The study confirmed that contrast agents do interfere with lab tests. The strongest effects were seen in electrolyte and enzyme measurements. These findings highlight the need for caution when interpreting post-contrast results.

Conclusions:

The study shows that contrast agents can interfere with biochemical assays. The interference varies by agent and analyte. Clinicians should consider these effects when interpreting lab results post-contrast. The findings suggest that some analytes are more affected than others. No single agent caused interference across all assays. The results emphasize the importance of concentration in interference patterns. The study supports the need for careful interpretation of lab values after contrast use. These conclusions align with the observed statistical significance in the data.

Iodixanol and iomeprol caused the most significant interference, affecting multiple analytes like calcium, potassium, and magnesium.

The agents were spiked into plasma, serum, and whole blood at concentrations of 0.5 mM for gadolinium agents and 12 mg iodine/mL for iodinated agents.

Testing at 1/2 and 1/4 concentrations helps determine how interference changes with lower doses, which are more common in clinical practice.

A paired Student’s t-test was used to compare baseline and spiked sample results for each analyte.

Calcium, potassium, and magnesium showed the strongest interference, with p-values below 0.0001 in several cases.

The findings suggest clinicians should interpret lab results cautiously after contrast administration, especially for affected analytes.