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Iodinated Contrast Media in Oncologic CT: A Narrative Review of Safety, Risk Stratification, and Practical
Sabina-Oana Vasii1,2, Florin-Gabriel Crișan2, Sandra-Monica Lazăr3,4
1Center for Drug Data Analysis, Cheminformatics, and the Internet of Medical Things, Victor Babeş University of Medicine and Pharmacy Timişoara, 300041 Timişoara, Romania.
Iodinated contrast media are vital for cancer imaging but require careful risk assessment in patients undergoing multiple treatments. Individualized safety evaluations are crucial, considering kidney, thyroid, and hypersensitivity risks.
Area of Science:
- Oncology
- Radiology
- Nephrology
- Endocrinology
Background:
- Iodinated contrast media are indispensable for oncologic imaging.
- Cancer patients face unique risks due to combined therapies like nephrotoxic drugs and radioiodine treatments.
- Repeated contrast-enhanced computed tomography scans increase cumulative exposure and potential risks.
Purpose of the Study:
- To review the safety of iodinated contrast media in oncology settings.
- To evaluate risks including renal injury, hypersensitivity reactions, and thyroid dysfunction.
- To explore interactions with cancer therapies and diagnostic/therapeutic pathways.
Main Methods:
- A narrative review of published literature was conducted.
- Searches focused on iodinated contrast use in oncology, renal risk, adverse reactions, and thyroid implications.
- Included studies addressed post-contrast acute kidney injury, hypersensitivity, drug interactions, and laboratory confounding.
Main Results:
- Renal safety is a primary concern, with kidney injury often multifactorial in cancer patients.
- Severe hypersensitivity reactions to modern contrast media are rare, but immune-modulating therapies may influence risk.
- Thyroid effects are typically transient but significant for patients with thyroid autonomy or differentiated thyroid carcinoma.
Conclusions:
- Iodinated contrast media use in oncology necessitates individualized risk stratification.
- A field-specific approach is recommended over automatic avoidance.
- Balancing diagnostic benefits with potential risks is key for optimal patient care.
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