Negative Predictive Value of Allergologic Work-Up with Iodinated Contrast Media in 'Real-Life' Practice

Area of Science:

• Allergy and Immunology
• Radiology and Imaging

Background:

• Iodinated contrast media (ICM) hypersensitivity reactions necessitate strategies for safe administration.
• Premedication and allergologic work-up are common approaches to mitigate risks.
• Real-world data on the predictive value of these diagnostic methods is crucial.

Purpose of the Study:

• To evaluate the negative predictive value of skin tests and comprehensive allergologic work-up for iodinated contrast media (ICM).
• To determine the safety of ICM application in patients with a history of hypersensitivity reactions.

Main Methods:

• Retrospective enrollment of 210 patients with prior ICM hypersensitivity.
• Stepwise protocol involving skin prick tests (SPTs), intracutaneous tests (ICTs), and intravenous drug provocation tests (DPTs).
• Telephone follow-up at least 6 months post-testing to assess outcomes.

Main Results:

• Skin tests (SPT/ICT) and DPTs identified safe ICMs in 87% of patients.
• Negative predictive value of skin tests relative to DPTs was 95%.
• Overall allergologic work-up showed a 90% negative predictive value in real-life settings, with 41% of patients receiving recommended ICMs.

Conclusions:

• Skin tests and DPTs possess high negative predictive value for determining safe ICMs.
• Allergologic work-up is effective in identifying safe ICMs for the majority of patients with hypersensitivity history.
• These diagnostic tools facilitate safer ICM administration in clinical practice.