Imaging Contrast

Contrast agents are injected into patients to help enhance images to make it easier for radiologists distinguish specific areas of the body from surrounding tissues. The most commonly used agents are iodinated contrast dye for computed tomography (CT), interventional cath lab angiography,  RF fluoroscopy, and in surgical OR procedures. MRI scans typically use gadolinium-based contrast agents. Ultrasound and echocardiography (cardiac ultrasound) imaging use contrast agents composed of microscopic bubbles to enhance images that otherwise would be suboptimal.

Arl Van Moore, MD, American College of Radiology (ACR) delegate to the American Medical Association (AMA) House of Delegates, former ACR president, chairman of the ACR Board and former CEO of Strategic Radiology, discusses two radiology related policy decisions at the AMA 2022 meeting. These included a AMA policy on the iodine contrast shortage and AUC CDS. #AMA #AMA22 #AMAmtg #AMA175 #ACR

VIDEO: Radiology takeaways from the 2022 AMA meeting

Arl Van Moore, MD, American College of Radiology (ACR) delegate to the American Medical Association House of Delegates, former ACR president, chairman of the ACR Board and former CEO of Strategic Radiology, discusses radiology-related policy decisions at the AMA 2022 meeting.

ACR: FDA evidence backing thyroid monitoring in peds after ICM use is 'weak'

The ACR statement also brought to light some of the unintended consequences of the FDA’s contrast media safety warning.

Example of various breast MRI protocol sequences that offer different types of soft tissue enhancement. Imaging performed on a Siemens Magnetom system. Breast MRI can help see through dense breast tissue to better detect cancers. #densebreasts #Breastdensity #BreastMRI

Contrast enhanced breast MRI superior to CEM, but accessibility remains an obstacle

In addition to CE-MRI's increased sensitivity for identifying breast cancers, the researchers also found the modality had superior negative likelihood ratios with higher pre-test probabilities for safely ruling out malignancy. 

An example of spectral cardiac CT being used to show iodine density in the myocardium to show perfusion deficits. Shown by Philips healthcare at ACC 2022.

VIDEO: Mitigating the contrast media shortage impact on CT imaging

Brian Ghoshhajra, MD, MBA, division chief, cardiovascular imaging, Massachusetts General Hospital and associate professor of radiology, Harvard Medical School, explains the impact of the iodine contrast shortage on computed tomography (CT) and cardiac imaging.
 

Contrast shortage update: GE expects supply to 'progressively recover' soon

Production at the facility in Shanghai is expected to be near 100% starting on June 6.

Iodine contrast being loaded into a contrast injector in preparation for a cardiac CT scan at Duly Health and Care in Lisle, Illinois. The contrast shortage is causing some healthcare organizations to postpone exams and procedures and ration contrast supplies. Photo by Dave Fornell

ACR working with FDA and HHS to help address imaging contrast shortage

The American College of Radiology (ACR) announced this week its government relations staff has been engaging federal agencies in an effort to improve product availability and hasten resolution of the ongoing iodine contrast shortage.

Interview with Alan H. Matsumoto, MD, FSIR, FACR, FAHA, professor of radiology, chair of the Department of Radiology at the University of Virginia, vice chair of the American College of Radiology (ACR) Board of Chancellors, and the chairman of the ACR Commission on Interventional and Cardiovascular Radiology. He explains how the ACR and group purchasing organizations are asking the FDA to mitigate the contrast shortage with an emergency use authorization (EUA) to allow non-FDA cleared iodine contrast use.

VIDEO: American College of Radiology working with FDA to mitigate contrast shortage

Alan Matsumoto, MD, chair of the department of radiology at the University of Virginia and vice chair of the ACR Board of Chancellors, explains how the ACR and group purchasing organizations are asking the FDA to mitigate the contrast shortage with an emergency use authorization to allow non-FDA cleared iodine contrast agents to be imported.

Eric Williamson, MD, MSCCT, the president of the Society of Cardiovascular Computed Tomography (SCCT) and professor of radiology at Mayo Clinic, explains how the iodine contrast shortage is causing issues for cardiac CT imaging. He discusses ways imagers can stretch they iodine contrast supplies and some technologies that might help conserve contrast. #contrastshortage

VIDEO: Contrast media shortage impacting cardiac CT imaging

Eric Williamson, MD, president of the Society of Cardiovascular Computed Tomography (SCCT) and professor of radiology at Mayo Clinic, explains how the iodine contrast shortage is causing issues for cardiac CT imaging and ways this can be mitigated.

Around the web

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.

The newly cleared offering, AutoChamber, was designed with opportunistic screening in mind. It can evaluate many different kinds of CT images, including those originally gathered to screen patients for lung cancer. 

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