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E1879. Effects of Varying Iodine Concentrations Upon Ureteral Opacification for CT Excretory Urography
Authors
  1. Xiaochen Liu; University of Toledo Medical School
  2. Sammy Droubi; University of Toledo Medical School
  3. Jacob Bieszczad; University of Toledo Medical School
  4. MIchael Walsh; University of Toledo Medical School
Objective:
Computed tomographic urography (CTU) is considered the gold standard for the detection of urinary tract disease. Multiple techniques have been reported in the literature to optimize urinary tract opacification and distention to enhance detection of genitourinary tract disease. However, the effect of iodine concentration upon urinary tract opacification has not been documented. To retrospectively analyze the effects of varying iodine concentration upon ureteral opacification and image quality of CTU.

Materials and Methods:
A retrospective chart review of CTU examinations was performed identifying 300 CTU examinations performed with varying intravenous iodine concentrations of 300, 320, and 350 mg iodine/mL. Two attending genitourinary radiologists experienced in cross-sectional body imaging, retrospectively reviewed all the images, blinded to the administered contrast. The reviewers were asked to quantify and grade urinary tract opacification. Statistical analysis of the means and variances of each contrast type was performed using one-way ANOVA on IBM SPSS Statistic 23. Statistical significance was defined as p<0.05.

Results:
A total of 283 patients and 566 ureters were evaluated. Mean opacification scores demonstrated no statistical significant difference in the degree of enhancement between the 300 mg iodine/mL, 320 mg iodine/mL and 350 mg iodine/mL concentrations.

Conclusion:
Our study results demonstrated there is no significant difference in ureteral opacification with varying iodine concentrations. Each concentration provided similar ureteral opacification without loss of diagnostic quality in our select patient population. Many published CTU protocols recommend higher iodine concentrations which is felt to improve ureteral opacification. Lower concentrations could result in decreased beam hardening artifacts facilitating improved diagnostic results. In addition, utilization of lower concentration agents could facilitate standardization to less contrast options within the department facilitating greater departmental efficiency and requiring less hospital resources. Cost savings could be obtained as well by shifting to more cost effective agents which may be a useful step toward cost-containment strategies pertinent in today’s healthcare landscape.