Newswise — Given the choice of contrast medium for a computed tomography (CT) scan, most patients wouldn’t know the difference between the two iodine-based options commonly used in cancer cases. But for some patients, particularly in the already fragile and potentially compromised cancer patient, it is important to be aware that iodated contrast media has been linked to kidney impairment and a condition known as Contrast-induced nephropathy (CIN). One study estimated the incidence of CIN at around 11% (Mitchell. Incidence of Contrast-Induced Nephropathy after Contrast-Enhanced Computed Tomography in the Outpatient Setting. Clin J Am Soc Nephrol, 2010 Jan; 5(1): 4–9.), with severe cases resulting in death 1-2% of the time.
Researchers working in collaboration with Professor Antonio Giordano, Director of the Sbarro Institute for Cancer Research and department of Biology at Temple University, recently published a study comparing two of the most common iodated contrast media to determine if one or the other had a lower correlation to cases of CIN. The study entitled “Iodixanol vs iopromide in cancer patients: evidence from a randomized clinical trial” has recently been published in the Journal of Cellular Physiology, an international peer-reviewed journal that focuses on cancer-related issues. This multi-center study, coordinated by the Regina Elena National Cancer Institute in Italy, involved three Italian cancer centers including The European Institute of Oncology of Milan, The National Cancer Institute of Naples (Fondazione Pascale) and the National Cancer Institute of Genoa (San Martino).
“Our results showed that the incidence of CIN is low, overall, but iodixanol seemed to have a better safety profile,” explains Dr. Stefano Canitano, Radiologist at Regina Elena National Cancer Institute.
CIN is defined in stages from minor, with a 25% increase in serum creatinine, to more severe cases involving renal failure and the need for dialysis, and in the most severe, death. Most patients tend to recover, as long as they are generally healthy, other than their presenting symptoms requiring CT scan in the first place. However, patients that may be weakened by disease or invasive treatments, such as chemo- and radiotherapy for cancer, may be more vulnerable.
“It is our responsibility to focus on the safety of fragile patients, such as those affected by cancer,” says Dr. Irene Terrenato, researcher at the Regina Elena National Cancer Institute. “Iodated contrast media is essential and, unfortunately, we often observe adverse events on renal function due to contrast media use, such as the CIN.”
“To understand which one minimizes the incidence of CIN is fundamental and this study arises from the need to protect our patients as much as possible,” adds Canitano.
“This study represents a first important step towards an ever more protective approach of the cancer patient, who is notoriously fragile due to the heavy treatment they constantly receive,” says Giordano. “What I would highlight is the fact that this study is well designed, therefore our results can represent a first indication for radiologists who responsible for performing CT scans on very compromised patients daily. However, further studies are strongly recommended to confirm these results as well as to clarify the underlying biological mechanisms that could explain the incidence of CIN,” Giordano concludes.
Professor Giordano is an internationally renowned scientist specializing in cancer research and international research collaboration between the Sbarro Institute and several research institutions in Italy.
About the Sbarro Health Research Organization
The Sbarro Health Research Organization (SHRO) is non-profit charity committed to funding excellence in basic genetic research to cure and diagnose cancer, cardiovascular diseases, diabetes and other chronic illnesses and to foster the training of young doctors in a spirit of professionalism and humanism. To learn more about the SHRO please visit www.shro.org