Advances in cardiac CT contrast injection and acquisition protocols

Peripherally inserted central catheters (PICCs) may be used to administer contrast injection during CT (computed tomography) scans to improve diagnostic accuracy. This is usually done with the use of a power injector. Research has shown that misplacement of catheters following contrast injection can occur. The aim of this review was to analyse appropriately positioned pre-scan PICCs that malposition following injection of contrast media during a CT scan, evaluate whether tip location or right or left insertion plays a part in the displacement of PICCs after CT, and to ensure those involved are aware of the risks and the safety checks required following such procedures. A quantitative method was used, gathering information from the team's insertion database to review 2045 records of contrast-injectable PICCs between 1 January 2015 and 30 April 2020. Analysis of the data indicated that 1% of appropriately sited PICCs malposition following contrast CT injection and that the catheter is able to self-correct back to its original position at an average interval of 24–72 hours without any other intervention. Further research is needed to explore other factors that could influence the rate of self-correction and complications of prolonged catheter malposition.

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Incidental 99mTc MDP uptake in the intestines and intravenous CT contrast

Nuklearmedizin ◽

10.3413/nukmed-0768-15-09 ◽

2016 ◽

Vol 55 (04) ◽

pp. 166-171 ◽

Cited By ~ 2

Author(s):

Soo Kim ◽

Joo Lee ◽

Seung Hyun ◽

Young Cho ◽

Seung Moon ◽

...

Keyword(s):

Breast Cancer ◽

Bone Scintigraphy ◽

Bone Scan ◽

Contrast Injection ◽

Intestinal Uptake ◽

Contrast Enhanced Ct ◽

Contrast Enhanced ◽

Enhanced Ct ◽

Bone Scans ◽

Ct Contrast

SummaryAim: We evaluated the association between intestinal visualization on bone scintigraphy and IV CT contrast in patients with breast cancer. Patients, methods: 452 patients with breast cancer underwent a 99mTc methylene diphosphonate (MDP) bone scan for surveillance of bone metastasis. Presence, site and intensity of intestinal uptake were visually assessed. For patients with intestinal visualization, medical records were reviewed to identify the alleged potential causes. When IV CT contrast was administrated on the same day as bone scan, the time between IV CT contrast injection, 99mTc MDP administration and bone scan was assessed. Results: Intestinal 99mTc MDP uptake was observed in 44 of the 452 patients (9.7%). Bone scans showed no thyroid or gastric uptake that suggested free pertechnetate. There were no patients with documented causes of intestinal uptake except for one patient with vesicoenteric fistula. Of the 452 patients, 149 (33.0%) underwent IV contrast-enhanced CT on the same day as bone scan. Forty of the 44 patients (90.9%) with intestinal uptake on bone scan underwent IV contrast-enhanced CT on the same day, whereas 109 of 408 (26.7%) patients without intestinal uptake on bone scintigraphy underwent IV contrast-enhanced CT on the same day (p < 0.001). The patients who underwent IV contrast injection between Tc-99m MDP administration and acquisition of bone scans had significantly more frequent intestinal uptake than patients who underwent IV contrast injection either before 99mTc MDP administration or after bone scanning (42.4% vs. 1.8%, p < 0.001). Conclusions: IV CT contrast injection administered on the same day as bone scintigraphy is significantly associated with 99mTc MDP uptake in the intestines among patients with breast cancer.

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