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13 protocols using iobitridol

1

Evaluating Iodine Contrast Agents Injection Protocols

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Group A: iobitridol (Guerbet, France; 350 mgI/100 mL) was administered at a volume of 0.8 mL/kg multiplied by the bodyweight; the injection time was 13 seconds; injection rate: volume/injection time, followed by saline injection at the same flow rate as the iodine contrast agent for 10 seconds; total injection time was 23 seconds.
Group B: iobitridol (Guerbet; 350 mgI/100 mL): bodyweight multiplied by 0.9 mL/kg; injection time: 13 seconds; injection rate: volume/injection time, followed by saline at the same flow rate as the iodine contrast agent for 10 seconds; total injection time: 23 seconds.
Group C: iobitridol (Guerbet; 350 mgI/100 mL), bodyweight multiplied by 0.8 mL/kg; injection time: 12 seconds; injection rate: volume/injection time, followed by saline at the same flow rate as the iodine contrast agent for 11 seconds; total injection time: 23 seconds.
Group D: iodixanol iodine contrast agent (Visipaque, GE Healthcare; 320 mgI/100 mL); injection volume: bodyweight multiplied by 0.8 mL/kg; injection time: 13 seconds; injection rate: injection volume/injection time, followed by saline injection at the same flow rate as the iodine contrast agent for 10 seconds; total injection time: 23 seconds (Fig. 1).
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2

Comprehensive Contrast-Enhanced CT Evaluation of Bladder Lesions

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All CECT were acquired in—at least—basal, portal-venous (fixed 90-s delay), and pyelographic phases after the administration of 1.4 mL/kg of a 350–370 mgI/mL contrast medium (Ioexol, Omnipaque, GE Healthcare, Chicago, IL, USA; Iobitridol, Xenetix, Guerbet; Iopamidol, Iopamiro, Bracco, Milano, Italy). Many different CT scanners were used (Somatom Definition 40, Siemens Healthineers, Erlangen, Germany; Aquilion 64, Toshiba, Tokyo, Japan; Revolution Evo 64, GE; IQon Spectral CT, Philips, Amsterdam, The Netherlands). In all cases, the CECT protocol was 120 KVp, automatic tube current modulation, and slice thickness 0.625–1.5 mm.
A radiologist (A.C.) and a radiology resident (T.G.), with 9 and 3 years of experience in urogenital radiology, reviewed all scans for the following parameters: ring enhancement; implantation site on the bladder wall; dimensions; density; margins; central necrosis; calcifications; the number of wall bladder lesions; wall thickness; depth of invasion in the soft tissue; invasion of the surrounding fat tissue; invasion of adjacent organs; lymph-node involvement; abdominal organ metastasis.
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3

Digital Subtraction Angiography IVC Occlusion

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A Innova-4100 (GE Healthcare®, Milwaukee, WI, USA) digital subtraction angiographic imaging system was used, and a 5F pigtail catheter was placed through the femoral or jugular vein to the edge of the IVC occlusion. Iobitridol (25−35 mL of 300 mg I/mL; Guerbet®, Roissy, France) was injected at a rate of 15−20 mL/s. When the patients presented with a complete IVC occlusion after injection through the femoral vein, a second injection was performed via jugular vein cannulation using a 5F single-curve catheter.
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4

Standardized CT Scan Protocol for Renal Imaging

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During the study period, all CT scans were performed using either a Brilliance 64-slice spiral CT or a Brilliance 256-ICT (Philips, Best, The Netherlands). The scanning parameters were: tube voltage of 120 kV, tube current of 250 to 300 mA, thread pitch of 1.0, thickness of scanning layer of 5 mm, and thickness of reconstruction layer of 1 mm. The scanning range was from the upper margin of the liver to the bilateral anterior superior iliac spine, totally covering the kidneys. Enhanced scan was performed using an antecubital venous injection of Iobitridol (350 mgI/mL; a nonionic contrast agent; Guerbet, Roissy-Charles-de-Gaulle, France) with a total dose of 80 to 100 mL and injection rate of 3.5 ml/s. After injection of the contrast agent, the corticomedullary phase scan was carried out at 30 to 40 ms, the parenchymal phase at 60 to 70 ms, and the excretory phase at 120 to 180 ms. The original data were uploaded to the postprocessing workstation (IntelliSpace Portal, Philips, Best, The Netherlands) for image analysis. The radiologists were blind to the clinical pathological data when reviewing the images.
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5

Contrast Media Injection Protocol

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For all patients in G1, CM was injected into the antecubital vein following the local standard‐of‐care tri‐phasic injection protocol, with fixed injection rate of 5 ml/s. In the first phase, a fixed amount (55 ml) of CM is administered, followed by 38 ml of a diluted solution (40% CM – 60% saline) (phase 2) for artifact‐free visualization of the right ventricular cavity,20 and subsequently 30 ml saline chaser (phase 3).
Four different contrast media were used in a weekly rotation: Iodixanol 320 mg I/ml (Visipaque, GE Healthcare, Cork, Ireland), Iomeprol 350 mg I/ml (Iomeron, Bracco, Milan, Italy), Iobitridol 350 mg I/ml (Xenetix, Guerbet, Paris, France) and 370 mg I/ml (Ultravist, Bayer, Leverkusen, Germany).
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6

Evaluating Iodinated Contrast Media Antioxidant Capacity

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Five commercially available iodinated radiographic contrast media are iobitridol (xenetix; Guerbet, France), iodixanol (visipaque; GE Healthcare, Ireland), iohexol (omnipaque; GE Healthcare, China), ioxaglate (hexabrix; Guerbet, France), and isovue (iopamiro; Bracco, Italy). These iodinated radiographic contrast media are mainly used in diagnostic radiology. Di(phenyl)-(2,4,6-trinitrophenyl) iminoazanium (DPPH), ascorbic acid, 2,4,6-tri(2-pyridyl)-s-triazine (TPTZ), Trolox, and 2,2′-azino-bis(3-ethylbenzthiazoline-6-sulphonic acid) (ABTS) were purchased from Sigma–Aldrich (St. Louis, MO, USA).
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7

Liver CT with Dual-Energy Arterial Phase

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Liver CT consisted of precontrast, arterial, portal venous, and equilibrium phases. Precontrast, portal venous, and equilibrium phase images were obtained using 90-kVp tube energy before, 70 s, and 180 s after contrast media administration (iobitridol 350 mgI/mL, Xenetix®, Guerbet, France) with weight-based dosing (1.6 mL/kg).
The arterial phase was scanned using dual-energy 17 s after the attenuation of the abdominal aorta reached 80 Hounsfield unit (HU) at 100 kVp, using the care bolus technique of the vendor. For arterial phase dual-energy scanning, a tube potential pair of 80/150 kV with a tin filter was used. The quality reference effective mAs was set to 250 mAs for the 80-kV tube and 125 mAs for the 150-kV tube. Detector configuration, gantry rotation time, and pitch were 192 × 0.6 mm, 0.5 s, and 0.6, respectively. Images were reconstructed with semi-smooth quantitative body kernels in all phases.
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8

Standardized Intravenous Contrast Allergy Testing

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STs were carried out as described (Torres et al., 2012 (link); Brockow et al., 2013 (link); Salas et al., 2013 (link); Brockow, 2020 (link)) using a battery that included the following ICMs: iomeprol (Iomeron, Rovi, Madrid, Spain), iodixanol (Visipaque, GE Healthcare Biosciences, Madrid, Spain), iobitridol (Xenetix, Guerbet, Madrid, Spain), iohexol (Omnipaque, GE Healthcare Biosciences, Madrid, Spain), iopromide (Clarograf, Bayer, Barcelona, Spain), ioversol (Optiray, Covidien, Barcelona, Spain), and ioxaglate (Hexabrix, Guerbet, Madrid, Spain). For IRs, skin prick tests (SPTs) were performed using undiluted ICM and if negative, and intradermal tests (IDTs) were performed using 10-fold dilutions, being read 20 min after testing. For NIRs, IDTs were performed using 10-fold diluted, and if negative, undiluted ICM, being read at 20 min, 1, 2, and 3 days after testing. Positive responses were considered for SPTs if a wheal larger than 3 mm surrounded by erythema appeared with a negative response to the control saline; and for IDTs, if the size of the initial wheal increased 3 mm or more in diameter, surrounded by erythema (Brockow et al., 2002 ).
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9

Contrast-Enhanced Dual-Source CT Imaging

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Imaging was performed in the single-energy mode using a second-generation dual-source CT scanner (Somatom Definition Flash; Siemens Healthineers) with our institutional default protocol: fixed tube voltage 100 kVp, reference tube current time product 100 mAs using automatic tube current modulation (CareDose4D, Siemens Healthineers), slice acquisition 128 × 0.6 mm by means of a z-flying spot, gantry rotation time 500 ms, pitch 1, and scan direction craniocaudal.
A bolus of 60-mL iso-osmolar, nonionic iodinated contrast material (350 mg I/mL, Iobitridol, Guerbet) followed by a saline flush of 30 mL was injected into an antecubital vein with a dual-head power injector at a flow rate of 4.0 mL/s. Image initiation was controlled by bolus tracking with a ROI in the pulmonary trunk, using a 120 Hounsfield units (HU) attenuation threshold at 120 kVp. After reaching this threshold, the scan was initiated after a fixed delay of 5 s.
All images were reconstructed with sinogram affirmed iterative reconstruction (SAFIRE, Siemens Healthineers) at a strength level of 3 using a medium-smooth reconstruction kernel (I30f), a slice thickness of 2 mm, and slice increment of 1.6 mm.
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10

Dynamic Chest CT Imaging Using Dual-Phase Contrast

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The examination was performed using a single tube and fast kVp-switching technique between 80 and 140 kVp on a high-definition CT (DiscoveryTM CT 750HD; GE healthcare, Milwaukee, WI). Plain scan and dual-phase contrast-enhanced CT of chest in GSI mode was performed in all the patients. Patients were placed in the craniocaudal direction and examined in the supine position with both arms extended above the head. Plain scan was performed first, and the scan volume ranged from thoracic inlet to base of lung. Then a bolus of 60 to 80 mL nonionic contrast media (Iobitridol 350 mgI/mL, Guerbet, France) was injected into the median cubital vein at a flow rate of 3 mL/s via a high-pressure injector with binocular tube (Ulrich, Germany), followed by 30 mL saline flush. Arterial phase and venous phase were obtained at 25 seconds and 50 seconds after contrast media injection with the same range of plain scan, respectively. The GSI scan parameters were as follows: helical scan mode with 80/140 kVp tube voltage fast switching and 550 mA tube current, 0.8 second tube rotation time, 5 mm slice thickness and interval, 1.25 mm reconstruction interval, and 1.375 pitch.
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