Unique Clinical Scenarios
 | 1. The patient has sickle cell disease. Can they get IV contrast? |
| 2. The patient has multiple myeloma. Can they get IV contrast material? |
| 3. If a patient has thyroid disease is iodinated contrast contraindicated? |
| 4. If a patient has thyroid cancer is iodinated contrast contraindicated? |
| 5. If a patient has myathenia gravis should iodinated contrast be used for a chest CT? |
| 6. If a patient is on glucophage (or other oral diabetes medications) is there an issue with iodinated contrast agents? What is the current rule with oral diabetes drugs? (glucophage) |
| 7. What patients take glucophage (metformin)? |
| 8. What is the danger of Metformin and iodinated contrast? |
| 9. What are the other names for metformin? |
| 10. What are the current guidelines for patients taking metformin and needing a contrast study? |
| 11. Is there any problem with using iodinated contrast for CT if a patient is on the cardiac drug Amiodarone? |
| 12. Can you use iodinated contrast on a patient with suspected or known pheochromocytoma? |
| 13. If a patient is nursing can she receive IV contrast? |
| 14. What is our policy for scanning a pregnant patient? |
| 15. If a CT is done on a pregnant patient and iodinated contrast is used can that affect the fetus? |
 | This has been an area of concern but recent publications say that this is not an issue and no harm is done to the fetal thyroid gland. "Based on neonatal TSH measurements in a small number of patients, we found no ill effect of iodinated contrast agents on neonatal thyroid function after in utero exposure." Neonatal Thyroid Function After Administration of IV Iodinated Contrast Agent to 21 Pregnant Patients Atwell TD et al. AJR 2008; 191:268-271 "In conclusion, based on neonatal TSH measurements in a small number of patients, the IV administration of water soluble nonionic iodinated contrast agents to pregnant patients has no subsequent effect on neonatal thyroid function." Neonatal Thyroid Function After Administration of IV Iodinated Contrast Agent to 21 Pregnant Patients Atwell TD et al. AJR 2008; 191:268-271 "No mutagenic or teratogenic effects have been described after the administration of iodinated contrast during pregnancy, and neither in vitro nor in vivo tests performed in animals revealed any deleterious effects from exposure to iodinated contrast material." Guidelines for Use of Medical Imaging During Pregnancy and Lactation Tremblay E et al. RadioGraphics 2012; 32:897-911 "Consequently the use of iodinated contrast agents in nursing mothers is considered safe." Guidelines for Use of Medical Imaging During Pregnancy and Lactation Tremblay E et al. RadioGraphics 2012; 32:897-911 "The dose of iodinated or gadolinium based contrast medium that reaches the infant through ingestion of breast milk is very small, and only a minute proportion of that which reaches the infants gastrointestinal tract is subsequently absorbed. There is insufficient evidence to recommend even a temporary cessation of breast feeding following the administration of either iodinated or gadolinium based contrast agents." Guidelines for Use of Medical Imaging During Pregnancy and Lactation Tremblay E et al. RadioGraphics 2012; 32:897-911 |
| 16. Who should get baseline serum creatinine levels before CT? |