Imaging Pearls ❯ PET-CT ❯ Use of IV Contrast
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- “Beyond introducing errors, IV contrast material administration creates the potential for contrast-related adverse events, including contrast material reactions, extravasations, and contrast-associated acute kidney injury. While these events are generally uncommon, they may still require workflow changes for their prevention and management. Furthermore, issues regarding reimbursement, and by extension the correct ordering of and billing for, diagnostic PET/CT studies using IV contrast material remain outstanding. Currently, no designated Current Procedural Terminology codes exist for integrated diagnostic PET/CT using IV contrast material,which could result in inappropriately billing, whether upcharging or downcharging, for the examination.”
IV Contrast Material for PET/CT: Counterpoint—Critical Concerns Remain
Merissa N. Zeman, MD, Esma A. Akin, MD
AJR (in press) - “In summary, IV contrast material is an established component of CT examinations that improves anatomic definition and provides important diagnostic information. An example of the benefits provided by integrated FDG PET and contrast-enhanced CT is shown in Figure 1. While IV contrast material is not needed for every PET/CT examination, fully diagnostic CT can provide valuable information in combination with PET and should be used when indicated. Patients and physicians benefit from the improved accuracy and confidence provided by a comprehensive PET/CT examination that fully harnesses the synergistic diagnostic capabilities of the CT and PET components. With new targeted PET tracers, the role of the diagnostic CT component will have even greater importance. As we move into an era of personalized medicine, it is crucial that we obtain the most accurate anatomic and functional information possible so that we can make informed treatment decisions for each patient. It is time for us to put the full diagnostic power of CT into PET/CT.”
IV Contrast Material for PET/CT: Point—Putting the CT Into PET/CT
Colm B. Kelleher Terence Z. Wong
AJR 2022 (in press)
- "Although there is a significant increase in SUV in regions of high contrast concentration when contrast enhanced CT is used for attenuation correction, this increase is clinically insignificant."
Quantifying the Effect of IV Contrast Media on Integrated PET/CT:Clinical Evaluation
AJR 2006; 186:308-319. - "Although there is a significant increase in SUV in regions of high contrast concentration when contrast enhanced CT is used for attenuation correction, this increase is clinically insignificant. Accordingly, in PET/CT, IV contrast can be used in combination with the PET to evaluate patients with cancer."
Quantifying the Effect of IV Contrast Media on Integrated PET/CT:Clinical Evaluation
AJR 2006; 186:308-319.