Role of Contrast Agents in Imaging

EP: 1.Imaging Modalities in Medical Diagnosis and Treatment

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EP: 2.Role of Contrast Agents in Imaging

EP: 3.Contrast Agent Protocol

EP: 4.Role of Generics in Imaging

EP: 5.Generic Contrast Agents

EP: 6.Contrast Media: American College of Radiology Recommendations

EP: 7.Unmet Needs in Imaging Modalities

Joseph Cavallo, MD, MBA: Let’s move on to some information about contrast agents. In your experience, how big of an impact has the use of contrast agents had in your daily practice?

Dushyant Sahani, MD: Contrast agents have played such a big role, but somehow it is underappreciated and under-recognized, and I will elaborate that further. Since the time computed tomography [CT] scans and magnetic resonance imaging [MRI] [were introduced]—2 major modalities that have a big impact on health care—initially, just the fact that we [could] create these images and see inside the body was so fascinating. Very soon we realized we had limitations. What we could do with just the imaging technique and to amplify the image quality or provide that clarity to the anatomic details and tissues, contrast agents became extremely valuable. Some of the success we have seen in imaging modalities is heavily influenced by safe and effective contrast media both on CT and MRI. I think it has engendered with patients, and referring providers have allowed them to order these types of exams in the outpatient setting where you have less oversight compared [with] when it’s done in the [emergency department] or inpatient setting.

Contrast media made a big impact on the impact [that] these imaging techniques have on health care. Sometimes we don’t appreciate the nuance of the contribution contrast media had. If you look at liver imaging as [an] example, both CT and MRI have a big impact, but the protocols are influenced by what type of contrast media we deliver and how we acquire images. The timing becomes so important, and that influences a lot…imaging in the abdomen is through contrast media protocols. Not only that, as we saw these contrast media make a difference to our diagnostic capabilities, clinical colleagues’ expectations [also] evolved. They wanted more tissue diagnosis. They wanted to have higher reliance on imaging techniques so they [could] minimize interventions [such as] having a tissue diagnosis. Then we had molecularly targeted or cellularly targeted agents that came up, and we found value for all those contrast agents in really advancing care delivery. Contrast media [is] extremely important.

If you look at positron emission tomography CTs without having a safe and effective tracer like FDG, we can’t do anything. It’s a CT scan. Without that, you have no hybrid, physiologic, [or] functional imaging capability available. Contrast media is so integral to the value [that] imaging technique adds. And despite many advances we have seen on MRI, including diffusion techniques, contrast media continues to play a very important role. One point we sometimes forget is [that] we need to be cognizant of the workforce. Globally, the workforce in radiology is much younger, and you need to provide images that are so clear that you can have a level playing field when it comes to providing the diagnosis and support to the referring providers and having all those benefits for patients. Contrast media lends that clarity on those images. If you take contrast media out of a lot of these techniques, [you] will see tremendous variability in how care is delivered [and] challenges with diagnosis and misdiagnosis. [You will also see that] the reliance on imaging techniques will drop substantially.

Transcript is AI-generated and edited for clarity and readability.