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CT Contrast in Radiation Oncology Simulation

Greg Kubicek, James E Kovacs, Tamara LaCouture


Objectives: With IMRT and advanced radiation planning, anatomy and contouring is becoming increasingly important in the field of radiation oncology. The use of iodinated computed tomography (CT) contrast for radiation simulation CT scans can help define anatomy more precisely and thus improve contouring.  The major risks of CT contrast (which at least partly accounts for the aversion by some departments to its routine use) are contrast induced nephropathy and allergic-like reactions.

Results: The evidence of complications attributable to standard doses of contrast for diagnostic CT examinations is weak.  The preponderance of data on contrast induced nephropathy has been compiled from interventional cardiology procedures, and the current guidelines regarding diagnostic CT contrast require extrapolation on mostly retrospective data.  The evidence available suggests that CT contrast related adverse events are rare, and contrast related nephropathy most often spontaneously resolves without further decline in baseline renal function.

Conclusion: The current data regarding safety of CT contrast provides a limited foundation on which to make evidence-based recommendations. We have reviewed the literature on CT contrast. By following some simple algorithms CT contrast can be safely utilized.


CT Contrast; contrast induced nephrotoxicity; contouring; simulation

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