Can Ultrasound Replace Computed Tomography (CT) Scan in Those Unable to Have Computed Tomography (CT) Contrast Agents (CEUS_CT)

Foothills Medical Centre

Status: Completed

Conditions: Sensitivity to CT Contrast Agents; Nephrotoxicity of CT Contrast Agents; US With CEUS as Replacement for Unenhanced CT Scan; CT Scans in Those With Renal Compromise

Study type: Observational

Funder types: Other; Industry

Identifiers

NCT01151566

21982

Details and patient eligibility

About

Computed tomography (CT) scan, performed with contrast enhancement, is one of the most commonly requested examinations in diagnostic imaging. In a patient with an elevated creatinine or an allergy to contrast agents, the scan may be performed without the benefit of contrast enhancement. Ultrasound (US), performed with contrast agent enhancement does not have any nephrotoxicity and may be performed on patients with CT contrast allergy. The investigators propose that US with Contrast enhanced ultrasound (CEUS) is superior to unenhanced CT scan in this population.

Full description

Contrast enhanced computed tomography (CT) is one of the most common investigations performed in any radiology department, used widely in evaluating pathology in any part of the body.

Historically, it is well known that the use of contrast agents for CT scans may result in nephropathy, or renal failure. Nephrotoxicity associated with the injection of CT contrast agents may occasionally occur in healthy individuals and more commonly in those with borderline renal function. If abnormal kidney function is known to exist in a patient sent for CT scan, the examination is performed without the valuable assistance of contrast enhancement. Further, if prior hypersensitivity to the contrast agent for CT scan is known, again, the scan will be performed without the use of contrast agent.

Ultrasound (US) performed conventionally in grayscale and with Doppler is able to evaluate most abdominal and pelvic organs and also provides vascular information related to large vessel blood flow. Contrast enhanced ultrasound (CEUS) provides more precise information on blood flow than is available with Doppler and has been shown to be comparable to CT scan in some circumstances. We believe that a comparison of conventional US, with CEUS, and unenhanced CT scan would clearly favor ultrasound for detection of soft tissue pathology on the basis of its inherent tissue contrast differentiation.

Enrollment: 250 patients

Sex: All

Ages: 18 to 95 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• unenhanced CT scan of abdomen
• known renal compromise
• known hypersensitivity to CT contrast agents

Exclusion criteria

• CT scan performed with contrast agent

Trial design

250 participants in 2 patient groups

Renal Compromise

Description:

Those referred for CT scan with identified renal compromise necessitating use of no contrast agent

Sensitivity to CT Contrast Agents

Description:

Those referred for CT scan with prior demonstration of contrast sensitivity requiring use of no contrast