Annie Lee Napper MS, BS, Presenter: Nothing to Disclose

John Gilbert Strang MD, Abstract Co-Author: Nothing to Disclose

Susan L. Voci MD, Abstract Co-Author: Nothing to Disclose

Sven E. Ekholm MD, Abstract Co-Author: Nothing to Disclose

Examine the benefit of creatinine/GFR determination at the time of CT and MRI examinations to decide the amount of intravenous contrast to be used; full dose, reduced dose, or not administered at all.

POC-C (i-STAT, Abbott Laboratories) was used to determine renal function on the day of examination. A test set was created consisting of all patients who had POC-C test on the day of examination due to outdated or absent renal laboratory results. The test set consisted of 28 patients (mean age 67, age range 41-92, male/female 11/17) who were referred for CT or MRI (15 and 13, resp., and was 5% of all referred patients). Three radiologists reviewed each patient’s anonymized medical history and most recent renal laboratory values to determine intravenous contrast dosing. The radiologists then repeated the review, blinded to their original decisions, including same day POC-C testing results and made a new decision about intravenous contrast dosing. Dosing was recorded as either full dose per routine protocol, reduced dose or withheld.

Overall, POC-C results changed the dosing of intravenous contrast in 58% of CT and 41% of MRI examinations. POC-C results permitted the use of intravenous contrast, either reduced or full dose, in 20% of patients who otherwise would have been scanned without. 13% of patients were able to receive a full dose versus a reduced dose of contrast based on POC-C results. Intravenous contrast was reduced or eliminated in 24% of patients who otherwise would have received the full dose of intravenous contrast. The three radiologist dosing decisions were completely concordant in 68% of the test patients when POC-C results were available versus 29% without POC-C results.

Same day POC-C renal function testing has a significant impact on intravenous contrast dosing in patients with outdated laboratory data upon presentation in an outpatient setting. Access to POC-C should improve patient safety and increase diagnostic quality/accuracy.

Outdated renal function tests are a common problem at outpatient imaging centers. POC-C testing allows better intravenous contrast dosing decisions, which should improve patient safety and care.

Napper, A, Strang, J, Voci, S, Ekholm, S, The Outcome of Same-Day Point of Care Testing for Renal Function Prior to Administration of Intravenous Contrast for CT and MR Imaging at an Outpatient Imaging Center.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9011494.html