Iomeron®
When the highest concentration of iodine makes the difference1, 2, 3, 4, 5, 6
Iomeron® is a non-ionic, monomeric, iodine contrast agent for radiology
It is important to underline that an injectable solution with a high iodine concentration allows a higher contrast peak in a shorter time after injection, when injected at the same volume and flow rate compared to solutions with a lower iodine concentration7.
Iomeron® has interesting features that make it unique in its class, namely:
- the lowest viscosity per predefined concentration among iso-osmolar (IOCM) and hypo-osmolar (LOCM) contrast agents7;
- the lowest osmolality among monomeric (LOCM) contrast agents7;
- the highest iodine concentration solution (400 mgl/mL) available on the market.
Iomeron® (Iomeprol) is the latest generation contrast agent produced by Bracco. Launched in 19959, this non-ionic, iodinated contrast agent has rapidly become the drug of choice for many radiologists9. Its unique and innovative profile boasts the highest concentration ever approved worldwide (400 mgl/mL) among non-ionic contrast agents10. Iomeprol is currently registered in more than 40 countries worldwide, including all major European and Middle Eastern countries, not to mention Japan and rest of Asia, and represents a significant step forward in its category.
Iomeprol has become the product of choice for multiple reasons:
- this innovative solution combines the lowest viscosity among non-ionic contrast agents and a very low osmolarity compared to other non-ionic monomers available on the market10;
- Iomeron® is available in a wide range of iodine concentrations and volumes for every clinical use;
- in MDCT, at the same flow rate and total iodine dose, Iomeprol 400 mgl /mL provides a better contrast effect and thus contributes significantly to improved image quality than contrast media with lower iodine concentration11, 12, 13;
- in a multi-centre randomized double-blind coronary-CT study comparing two different contrast agents, Iomeprol and Iodixanol, the changes in mean heart rate observed during the procedure after intravenous contrast injection were in general neglibigle, and in any case similar for Iomeprol 400 and Iodixanol 32014.
- In addition, a prospective study of a significant cohort of patients undergoing CTA showed that a low-dose acquisition protocol, in conjunction with the use of Iomeron 400 provided a significant reduction in radiation exposure while maintaining a constant CNR (contrast-to-noise ratio) and good image quality, compared to a standard protocol using a lower concentration of contrast medium15.
- Besides, a prospective multi-center study compared the effects of Iomeprol 400 and Iodixanol 320, administered at the same dose of iodine, on renal function and the incidence of CIN in patients with moderate to severe renal impairment undergoing liver CT. Based on the results of the study, the authors concluded that: "The incidence of CIN was significantly higher after intravenous administration of iodixanol-320 rather than Iomeprol-400, in patients with moderate to severe chronic renal failure. The mean increase in serum creatinine above the threshold value was indeed higher in patients treated with iodixanol. It must be considered that nephrotoxicity is a multifactorial problem and, in addition to osmolality, other intrinsic characteristics of the molecule also count" 16.
1) High iodine concentration contrast material for noninvasive multislice computed tomography coronary angiography:iopromide 370 versus iomeprol 400.
Cademartiri F, de Monye C, Pugliese F, Mollet NR, Runza G, van der Lugt A, Midiri M, de Feyter PJ, Lagalla R, Krestin GP.Invest Radiol. 2006 Mar;41(3):349-53.
2) MDCT angiography of the pulmonary arteries: influence of iodine flow concentration on vessel attenuation and visualization.
Schoellnast H, Deutschmann HA, Fritz GA, Stessel U, Schaffler GJ, Tillich M. AJR Am J Roentgenol. 2005 Jun;184(6):1935-9.
3) Does iodine concentration affect the diagnostic efficacy of biphasic spiral CT in patients with hepatocellular carcinoma?
Marchianò A., Spreafico C., Lanocita R., Frigerio L., Di Tolla G., Patelli G., Garbagnati F., Heiman F., Taroni P., Damascelli B. Abdom Imaging. 2005 May-Jun;30(3):274-80.
4) Multidetector-Row Computed Tomography
Hammerstingl et al.
5) Effect of iodine concentration of contrast media on contrast enhancement in multislice CT of the pancreas.
Fenchel S, Fleiter TR, Aschoff AJ, van Gessel R, Brambs HJ, Merkle EM.Br J Radiol. 2004 Oct;77(922):821-30.
6) Enhancement and safety of iomeprol-400 and iodixanol-320 in patients undergoing abdominal multidetector CT.
Romano L, Grazioli L, Bonomo L, Xu JR, Chen KM, Dore R, Vanzulli A, Catalano C. Br J Radiol. 2009 Mar;82(975):204-11. Epub 2008 Dec 8.
7) The chemistry of iomeprol and physico-chemical properties of its aqueous solutions and pharmaceutical formulations.
Gallotti A, Uggeri F, Favilla A, Cabrini M, de Haën C.Eur J Radiol. 1994 May;18 Suppl 1:S1-12.
8) Computed Tomography Contrast Enhancement Principles and the Use of High-Concentration Contrast Media.
Herman S.J., Comput Assist Tomogr. 2004 Jul-Aug;28 Suppl 1:S7-11.
9) Bracco internal data.
10) Iomeron® SPC
11) 16MDCT angiography of aortoiliac and lower extremity arteries: comparison with digital subtraction angiography.
Albrecht T, Foert E, Holtkamp R, Kirchin MA, Ribbe C, Wacker FK, Kruschewski M, Meyer BC. AJR Am J Roentgenol. 2007 Sep;189(3):702-11.
12) High-concentration contrast media (HCCM) in CT angiography of the carotid system: impact on therapeutic decision making.
Schuknecht B. Neuroradiology. 2007 Jul;49 Suppl 1:S15-26.
13) Does iodine concentration affect the diagnostic efficacy of biphasic spiral CT in patients with hepatocellular carcinoma?
Marchianò A, Spreafico C, Lanocita R, Frigerio L, Di Tolla G, Patelli G, Garbagnati F, Heiman F, Taroni P, Damascelli B.Abdom Imaging. 2005 May-Jun;30(3):274-80.
14) Multicenter comparison of high concentration contrast agent iomeprol-400 with iso-osmolar iodixanol-320: contrast enhancement and heart rate variation in coronary dual-source computed tomographic angiography.
Becker CR, Vanzulli A, Fink C, de Faveri D, Fedeli S, Dore R, Biondetti P, Kuettner A, Krix M, Ascenti G. Invest Radiol. 2011 Jul;46(7):457-64.
15) Low-dose multidetector-row CT-angiography of abdominal aortic aneurysm after endovascular repair.
Iezzi R, Cotroneo AR, Giammarino A, Spigonardo F, Storto ML. Eur J Radiol. 2011 Jul;79(1):21-8. Epub 2009 Dec 16.
16) The ACTIVE Trial: comparison of the effects on renal function of iomeprol-400 and iodixanol-320 in patients with chronic kidney disease undergoing abdominal computed tomography.
Thomsen HS, Morcos SK, Erley CM, Grazioli L, Bonomo L, Ni Z, Romano L; Investigators in the Abdominal Computed Tomography: IOMERON 400 Versus VISIPAQUE 320 Enhancement (ACTIVE) Study.Invest Radiol. 2008 Mar;43(3):170-8.
Intravenous contrast material administration at helical 16-detector row CT coronary angiography: effect of iodine concentration on vascular attenuation.
Cademartiri F, Mollet NR, van der Lugt A, McFadden EP, Stijnen T, de Feyter PJ, Krestin GP.Radiology. 2005 Aug;236(2):661-5.
Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing.
Cademartiri F, Mollet NR, Runza G, Baks T, Midiri M, McFadden EP, Flohr TG, Ohnesorge B, de Feyter PJ, Krestin GP.AJR Am J Roentgenol. 2006 Mar;186(3):634-8.
Influence of intra-coronary enhancement on diagnostic accuracy with 64-slice CT coronary angiography.
Cademartiri F, Maffei E, Palumbo AA, Malagò R, La Grutta L, Meiijboom WB, Aldrovandi A, Fusaro M, Vignali L, Menozzi A, Brambilla V, Coruzzi P, Midiri M, Kirchin MA, Mollet NR, Krestin GP.Eur Radiol. 2008 Mar;18(3):576-83. Epub 2007 Oct 13.
Effect of iodine concentration of contrast media on contrast enhancement in multislice CT of the pancreas.
Fenchel S, Fleiter TR, Aschoff AJ, van Gessel R, Brambs HJ, Merkle EM.Br J Radiol. 2004 Oct;77(922):821-30.
Detection and localization of acute upper and lower gastrointestinal (GI) bleeding with arterial phase multi-detector row helical CT.
Jaeckle T, Stuber G, Hoffmann MH, Jeltsch M, Schmitz BL, Aschoff AJ.Eur Radiol. 2008 Jul;18(7):1406-13. Epub 2008 Mar 20.
Image quality in CT perfusion imaging of the brain. The role of iodine concentration.
König M, Bültmann E, Bode-Schnurbus L, Koenen D, Mielke E, Heuser L.Eur Radiol. 2007 Jan;17(1):39-47. Epub 2006 May 16.
MDCT angiography for detection of pulmonary emboli: comparison between equi-iodine doses of iomeprol 400 mgI/mL and iodixanol 320 mgI/mL.
Langenberger H, Friedrich K, Plank C, Matzek W, Wolf F, Storto ML, Schaefer-Prokop C, Herold C.Eur J Radiol. 2009 Jun;70(3):579-88. Epub 2008 Apr 1.
Clinical value of MDCT in the diagnosis of coronary artery disease in patients with a low pretest likelihood of significant disease.
Nikolaou K, Rist C, Wintersperger BJ, Jakobs TF, van Gessel R, Kirchin MA, Knez A, von Ziegler F, Reiser MF, Becker CR.AJR Am J Roentgenol. 2006 Jun;186(6):1659-68.
Effects of non-ionic iodinated contrast media on patient heart rate and pressures during intra-cardiac or intra-arterial injection.
Schmid I, Didier D, Pfammatter T, Garachemani A, Fleisch M, Kirchin MA, Meier B.Int J Cardiol. 2007 Jun 12;118(3):389-96. Epub 2007 Mar 21.
Optimization of cardiac MSCT contrast injection protocols: dependency of the main bolus contrast density on test bolus parameters and patients' body weight.
Rist C, Becker CR, Kirchin MA, Johnson TR, Busch S, Bae KT, Leber AW, Reiser MF, Nikolaou K.Acad Radiol. 2008 Jan;15(1):49-57.
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For any product or type of product, whether a drug or device, referenced in this website, physicians should carefully review the product's package insert, instructions for use, or user manual prior to patient administration to ensure proper utilization of the product. The local Summaries of Product Characteristics of the main Bracco Imaging products are available on line.