Effect of diagnostic radioisotopes and radiographic contrast media on measurements of lumbar spine bone mineral density and body composition by dual-energy x-ray absorptiometry.
Since there is almost no information on whether the concomitant use of diagnostic radioisotopes and radiographic contrast media interferes with dual-energy X-ray absorptiometry (DXA), we investigated these potentially confounding effects. At routine scheduled radiographic follow-up, 40 patients previously treated for malignant lymphomas or solid tumors in Hamilton and Ottawa, Canada were evaluated, 10 in each of the following 4 categories of diagnostic procedure: (1) computed tomography (CT) with intravenous, iodine-based contrast (+/-oral contrast), (2) magnetic resonance imaging (MRI) with gadolinium-based contrast, (3) gallium scan (GS), and (4) technetium bone scan (TBS). Whole body bone mineral content (WB-BMC) and lumbar spine bone mineral density (LS-BMD), total fat mass (TFM), and lean body mass (LBM) were measured by DXA immediately before and after the other radiological studies (on the same day) and then 7 days later. No statistically significant differences were found among WB-BMC, LS-BMD, TFM, and LBM Z-scores immediately before and after MRI, GS, TBS, and 7 days later. The DXA measurements performed immediately before and after CT showed statistically significant differences in WB-BMC (100% vs 124.5%, p<0.001), TFM (100% vs 75.4%, p<0.001), and LBM (100% vs 110%, p<0.001), resulting from the CT contrast agents compromising the precision of the DXA. The DXA results after 7 days were not statistically different from those at baseline. Dual-energy X-ray absorptiometry can be performed in association with other radiological techniques, with the exception of CT conducted with contrast within 1 week. This study provides information that applies not only to patients with cancer but to the general population undergoing diagnostic procedures.
Sala
Alessandra
A
Health Sciences Centre, McMaster University, and McMaster Children's Hospital, Hamilton, Ontario, Canada.
Webber
Colin
C
Halton
Jacqueline
J
Morrison
Judy
J
Beaumont
Lesley
L
Zietak
Anna
A
Barr
Ronald
R
D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D001835:Body Weight; D015519:Bone Density / Q000528:radiation effects; D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D006801:Humans; D007472:Iohexol; D008159:Lumbar Vertebrae / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
D003287:Contrast Media; D007472:Iohexol