title: Safe use of iodinated and gadolinium-based contrast media in current practice in Japan: a questionnaire survey.
abstract: OBJECTIVE
  To help establish consensus on the safe use of contrast media in Japan.
  
  
  METHODS
  Questionnaires were sent to accredited teaching hospitals with radiology residency programs.
  
  
  RESULTS
  The reply rate was 45.4% (329/724). For contrast-induced nephropathy (CIN), chronic and acute kidney diseases were considered a risk factor in 96.7 and 93.6%, respectively, and dehydration in 73.9%. As preventive actions, intravenous hydration (89.1%) and reduction of iodinated contrast media dose (86.9%) were commonly performed. For nephrogenic systemic fibrosis (NSF), chronic and acute kidney diseases were considered risk factors in 98.5 and 90.6%, respectively, but use of unstable gadolinium-based contrast media was considered a risk factor in only 55.6%. A renal function test was always (63.5% in iodinated; 65.7% in gadolinium) or almost always (23.1; 19.8%) performed, and estimated glomerular filtration rate (eGFR) was the parameter most frequently used (80.8; 82.6%). For the patients with risk factors for acute adverse reaction (AAR), steroid premedication or/and change of contrast medium were frequent preventive actions, but intravenous steroid administration immediately before contrast media use was still performed.
  
  
  CONCLUSIONS
  Our questionnaire survey revealed that preventive actions against CIN were properly performed based on patients' eGFR. Preventive actions against NSF and AAR still lacked consensus.
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma, 373-8511, Japan. tsushima.rad.gunma@gmail.com.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.affiliation: Department of Radiology, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Ishiguchi
authors.affiliation: Department of Radiology, Kinki University, Faculty of Medicine, Osaka, Japan.
authors.forename: Takamichi
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Radiology, Nippon Medical School, Tokyo, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Department of Radiology, Iwate Prefectural Kamaishi Hospital, Kamaishi, Iwate, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Hayakawa
authors.affiliation: Department of Radiology, The Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Fukuda
authors.affiliation: Department of Radiology, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Yukunori
authors.initials: Y
authors.lastname: Korogi
authors.affiliation: Department of Radiology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Sugimoto
authors.affiliation: Department of Radiology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Takehara
authors.affiliation: Department of Radiology, Osaka Medical College, Takatsuki, Osaka, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Narumi
authors.affiliation: Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.affiliation: Department of Radiology, Faculty of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kuwatsuru
authors.affiliation: Department of Radiology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.affiliation: Department of Diagnostic Radiology, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.affiliation: Department of Radiology, Gifu University School of Medicine, Gifu, Gifu, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kanematsu
authors.affiliation: Department of Radiology, Nippon Medical School, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Takagi
mesh_terms: D001942:Breast Feeding; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects*; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D007455:Iodine / Q000008:administration & dosage* / Q000009:adverse effects*; D007564:Japan; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D054989:Nephrogenic Fibrosing Dermopathy / Q000139:chemically induced / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D003287:Contrast Media; D007455:Iodine; D005682:Gadolinium
keywords: Contrast medium; Guideline; Japan; Questionnaire; Safety