Knowledge gaps

Module 1

It is unclear which treatments of acute hypersensitivity reactions after CM administration lead to a higher severity of complaints. The following outcomes would be relevant to study: duration of acute reaction, morbidity, mortality, costs, hospitalization in an IC-unit, and length of stay.

 

Module 2

It is unclear whether any treatment of late hyper sensitivity reactons after contrast administration leads to a quicker recovery, a less serious course, sequelae, mortality, morbidity hospitalization. It is also not clear whether one treatment option might lead to a better outcome (as described in the previous sentence) compared to another.

 

Module 3

It is not clear whether serum tests for hypersensitivity reactions after contrast administration lead to a better probability of a correct diagnosis, and ultimately, a better patient outcome (measured as less recurrent hypersensitivity reactions after contrast administration, less morbidity and mortality).

 

Module 4

It is unclear whether application of cutaneous tests (skin test, patch test (PT), Intradermal test (IDT), skin prick test (SPT) or scratch test) in patients who have had an acute hypersensitivity reaction after contrast medium administration leads to a better correctly confirmed diagnosis of hypersensitivity reaction.

 

It is unclear which contrast media should be included in a panel for cutaneous tests.

 

Module 5

What factors are related to an increased risk of developing hypersensitivity reactions after contrast administration?

 

What are the effects of a prophylactic measure to prevent hypersensitivity reactions after contrast administration compared to a different/ control measure to prevent hypersensitivity reactions after contrast administration or to no prophylactic measure, in patients undergoing radiological examinations with contrast media?

 

Module 6

The incidence of PC-AKI after administration of GBCA is unknown.

 

The difference in nephrotoxic potential between different GBCA’s is unknown.

 

Module 7

It is unclear whether ionic macrocyclic GBCAs compared to non-ionic macrocyclic GBCAs in renal insufficiency patients (eGFR <30 ml/min/1.73m²) are associated with different risk of NSF.

 

It is unclear whether residual kidney function in dialysis patients is affected by the timing of haemodialysis after administration of GBCA.

 

It is unclear whether timing of dialysis after administration of GBCA affects patient outcomes.

 

Module 8

It is not clear what the clinical relevance is of gadolinium-based contrast agent (GBCA) induced T₁w hyperintensity of the nucleus dentatus and the globus pallidus in the brain?

 

Module 9

It is not clear what the safety and efficacy is of contrast administration with haemodialysis catheters versus peripheral intravenous access sites.

 

It is not clear what the effect is on image quality when contrast power injection is performed using CVCs, HD catheters, PICCs and TIVAPs versus peripheral catheters.

 

Module 10

It is not clear what the best treatment is for contrast extravasation, and if any treatment is effective at all.