Evidence map›Paper›PMID 28856420›Full record

SynthesisEuropean radiology2018

Iodine-based contrast media, multiple myeloma and monoclonal gammopathies: literature review and ESUR Contrast Media Safety Committee guidelines.

Fulvio Stacul, Michele Bertolotto, Henrik S Thomsen, Gabriele Pozzato, Donatella Ugolini, Marie-France Bellin, Georg Bongartz, Olivier Clement, Gertraud Heinz-Peer, Aart van der Molen and 3 more

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 2 pooled it
3.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.

  1. EANM guidelines on the use of [European journal of nuclear medicine and molecular imaging · 2024
    Guideline
  2. Pooled it
  3. Risk of acute kidney injury following repeated contrast exposure in trauma patients.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Article
  4. Multiple myeloma.Nature reviews. Disease primers · 2024
    Review
  5. Review
  6. Article
  7. Article
  8. Light Chain Cast Nephropathy in Multiple Myeloma: Prevalence, Impact and Management Challenges.International journal of nephrology and renovascular disease · 2022
    Review
  9. Review
  10. Review
  11. Article
  12. Review
  13. Article
  14. Review
  15. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 11 institutions in 8 countries.

Fulvio StaculS.C. Radiologia Ospedale Maggiore, Piazza Ospitale 1, IT-34129, Trieste, Italy.
Michele BertolottoDepartment of Radiology, University of Trieste, Strada di Fiume 447, IT-34149, Trieste, Italy.
Henrik S ThomsenDepartment of Diagnostic Radiology 54E2, Copenhagen University Hospital Herlev, Herlev Ringvej 75, DK-2730, Herlev, Denmark. Henrik.Thomsen@regionh.dk.
Gabriele PozzatoDepartment of Medical and Surgical Sciences, University of Trieste, Piazza Ospitale 1, IT-34129, Trieste, Italy.
Donatella UgoliniDepartment of Internal Medicine, University of Genoa, Genoa, Italy.
Marie-France BellinService Central de Radiologie Hôpital Paul Brousse 14, av. P.-V.-Couturier, F-94807, Villejuif, France.
Georg BongartzDepartment of Diagnostic Radiology, University Hospitals of Basel, Petersgaben 4, CH-4033, Basel, Switzerland.
Olivier ClementDepartment of Radiology, Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, 20, rue Leblanc, Paris Cedex 15, F-71015, Paris, France.
Gertraud Heinz-PeerDepartment of Radiology, Zentralinstitut für medizinische Radiologie, Diagnostik und Intervention, Landesklinikum St. Pölten, Propst Führer-Straße 4, St. Pölten, AT-3100, St. Pölten, Austria.
Aart van der MolenDepartment of Radiology, C2-S, Leiden University Medical Center, NL-2300 RC, Leiden, The Netherlands.
Peter ReimerRadiology, Klinikum Karlsruhe, Academic Teaching Hospital of the University of Freiburg, Molkestreet 90, D-76133, Karlsruhe, Germany.
Judith A W WebbDepartment of Radiology, St. Bartholomew's Hospital, University of London, West Smithfield, London, EC1A 7BE, UK.
ESUR Contrast Media Safety Committee
University of Trieste · ITHerlev Hospital · DKHôpital Européen · FRHôpital Paul-Brousse · FRIstituti di Ricovero e Cura a Carattere Scientifico · ITLeiden University Medical Center · NLOspedale Maggiore · ITSt Bartholomew's Hospital · GBUniversitätsklinikum St. Pölten · ATUniversity Hospital of Basel · CHUniversity of Freiburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesMany radiologists and clinicians still consider multiple myeloma (MM) and monoclonal gammopathies (MG) a contraindication for using iodine-based contrast media. The ESUR Contrast Media Safety Committee performed a systematic review of the incidence of post-contrast acute kidney injury (PC-AKI) in these patients.

methodsA systematic search in Medline and Scopus databases was performed for renal function deterioration studies in patients with MM or MG following administration of iodine-based contrast media. Data collection and analysis were performed according to the PRISMA statement 2009. Eligibility criteria and methods of analysis were specified in advance. Cohort and case-control studies reporting changes in renal function were included.

resultsThirteen studies were selected that reported 824 iodine-based contrast medium administrations in 642 patients with MM or MG, in which 12 unconfounded cases of PC-AKI were found (1.6 %). The majority of patients had intravenous urography with high osmolality ionic contrast media after preparatory dehydration and purgation.

conclusionsMM and MG alone are not risk factors for PC-AKI. However, the risk of PC-AKI may become significant in dehydrated patients with impaired renal function. Hypercalcaemia may increase the risk of kidney damage, and should be corrected before contrast medium administration. Assessment for Bence-Jones proteinuria is not necessary. KEY POINTS: • Monoclonal gammopathies including multiple myeloma are a large spectrum of disorders. • In monoclonal gammopathy with normal renal function, PC-AKI risk is not increased. • Renal function is often reduced in myeloma, increasing the risk of PC-AKI. • Correction of hypercalcaemia is necessary in myeloma before iodine-based contrast medium administration. • Bence-Jones proteinuria assessment in myeloma is unnecessary before iodine-based contrast medium administration.

Indexed as

Acute Kidney InjuryRadiologySocieties, MedicalContrast MediaEuropeHumansIncidenceIodineMultiple MyelomaParaproteinemiasRisk FactorsContrast MediaIodineAcute kidney injuryContrast mediaMonoclonal gammopathiesMultiple myelomaRenal failure

Identifiers

PMID28856420
PMCPMC5740198
OpenAlexW2753201999

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.