The use of contrast media in many imaging modalities continues to evolve as physicians seek to improve dose management practices and vendors churn out automated injectors that can precisely control the amount of contrast and personalize doses for patients using information pulled from an electronic medical record (EMR) or picture archiving and communication system (PACS). The features of today’s contrast media injectors include syringeless options and dose recording software, offering new possibilities for radiology departments looking to streamline and document their contrast media usage.
Syringeless power injectors have emerged recently as a solution to contrast media waste. As the Joint Commission does not allow the reuse of unused doses from single-use syringe injectors, this option gives facilities the opportunity to use contrast media as efficiently as possible.
A study published online in the Journal of Medical Devices: Evidence and Research in November 2013 sought to evaluate the use of syringeless injectors versus dual-syringe injectors for contrast-enhanced computed tomography (CT) in a hospital setting.1 Studying patients enrolled at Legnano Hospital in Italy, the authors recorded data on the quantity of media used as well as time spent and overall satisfaction on the radiologic technologists’ part. They found syringeless power injectors were more user-friendly and efficient than the dual-syringe power injector, with more waste per contrast-enhanced CT observed for the latter. The syringeless injector also allowed a cost savings of about $8 per patient when considering the lower cost and improved performance of the devices.
In March, Guerbet launched FlowSens, its syringe-free injection system solution aimed at the X-ray market, after receiving CE mark in Q1 2014. The system is composed of a softbag injector and associated disposables, using a hydraulic syringe-free injector to deliver contrast media. It is compatible with the company’s ScanBag solution as well as any type of contrast agent available on the market.
Bracco Imaging’s EmpowerMR hydraulic-powered contrast media injection system is designed for advanced magnetic resonance imaging (MRI) procedures, conditional for use in 1.5T, 3.0T and even up to 7.0T scanners. The company bills it as the “first injector to employ hydraulics rather than an electric motor to power rams” with the ability to eliminate any causes for artifacts on MR images. Both EmpowerMR and EmpowerCTA, another Bracco system, include preprogrammed protocols to work with any make and model of MR and CT angiography (CTA) scanners. With EmpowerCTA, automatic initialization options prepare syringes for filling, and an auto-purge function automatically purges air from the syringe.
The IRiSCT information reporting system module captures injection-related information, including patient identification. This information can be sent to a PACS, recording the amount of dose used and any reactions observed by the patient, including any extravasation that may have occurred.
Other systems on the market include Covidien’s Optivantage dual-head contrast media delivery system for CT, launched in 2012. The RFID-enabled system features simultaneous injection and prefilled Ultraject syringes, offering flexibility for radiology technicians and helping reduce the risk of infection. It automatically captures drug information and checks for expired materials, ensuring patients receive the correct prescribed dose of contrast for the CT examination.
Nemoto Kyorindo offers contrast media injectors for CT, MR and angiography. Customizable protocols give radiologists the opportunity to tailor programs for any diagnostic objective. The company’s MR injectors use non-ferrous construction to allow for safe integration in the MRI room. The latest angiography injector, Press Duo, features air-purge functions and is billed as the first dual injector for angiography.
Extravasation detectors are also now found on contrast media injectors. Nemoto offers a contrast media leak detection system to improve patient safety while finding extravasations earlier on in the injection process. Bayer’s XDS extravasation detector stops injections when pooling fuid is detected under the patient’s skin.
Contrast Media Uses
The use of contrast media in medical imaging continues to vary, with agents more commonly used for MR and CT examinations. Contrast-enhanced ultrasound, already a smaller niche market in comparison, makes up less than 10 percent of all echocardiograms, according to the American Society of Echocardiography (ASE). The society released a new set of guidelines for cardiac sonographers in August, to help expand the use of contrast media in cardiac ultrasound, citing its benefits in better detecting myocardial ischemia at rest and during stress echos.
Automated contrast media injectors will likely remain in demand on the market as radiology departments seek to improve efficiencies and record management, while manual injection of contrast agents will continue to be preferred by end users, particularly in cardiology, who desire greater control of precision. Look for vendors to continuously update their technologies as trends evolve, making them more ideal for integration with information systems and imaging scanners.
1. www.ncbi.nlm.nih.gov/pmc/articles/PMC3821755/, accessed Sept. 5, 2014.