Abstract
ObjectiveTo compare the diagnostic image quality between three different water soluble iodinated contrast media in hysterosalpingography (HSG).Material and methodIn a prospective randomised study of 204 patients, the diagnostic quality of images obtained after hysterosalpingography were evaluated using Iopramide (106 patients) and Ioxaglate (98 patients). 114 patients who had undergone HSG examination using Iodamide were analysed retrospectively. Image quality was assessed by three radiologists independently based on an objective set of criteria. The obtained results were statistically analysed using Kruskal-Wallis and Mann-Whitney U test.ResultsVisualisation of fimbrial rugae was significantly better with Iopramide and Ioxaglate than Iodamide. All contrast media provided acceptable diagnostic image quality with regard to uterine, fallopian tubes outline and peritoneal spill. Uterine opacification was noted to be too dense in all three contrast media and not optimal for the assessment of intrauterine pathology. Higher incidence of contrast intravasation was noted in the Iodamide group. Similarly, the numbers of patients diagnosed with bilateral blocked fallopian tubes were also higher in the Iodamide group.ConclusionHSG using low osmolar contrast media (Iopramide and Ioxaglate) demonstrated diagnostic image qualities similar to HSG using conventional high osmolar contrast media (Iodamide). However, all three contrast media were found to be too dense for the detection of intrauterine pathology. Better visualisation of the fimbrial outline using Ioxaglate and Iopramide were attributed to their low contrast viscosity. The increased incidence of contrast media intravasation and bilateral tubal blockage using Iodamide are probably related to the high viscosity.
Highlights
Intensity modulated radiotherapy (IMRT) utilises small beamlets of ionising radiation to provide a highKhamfongkhruea et al Biomed Imaging Interv J 2012; 8(1):e5This page number is not for citation purposes use a respiratory gating system
The measurements by MapCheck show the gamma index of the planned absolute dose distribution in static and moving targets with gating, resulting in more than 96% passing for all dose rates
The absolute dose distribution measured by film for the static target was agreeable with the value of moving target with gating
Summary
Intensity modulated radiotherapy (IMRT) utilises small beamlets of ionising radiation to provide a highKhamfongkhruea et al Biomed Imaging Interv J 2012; 8(1):e5This page number is not for citation purposes use a respiratory gating system. Chen et al [5] studied the dosimetric effects caused by the respiratory motion during IMRT by using Kodak EDR2 films. They concluded that, without the gating system, the dose distribution of the stationary phantom was different from the moving one. Duan et al [7] studied the dosimetric effect of respiration-gated beam with IMRT delivery Their results suggested that low dose rate can reduce the effect of delay and catch-up cycle. Lin et al [2] determined the effect of radiation dose rate with moving target and the gated treatment using step-and-shoot IMRT delivery. The high dose rate gated stepand-shoot IMRT was dosimetrically accurate, shortened the delivery time, and was safe to use clinically
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