Myelography: current status and post-marketing experience with iotrolan

Abstract

There are three imaging modalities for the diagnosis of spinal diseases: magnetic resonance imaging (MRI), computed tomography (CT) and myelography. The choice of modality is influenced by factors including diagnostic accuracy cost, radiation dose and invasiveness. For many indications, MRI has advantages over CT and myelography and is the modality of choice, and there is likely to be a trend away from myelographic examinations. In cases where myelography is indicated, it is of prime importance to reduce the frequency and severity of adverse events. During phase III and IV trials, involving over 2000 patients, general and neural tolerance of iotrolan was shown to be significantly better than iopamidol or metrizamide. These results were confirmed by post-marketing reporting over 5 years with more than 1.5 million applications of iotrolan. Iotrolan 240 and 300 were concluded to be the “gold-standard” contrast agents, showing advantages in myelography over monomeric contrast agents, especially at high doses.