You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Urodynamics Testing1 Apr 20132282 CONTRAST CONCENTRATION DOES NOT ALTER FLUORO-URODYNAMIC INTERPRETATION Brian Marks, Sandip Vasavada, and Howard B. Goldman Brian MarksBrian Marks Cleveland, OH More articles by this author , Sandip VasavadaSandip Vasavada Cleveland, OH More articles by this author , and Howard B. GoldmanHoward B. Goldman Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2211AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The use of urodynamic studies in routine evaluation of the urologic patient has increased in recent years and patients with more complex voiding dysfunction often require evaluation with fluoro-urodynamics (FUDS). Standardization of contrast concentration has not been established and understanding differences in outcomes is important for developing guidelines. METHODS In this IRB approved, double-blinded prospective study, patients were randomized to receive either full strength intravesical contrast for the entire study or contrast for the first 250 mL followed by sterile saline. Fellowship trained urologists graded images using an ordinal scale to rank their confidence in interpreting the visibility of the bladder silhouette, bladder neck, and urethra during filling and voiding. Inter-reader reliability was compared and responses were analyzed using Visual Grading Characteristics (VCG), a validated method of radiological image analysis. Contrast-to-noise ratios (CNR) were compared to biometric and urodynamic variables. RESULTS Fifty subjects were randomized, 27 subjects to dilute and 23 to non-dilute contrast with mean age 52. Mean maximum cystometric capacity (MCC) was 424 mL in the dilute group and 472 mL in the non-dilute group; 73% had volumes greater than 250 mL Agreement was found between raters. VCG analysis demonstrated no difference in image interpretability between dilute and non-dilute contrast groups for each criterion assessed. Interpreters were unable to consistently identify the study group and were correct in only 55% of cases. The mean CNR was 7.4 ± 6.0 and 4.6 ± 3.2 in the dilute contrast group during filling and voiding, respectively, compared to 7.9 ±4.7 and 5.4 ±4.0 in the non-dilute group; these differences were not significant (p > 0.05). CNR did not correlate to body mass index, waist circumference, or MCC. CONCLUSIONS Image quality did not deteriorate and interpretability of FUDS images was not altered with the use of dilute intravesical contrast. Interpreters could not distinguish between dilute and non-dilute contrast studies. Contrast concentration had limited impact on study interpretation and intravesical contrast is only necessary for the first 250 mL of filling during FUDS. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e936 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Brian Marks Cleveland, OH More articles by this author Sandip Vasavada Cleveland, OH More articles by this author Howard B. Goldman Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...