Can you use iodinated contrast on a patient with suspected or known pheochromocytoma?

Can you use iodinated contrast on a patient with suspected or known pheochromocytoma?

In the past this was always considered a high risk to the patient. However, that was in the ionic contrast days. Today in the era of non-ionic contrast this is no issue. Several select references define current policy.

Pheochromocytomas and IV Contrast (True/False)

• If a pheo is suspected IV contrast is usually not given unless patient is treated with an alpha-adrenergic blocking drug
• Contrast related reactions with pheo’s are very uncommon with the use of non-ionic contrast agent

"IV administration of nonionic contrast material for CT is a safe practice for patients with pheochromocytoma and related tumors even without alpha-blocking medication."

CT of Pheochromocytoma and Paraganglioma: Risk of Adverse Events with IV Administrationof Nonionic Contrast Material


Bessell-Browne R et al.
 AJR 2007; 188:970-974

"Our results and the clinical practice described in the recent literature suggest that alpha-blockade is not specifically required before IV administration of nonionic contrast material to patients with suspected or known pheochromocytoma or related tumors."

CT of Pheochromocytoma and Paraganglioma: Risk of Adverse Events with IV Administrationof Nonionic Contrast Material
Bessell-Browne R et al. AJR 2007; 188:970-974