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Milk Shows Potential as CT Contrast Agent

Milk Shows Potential as CT Contrast Agent Chicago—Radiologists looking to replace chalky-tasting barium-based contrast agents used for some computed tomography (CT) imaging may need to look no further than their dairy case. It appears whole milk may be an adequate substitute. Researchers from St Luke’s-Roosevelt Hospital in New York City said their preliminary findings from an ongoing study found milk achieved similar bowel distension and enhancement as a commonly used barium-based contrast agent, VoLumen. Their findings were presented at the Scientific Assembly of the Radiological Society of North America meeting, held here in November. (Photo credit: Paul Johnson/iStockphoto.com) CT imaging of the gastrointestinal tract is a diagnostic tool for evaluating patients complaining of abdominal pain. When CT is used for visualization of the small intestinal wall, it requires a negative oral contrast agent, such as VoLumen. But the group's early findings suggest milk may be a practical substitute for VoLumen, according to Lisa R. Shah-Patel, MD, a radiological resident at St Luke’s-Roosevelt Hospital. A negative oral contrast agent allows better visualization of the bowel wall and clearer delineation between the bowel cavity and soft tissue. Using whole milk (not skim or reduced fat milk because the fat content makes a difference), the milk-filled intestinal cavity appears dark while the intestinal wall appears brighter. This contrast effect helps radiologists see evidence of disease associated with the bowel wall. The investigators studied 62 consecutive adult patients receiving VoLumen (who drank 900 mL 30 minutes before the CT test plus 300 mL immediately prior to the test) and 117 consecutive patients receiving milk (who drank 400 mL to 600 mL 1 hour before the test plus 200 mL to 400 mL 20 minutes prior to imaging). About 42% of the 57 VoLumen patients who subsequently completed a questionnaire experienced abdominal discomfort such as cramps, diarrhea, and nausea compared with only 23% of the 117 patients given milk. Of those taking the VoLumen, 40% said they would have preferred milk and 85% of the milk drinkers said they would select it again. The researchers hope to ultimately enroll 130 patients in each arm of the trial. The researchers said that milk may be a good contrast agent for children, who tend to balk at drinking barium-based drinks. They also said using milk (which costs less than $1.50 per patient) rather than VoLumen (costing about $18 per patient) as a contrast agent could have an impact on health care costs. Of the 30 to 40 million CT scans performed annually in the United States, about 30% are for abdominal conditions where milk could be used. As for effectiveness, the researchers said both contrast agents worked similarly, although they did note a trend suggesting better distension and visualization of the bowel wall with VoLumen compared with milk. Still, they argued, milk may have a place in CT imaging because of patient acceptance, fewer abdominal symptoms, and lower cost. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Milk Shows Potential as CT Contrast Agent

JAMA , Volume 297 (4) – Jan 24, 2007

Milk Shows Potential as CT Contrast Agent

Abstract

Chicago—Radiologists looking to replace chalky-tasting barium-based contrast agents used for some computed tomography (CT) imaging may need to look no further than their dairy case. It appears whole milk may be an adequate substitute. Researchers from St Luke’s-Roosevelt Hospital in New York City said their preliminary findings from an ongoing study found milk achieved similar bowel distension and enhancement as a commonly used barium-based contrast agent, VoLumen. Their findings...
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Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.297.4.353
Publisher site
See Article on Publisher Site

Abstract

Chicago—Radiologists looking to replace chalky-tasting barium-based contrast agents used for some computed tomography (CT) imaging may need to look no further than their dairy case. It appears whole milk may be an adequate substitute. Researchers from St Luke’s-Roosevelt Hospital in New York City said their preliminary findings from an ongoing study found milk achieved similar bowel distension and enhancement as a commonly used barium-based contrast agent, VoLumen. Their findings were presented at the Scientific Assembly of the Radiological Society of North America meeting, held here in November. (Photo credit: Paul Johnson/iStockphoto.com) CT imaging of the gastrointestinal tract is a diagnostic tool for evaluating patients complaining of abdominal pain. When CT is used for visualization of the small intestinal wall, it requires a negative oral contrast agent, such as VoLumen. But the group's early findings suggest milk may be a practical substitute for VoLumen, according to Lisa R. Shah-Patel, MD, a radiological resident at St Luke’s-Roosevelt Hospital. A negative oral contrast agent allows better visualization of the bowel wall and clearer delineation between the bowel cavity and soft tissue. Using whole milk (not skim or reduced fat milk because the fat content makes a difference), the milk-filled intestinal cavity appears dark while the intestinal wall appears brighter. This contrast effect helps radiologists see evidence of disease associated with the bowel wall. The investigators studied 62 consecutive adult patients receiving VoLumen (who drank 900 mL 30 minutes before the CT test plus 300 mL immediately prior to the test) and 117 consecutive patients receiving milk (who drank 400 mL to 600 mL 1 hour before the test plus 200 mL to 400 mL 20 minutes prior to imaging). About 42% of the 57 VoLumen patients who subsequently completed a questionnaire experienced abdominal discomfort such as cramps, diarrhea, and nausea compared with only 23% of the 117 patients given milk. Of those taking the VoLumen, 40% said they would have preferred milk and 85% of the milk drinkers said they would select it again. The researchers hope to ultimately enroll 130 patients in each arm of the trial. The researchers said that milk may be a good contrast agent for children, who tend to balk at drinking barium-based drinks. They also said using milk (which costs less than $1.50 per patient) rather than VoLumen (costing about $18 per patient) as a contrast agent could have an impact on health care costs. Of the 30 to 40 million CT scans performed annually in the United States, about 30% are for abdominal conditions where milk could be used. As for effectiveness, the researchers said both contrast agents worked similarly, although they did note a trend suggesting better distension and visualization of the bowel wall with VoLumen compared with milk. Still, they argued, milk may have a place in CT imaging because of patient acceptance, fewer abdominal symptoms, and lower cost.

Journal

JAMAAmerican Medical Association

Published: Jan 24, 2007

Keywords: contrast media,milk

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