Low-keV and Low-kVp CT for Positive Oral Contrast Media in Patients with Cancer: A Randomized Clinical Trial.

08:00 EDT 9th April 2019 | BioPortfolio

Summary of "Low-keV and Low-kVp CT for Positive Oral Contrast Media in Patients with Cancer: A Randomized Clinical Trial."

Background Substantial gain in the attenuation of iodine on low-kVp and dual-energy CT processed low-keV virtual monochromatic images provides an opportunity for customization of positive oral contrast media administration. Purpose To perform an intrapatient comparison of bowel labeling, opacification, and taste preference with iodinated oral contrast medium (ICM) in standard (sICM) and 25%-reduced (rICM) concentrations at low tube voltage (100 kVp) or on low-energy (50-70 keV) virtual monochromatic images compared with barium-based oral contrast medium (BCM) at 120 kVp. Materials and Methods In this prospective clinical trial, 200 adults (97 men, 103 women; mean age, 63 years ± 13 [standard deviation]) who weighed less than 113 kg and who were undergoing oncologic surveillance (from April 2017 to July 2018) and who had previously undergone 120-kVp abdominopelvic CT with BCM randomly received sICM (7.2 g iodine) or rICM (5.4 g iodine) and underwent 100-kVp CT or dual-energy CT (80/140 kVp) scans to be in one of four groups (n = 50 each): sICM/100 kVp, rICM/100 kVp, sICM/dual-energy CT, and rICM/dual-energy CT. Qualitative analysis was performed for image quality (with a five-point scale), extent of bowel labeling, and homogeneity of opacification (with a four-point scale). Intraluminal attenuation of opacified small bowel was measured. A post-CT patient survey was performed to indicate contrast medium preference, taste of ICM (with a five-point scale), and adverse effects. Data were analyzed with analogs of analysis of variance. Results All CT studies were of diagnostic image quality (3.4 ± 0.3), with no difference in the degree of bowel opacification between sICM and rICM (P > .05). Compared with BCM/120 kVp (282 HU ± 73), mean attenuation was 78% higher with sICM/100 kVp (459 HU ± 282) and 26%-121% higher at sICM/50-65 keV (50 keV = 626 HU ± 285; 65 keV = 356 HU ± 171). With rICM, attenuation was 46% higher for 100 kVp (385 HU ± 215) and 19%-108% higher for 50-65 keV (50 keV = 567 HU ± 270; 65 keV = 325 HU ± 156) compared with BCM (P < .05). A total of 171 of 200 study participants preferred ICM to BCM, with no taste differences between sICM and rICM (3.9 ± 0.6). Fifteen participants had diarrhea with BCM, but none had diarrhea with ICM. Conclusion A 25%-reduced concentration of iodinated oral contrast medium resulted in acceptable bowel labeling while yielding substantially higher luminal attenuation at low-kVp and low-keV CT examinations with improved preference in patients undergoing treatment for cancer. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Laghi in this issue.


Journal Details

This article was published in the following journal.

Name: Radiology
ISSN: 1527-1315
Pages: 182393


DeepDyve research library

PubMed Articles [48690 Associated PubMed Articles listed on BioPortfolio]

Effectiveness of a comprehensive oral management protocol for the prevention of severe oral mucositis in patients receiving radiotherapy with or without chemotherapy for oral cancer: a multicentre, phase II, randomized controlled trial.

The aim of this phase II, multicentre, randomized controlled trial was to evaluate the effectiveness of a comprehensive oral management protocol for the prevention of severe oral mucositis in patients...

Local analgesic effect of a bioadhesive barrier-forming oral liquid in cancer patients with oral mucositis caused by chemotherapy and/or radiotherapy: a randomized multicenter, single-use, positive-controlled, open-label study.

CAM2028 (Episil; Camurus AB, Lund, Sweden) is a liquid for use in the oral cavity to treat various pains associated with mouth injuries. Upon contact with the swollen oral mucosa, the oral liquid form...

Comparison of three oral contrast preparations for magnetic resonance enterography in pediatric patients with known or suspected Crohn disease: a prospective randomized trial.

Oral contrast preparation is fundamental to ensuring diagnostic examination quality for magnetic resonance enterography (MRE), yet little is known about the relative palatability and tolerability of v...

Comparison of Positive Oral Contrast Agents for Abdominopelvic CT.

The objective of our study was to compare the quality of bowel opacification from three different positive oral contrast agents-barium sulfate, diatrizoate, and iohexol-at abdominopelvic CT.

Molecular epidemiology of human papillomavirus genotypes in oral rinses from HIV-positive and HIV-negative Jamaican patients.

Human papillomavirus (HPV) has been reported to be associated with oral and oropharyngeal cancer. However, little information is available about the epidemiology of oral HPV infection in Jamaica. The ...

Clinical Trials [26210 Associated Clinical Trials listed on BioPortfolio]

Renal Effects of Two Iodinated Contrast Media in Patients at Risk Undergoing Computed Tomography

It is well known that X-ray contrast media can affect kidney function in some patients, especially when administered intra-arterially, and patients who already suffer from reduced kidney f...

Ioxaglate Versus Iodixanol for the Prevention of Contrast-induced Nephropathy in High-risk Patients (IDPC Trial)

Contrast media-induced nephropathy following diagnostic and therapeutic cardiac catheterization.

Renal Effects of Two Iodinated Contrast Media in Patients at Risk Undergoing Coronary Angiography

The main purpose of this study is to evaluate and compare the effects on kidney function of two contrast media, the iso-osmolar iodixanol and the low-osmolar iopamidol in patients at risk ...

Uniformity of Oral Contrast Material in the Bowel

Although positive oral contrast agents are used for the majority of abdominopelvic CT scans in the United States, the quality of bowel opacification has not been compared between the three...

Study of Iodine Contrast Media Extravasation

The purpose of this study is to determine the best intervention after the extravasation of the iodinated contrast medium out of a vessel into the surrounding tissues.

Medical and Biotech [MESH] Definitions

Any liquid or solid preparation made specifically for the growth, storage, or transport of microorganisms or other types of cells. The variety of media that exist allow for the culturing of specific microorganisms and cell types, such as differential media, selective media, test media, and defined media. Solid media consist of liquid media that have been solidified with an agent such as AGAR or GELATIN.

Iodinated pyridine derivatives that are often used as contrast media.

Substances used to allow enhanced visualization of tissues.

A water-soluble radiographic contrast media for cholecystography and intravenous cholangiography.

Radiographic examination of the process of defecation after the instillation of a CONTRAST MEDIA into the rectum.

Quick Search


DeepDyve research library

Relevant Topics

  Bladder Cancer Brain Cancer Breast Cancer Cancer Cervical Cancer Colorectal Head & Neck Cancers Hodgkin Lymphoma Leukemia Lung Cancer Melanoma Myeloma Ovarian Cancer Pancreatic Cancer ...

Drug Discovery
Clinical Approvals Clinical Trials Drug Approvals Drug Delivery Drug Discovery Generics Drugs Prescription Drugs In the fields of medicine, biotechnology and pharmacology, drug discovery is the process by which drugs are dis...

Clincial Trials
In a clinical trial or interventional study, participants receive specific interventions according to the research plan or protocol created by the investigators. These interventions may be medical products, such as drugs or devices; procedures; or change...

Searches Linking to this Article