Utilization of Milk as an Oral Contrast Agent in CT Scan of the Abdomen

Abstract

The present study aimed to evaluate using the whole milk as alternative oral contrast for the as-sessment of gastrointestinal CT enterography. Fifty patients undergo (18 female and 32 male) aged from 21 to 79 years (mean 45 years) undergo abdominal CT at the department of diagnostic radiology of King Abdulaziz University Hospital. They receive 1 - 1.5 liter whole milk. Siemens SOMATOM definition CT Scan Machine with 64 slices and dual source was utilized to image all pa-tients in research population group where iodinated oral contrast media was replaced by a whole milk available in the local market. Patients were scanned as per the routine protocol used for CT Abdomen at KAUH-CT Unit: Helical Mode with 0.7 Pitch was performed on all paints in supine po-sition using a 16-detector row scanner (Bright Speed S, General Electric-Milwaukee Wisconsin, USA). The following parameters were applied: collimation of 16 × 0.625 (1.25 - 3.75) mm, pitch of 3, Slice thickness: 5 mm, gantry rotation time of 400 mAs, tube voltage of 120 KV and scan time 11.05 second. The images of all cases were reviewed by two qualified radiologists. Conclusion: The present study suggested that whole milk was found to be an effective alternative negative contrast for the assessment of the jejunum, ileum and terminal ileum in CT enterography. It was excellent for gastric imaging and we recommended replacing milk as negative oral contrast since it is available and cost effective. Further research to be conducted with modified milk drinking timing for better large bowel distention.

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Badawood, A. , Alsioufi, N. , Fathuddin, S. , Mishah, N. and Jastaniah, S. (2015) Utilization of Milk as an Oral Contrast Agent in CT Scan of the Abdomen. Advances in Computed Tomography, 4, 33-41. doi: 10.4236/act.2015.43005.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Dizendorf, E.V., Treyer, V., Von Schulthess, G.K. and Hany, T.F. (2002) Application of Oral Contrast Media in Coregistered Positron Emission Tomography-CT. American Journal of Roentgenology, 179, 477-481.
http://dx.doi.org/10.2214/ajr.179.2.1790477
[2] Megibow, A.J., Babb, J.S., Hecht, E.M., Cho, J.J., Houston, C. and Boruch, M.M. (2006) Evaluation of Bowel Distention and Bowel Wall Appearance by Using Neutral Oral Contrast Agent for Multidetector Row CT. Radiology, 236, 87-95.
http://dx.doi.org/10.1148/radiol.2381041985
[3] Nyman, U., Dinnetz, G. and Anderson, I. (1984) E-Z-CAT: An Oral Contrast Medium for Use in Computed Tomography of the Abdomen. Acta Radiologica, 25, 121-124.
http://dx.doi.org/10.1177/028418518402500206
[4] Raptopoulos, V. (1989) Technical Principles in CT Evaluation of the Gut. Radiologic Clinics of North America, 27, 631-651.
[5] Fisher, J.K. (1982) Normal Colon Wall Thickness on CT. Radiology, 145, 415-418.
http://dx.doi.org/10.1148/radiology.145.2.7134445
[6] Nakada, K., Brown, R.S., Fisher, S.J., Higashi, T., Walter, G.L., Wahl, R.L., et al. (2001) Histological Localization of Tritiated FDG in the GI Tract: An Autoradiographic Study (abstr). Journal of Nuclear Medicine, 42, 25.
[7] Antoch, G., Kuehl, H., Kanja, J., Lauenstein, T.C., Schneemann, H., Hauth, E., et al. (2004) Dual-Modality PET/CT Scanning with Negative Oral Contrast Agent to Avoid Artifacts: Introduction and Evaluation. Radiology, 230, 879-885.
http://dx.doi.org/10.1148/radiol.2303021287
[8] Makarawo, T.P., Negussie, E., Malde, S., Tilak, J., Gayagoy, J., Watson, J., Francis, F., Lincoln, D. and Jacobs, M.J. (2013) Water as a Contrast Medium: A Re-Evaluation Using the Multidetector-Row Computed Tomography. The American Surgeon, 79, 728-733.
[9] Sun, X.G., Huang, G., Zhang, C., Chen, Y., Xue, H., Zheng, P., et al. (2006) Comparison of the Effect of Positive and Negative Oral Contrast Agent in FDG PET/CT Scan. Journal of Nuclear Medicine, 47, 149.
[10] Bae, K.T. (2010) Intravenous Contrast Medium Administration and Scan Timing at CT: Considerations and Approaches. Radiology, 256, 32-61.
http://dx.doi.org/10.1148/radiol.10090908
[11] Oliva, M.R., Erturk, S.M., Ichikawa, T., Rocha, T., Ros, P.R., Silverman, S.G. and Mortele, K.J. (2012) Gastrointestinal Tract Wall Visualization and Distention during Abdominal and Pelvic Multidetector CT with a Neutral Barium Sulphate Suspension: Comparison with Positive Barium Sulphate Suspension and with Water. JBR-BTR, 95, 237-242.
[12] Meyer, S.A. and Gawde, S. (2012) Utility of Negative Oral Contrast (Milk with 4% Fat) in PET-CT Studies. Indian Journal of Nuclear Medicine, 27, 151-155.
[13] Rupa, S.A., Al Azad, S. and Chakraborty, N.R. (2013) Milk—An Effective Low-Attenuation Computed Tomography Oral Contrast Medium. Journal of Enam Medical College, 3, 71-76.
[14] Winter, T.C., Ager, J.D., Nghiem, H.V., Hill, R.S., Harrison, S.D. and Freeny, P.C. (1996) Upper Gastrointestinal Tract and Abdomen: Water as an Orally Administered Contrast Agent for Helical CT. Radiology, 201, 365-370.
http://dx.doi.org/10.1148/radiology.201.2.8888224
[15] Scanlon, M.H., Blumberg, M.L. and Ostrum, B.J. (1983) Computed Tomographic Recognition of Gastrointestinal Pathology. RadioGraphics, 3, 201-227.
http://dx.doi.org/10.1148/radiographics.3.2.201
[16] Raptopoulos, V., Davis, M.A. and Smith, E.H. (1986) Imaging of the Bowel Wall: Computed Tomography and Fat Density Oral-Contrast Agent in an Animal Model. Investigative Radiology, 21, 847-850.
http://dx.doi.org/10.1097/00004424-198611000-00003
[17] Garrett, P.R., Meshkov, S.L. and Perlmutter, G.S. (1984) Oral Contrast Agents in CT of the Abdomen. Radiology, 153, 545-546.
http://dx.doi.org/10.1148/radiology.153.2.6484186
[18] Hebert, J.J., Taylor, A.J., Winter, T.C., Reichelderfer, M. and Weichert, J.P. (2006) Low-Attenuation Oral GI Contrast Agents in Abdominal-Pelvic Computed Tomography. Abdominal Imaging, 31, 48-53.
http://dx.doi.org/10.1007/s00261-005-0350-4
[19] Mitka, M. (2007) Milk Shows Potential as CT Contrast Agent. Journal of the American Medical Association, 297, 353.
[20] Apisarnthanarak, P., Tiangpug, T., Pongpornsup, S., Janpanich, S. and Suwannasit, T. (2013) Comparison of Pasteurized Whole Milk, UHT Whole Milk, Water, and Diluted Iodine Contrast as Computed Tomographic Enteric Contrasts. Journal of the Medical Association of Thailand, 96, 467-476.
[21] Cohade, C., Osman, M., Nakamoto, Y., Marshall, L.T., Links, J.M., Fishman, E.K., et al. (2003) Initial Experience with Oral Contrast in PET/CT: Phantom and Clinical Studies. Journal of Nuclear Medicine, 44, 412-416.
[22] Thompson, S.E., Raptopoulos, V., Sheiman, R.L., McNicholas, M.M. and Prassopoulos, P. (1999) Abdominal Helical CT: Milk as a Low-Attenuation Oral Contrast Agent. Radiology, 211, 870-875.
http://dx.doi.org/10.1148/radiology.211.3.r99jn25870
[23] Koo, C.W., Shah-Patel, L.R., Baer, J.W. and Frager, D.H. (2008) Cost-Effectiveness and Patient Tolerance of Low-Attenuation Oral Contrast Material: Milk versus Volumen. American Journal of Roentgenology, 190, 1307-1313.
http://dx.doi.org/10.2214/AJR.07.3193
[24] Lim, B.K., Bux, S.I., Rahmat, K., Lam, S.Y. and Liew, Y.W. (2012) Evaluation of Bowel Distension and Mural Visualisation Using Neutral Oral Contrast Agents for Multidetector-Row Computed Tomography. Singapore Medical Journal, 53, 732-736.

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