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Better Tasting Contrast Agent Could Improve Pediatric Imaging

For children and adolescents, a good taste in the mouth might enhance compliance during radiologic exams.

By
Janelle Weaver, Contributor
Monday, June 11, 2018

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The incidence of inflammatory bowel disease is on the rise in pediatric populations. Currently, the most appropriate radiologic tests for diagnosing inflammatory bowel disease in children and adolescents are computed tomographic and magnetic resonance enterography. These tests require patients to consume contrast agents that fill up and distend the small bowel, allowing for the accurate assessment of imaging findings. Unfortunately, the traditional contrast agent, a barium sulfate suspension called VoLumen, can leave a bad taste in the mouth, making noncompliance a problem among fussy kids.

This issue was the focus of a prospective randomized study and a related editorial published May 8 in the journal Radiology. In the study, 66 8- to 17-year-old patients undergoing CT or MR enterography for suspected or known inflammatory bowel disease were randomized to receive either VoLumen or Breeza, a flavored beverage for abdominal and pelvic imaging. As expected, the contrast agents did not produce a significant difference in the amount of bowel distention between the two groups.

On a 10-point scale, Breeza received higher scores than VoLumen for taste (6.1 versus 2.7) and texture (7.3 versus 3.6). While 85 percent of patients guzzled the full dose of Breeza, only 52 percent of patients were able to swallow the required amount of VoLumen. Because of its superior palatability, Breeza could be an alternative for children and adolescents undergoing CT and MR enterography.

However, one study limitation was that the researchers did not compare the effects of the contrast agents on diagnostic accuracy or clinical outcomes. And according to the editorial author Donald Frush, a pediatric radiologist at Duke University Medical Center in Durham, North Carolina, the study should have included side-by-side taste comparisons of both agents, and assessments of delayed reactions such as diarrhea. “Despite these hesitations, this research study is valuable in adding to the limited knowledge of variables with aspects of enteral contrast administration for CT enterography and MR enterography in children,” Frush wrote.

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