An evaluation of the use of oral contrast media in abdominopelvic CT

Buttigieg, Erica Lauren; Grima, Karen Borg; Cortis, Kelvin; S, Soler; Zarb, Francis

doi:10.1007/s00330-014-3285-8

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…In the study of Buttigieg et al 8 , 46 oncological patients who previously underwent abdominopelvic CT with positive oral contrast, were scheduled for follow-up and received water only as oral contrast (n = 25) or no oral contrast agent (n = 21). The data showed comparable image quality concerning the reproduction of abdominal structures, bowel discrimination, presence of artefacts, and visualization of the amount of intra-abdominal fat for the three protocols.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is not clear whether the advantages of withholding oral contrast in the emergency department can be extrapolated to the outpatient setting, as they have different clinical questions and patient spectrum. There are no sufficient data on withholding oral contrast in this patient population [6][7][8][9] and the available data are also equivocal. positive and negative oral contrast.…”

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confidence: 99%

“…positive and negative oral contrast. However several studies 7-10 evaluated the role of ''negative oral contrast" with water only and showed that the use of water only had similar image quality in follow-up abdominopelvic CT for general oncological indications [7][8][9] and even better delineation 8,10 and/or diagnosis compared to "positive oral contrast". Although limited data is available, it seems that positive oral contrast can be replaced by water only, without losing image quality and the confidence of the diagnosis.…”

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confidence: 99%

“…However, all the aforementioned data [7][8][9][10][11] were retrospectively obtained and it is known that retrospective studies have several limitations, such as selection bias, missing data and potential confounders. This makes the implementation of the findings of these studies in routine practice difficult.…”

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A prospective study comparing water only with positive oral contrast in patients undergoing abdominal CT scan

Wit

Tielbeek

Diepen

et al. 2020

Sci Rep

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A prospective study comparing water only with positive oral contrast in patients undergoing abdominal ct scan pascale A. M. de Wit ✉ , Jeroen A. W. tielbeek, pascal R. van Diepen, ikrame oulad Abdennabi, Ludo f. M. Beenen & Shandra Bipatconsecutive adults scheduled to undergo abdominal ct with oral contrast were asked to choose between 1000 ml water only or positive oral contrast (50 ml Télébrix-Gastro diluted in 950 ml water). two abdominal radiologists independently reviewed each scan for image quality of the abdomen, the diagnostic confidence per system (gastrointestinalsystem/organs/peritoneum/retroperitoneum/ lymph nodes) and overall diagnostic confidence to address the clinical question (not able/partial able/ fully able). Radiation exposure was extracted from dose reports. Differences between both groups were evaluated by Student's t-test, Mann-Whitney-U-test or chi-square-test. Of the 320participants, 233chose water only. All baseline characteristics, image quality of the abdomen and the diagnostic confidence of the organs were comparable between groups and both observers. Diagnostic confidence in the water only group was more commonly scored as less than good by observer1. The results were as follows: the gastrointestinal system(18/233vs1/87; p = 0.031), peritoneum (21/233vs1/87; p = 0.012), retroperitoneum (11/233vs0/87; p = 0.040) and lymph nodes (11/233vs0/87; p = 0.040). These structures were scored as comparable between both groups by observer2. The diagnostic confidence to address the clinical question could be partially addressed in 6/233 vs 0/87 patients (p = 0.259). The water only group showed a tendency towards less radiation exposure. In summary, most scan ratings were comparable between positive contrast and water only, but slightly favored positive oral contrast for one reader for some abdominal structures. therefore, water only can replace positive oral contrast in the majority of the outpatients scheduled to undergo an abdominal ct.www.nature.com/scientificreports www.nature.com/scientificreports/ Radiation exposure. Although not significant, all medians (except CTDI vol in the chest/abdomen region) were higher in the positive oral contrast group scanned by 64 slice scanners ( Table 2). The medians of the total DLP and CTDI vol of the different regions scanned by the 128 and 2*192 slice scanners seem comparable between the two oral contrast groups (Table 3), but this might be explained by the low number of patients.image quality of the abdomen. The agreement between the observers was 86.9% (53/61). There was no difference between the water only and positive contrast for both observer 1 and observer 2 (p-values were respectively 0.574 and 0.310) ( Figs. 2 and 3).Diagnostic confidence per structure of abdomen. Gastrointestinal system. The agreement between the observers for the evaluation of the diagnostic confidence was 90.3% (289/320). Observer 1 scored significantly more scans as less than good in the water only group compared to the positive contrast group (18/233 vs 1/87); p = 0.031. Ob...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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A prospective study comparing water only with positive oral contrast in patients undergoing abdominal CT scan

Wit

Tielbeek

Diepen

et al. 2020

Sci Rep

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“…[24][25][26] There are two primary methods for evaluating visual grading-image criteria study and visual grading analysis. Image criteria studies characterize the observer confidence about the fulfilment of specific image quality criterion, while visual grading analysis characterizes the observer opinion about the reproduction of a certain anatomical structure.…”

Section: Discussionmentioning

confidence: 99%

Image quality of cone beam computed tomography for evaluation of extremity fractures in the presence of metal hardware: visual grading characteristics analysis

Osgood

Thawait

Hafezi-Nejad

et al. 2017

BJR

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Objective: To evaluate image quality and interobserver reliability of a novel cone-beam CT (CBCT) scanner in comparison with plain radiography for assessment of fracture healing in the presence of metal hardware. Methods: In this prospective institutional review boardapproved Health Insurance Portability and Accountability Act of 1996-complaint study, written informed consent was obtained from 27 patients (10 females and 17 males; mean age 44 years, age range 21-83 years) with either upper or lower extremity fractures, and with metal hardware, who underwent CBCT scans and had a clinical radiograph of the affected part. Images were assessed by two independent observers for quality and interobserver reliability for seven visualization tasks. Visual grading characteristic (VGC) curve analysis determined the differences in image quality between CBCT and plain radiography.Interobserver agreement was calculated using Pearson's correlation coefficient. Results: VGC results displayed preference of CBCT images to plain radiographs in terms of visualizing (1) cortical and (2) trabecular bones; (3) fracture line; (4) callus formation; (5) bridging ossification; and (6) screw thread-bone interface and its inferiority to plain radiograph in the visualization of (7) large metallic side plate contour with strong interobserver correlation (p-value , 0.05), except for visualizing large metallic side plate contour. Conclusion: For evaluation of fracture healing in the presence of metal hardware, CBCT image quality is preferable to plain radiograph for all visualization tasks, except for large metallic side plate contours. Advances in knowledge: CBCT has the potential to be a good diagnostic alternative to plain radiographs in evaluation of fracture healing in the presence of metal hardware.

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Impact of low-energy CT imaging on selection of positive oral contrast media concentration

et al. 2016

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An evaluation of the use of oral contrast media in abdominopelvic CT

Cited by 9 publications

References 24 publications

A prospective study comparing water only with positive oral contrast in patients undergoing abdominal CT scan

A prospective study comparing water only with positive oral contrast in patients undergoing abdominal CT scan

Image quality of cone beam computed tomography for evaluation of extremity fractures in the presence of metal hardware: visual grading characteristics analysis

Impact of low-energy CT imaging on selection of positive oral contrast media concentration

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