Comparison of Two Neutral Oral Contrast Agents in Pediatric Patients: A Prospective Randomized Study

Abstract

Purpose To prospectively compare small bowel distention provided by, as well as patient acceptance of, two different neutral (negative) oral contrast materials used for cross-sectional enterography in a pediatric population. Materials and Methods In this noninferiority study, 66 pediatric patients undergoing clinical computed tomographic (CT) or magnetic resonance (MR) enterography were randomized to receive either a flavored beverage for neutral abdominal and pelvic imaging (Breeza; Beekley Medical, Bristol, Conn) or a low-density barium sulfate suspension. Patients were blinded to the oral contrast material administered and were asked to rate taste, texture, and their perceived health state (where 0 was very bad and 10 was very good). Ingested volume of the prescribed weight-based oral contrast material preparation was recorded. Maximum small bowel diameter was measured in all four abdominal quadrants. Mean bowel diameter as well as taste, texture, and health state scores were compared between cohorts by using t tests; proportions were compared by using Fisher exact tests. Results Thirty-three patients each received Breeza and barium sulfate suspension, respectively. No difference was found in age (Breeza, 13.5 years ± 2.6 [standard deviation]; barium sulfate suspension, 13.9 years ± 2.8; P = .49), sex distribution (15 girls each; P > .99), or health state (P = .21) between cohorts. Twenty-eight of 33 (84.8%) and 17 of 33 (51.5%) patients completed the Breeza and barium sulfate suspension preparations, respectively (P = .007). Breeza received higher scores for taste (6.1 ± 2.5 vs 2.7 ± 2.5; P < .0001) and texture (7.3 ± 2.3 vs 3.6 ± 2.9; P < .0001). No difference was found in bowel distention between Breeza and barium sulfate suspension (1.63 cm ± 0.24 vs 1.69 cm ± 0.25; P = .44). Conclusion The neutral oral contrast materials Breeza and low-density barium sulfate suspension provide similar small bowel distention. Patients receiving Breeza are more likely to ingest the entire prescribed volume.

Cooperative Doping in Ultrasmall BaF2 Nanocrystals for Multimodal 19F-MRI and CT Applications

“…Other barium-based nanofluorides, like BaYbF 5 or BaHoF 5 , have shown to be promising as nanoformulations for computed tomography (CT) applications. These findings, along with the successful use of barium sulfate (BaSO 4 ) emulsions as clinically approved CT agents for gastrointestinal tract imaging, , have inspired the development of other barium-based formulations for various imaging techniques, including MRI. If these formulations are successfully developed, they could offer advantages over optical and CT imaging methods or be used in multimodal imaging setup, where MRI, CT, and luminescent signals are obtained from the same imaging agent.…”

“…Other barium-based nanofluorides, like BaYbF 5 28 or BaHoF 5 , 29 have shown to be promising as nanoformulations for computed tomography (CT) applications. These findings, along with the successful use of barium sulfate (BaSO 4 ) emulsions as clinically approved CT agents for gastrointestinal tract imaging, 30,31 Nevertheless, low-temperature metastable orthorhombic and cubic pure BaF 2 NC can coexist and undergo an Ostwald ripening process during the synthesis, resulting in the shape of a square sheet. 33 This phenomenon restricts their applicability in biomedical studies, where stable and monodispersed materials are desired.…”

Evaluation of the performance of two neutral oral contrast agents in computed tomography enterography: A randomized controlled trial

“…The sample size was calculated based on the average diameter of intestinal distention at all four abdominal quadrants. Assuming a significance level of 0.05, a power of 0.8, a standard deviation of 3 mm and a non‐inferiority margin of 2 mm, the calculated total sample size required was 58 patients. Considering 15% of the patients might drop out, at least 70 patients should be included.…”

An MRI-guided HIFU-triggered wax-coated capsule for supertargeted drug release: a proof-of-concept study

“…To coat the capsules, 0.7 g barium sulphate and 0.2 mL gadoteric acid meglumine (0.5 mmol/mL) were mixed, lyophilised (Alpha 2-4 LSC, Christ, Osterode am Harz, Germany) overnight, and subsequently filled into a hydroxypropyl methylcellulose capsule. Barium sulphate was used as a filling agent due to its high density, due to its biocompatibility as it is used as an oral contrast agent for computed tomography (CT) and x-ray, and for its radiopaque properties, which would in addition allow a localisation of the capsule using CT or x-ray (with the downside of using ionising radiation) [32]. As a first step in the capsule coating procedure, a layer of 1 mm wax mixture at approximately 70 °C was poured into a weighing dish (85 × 85 × 24 mm, VWR International, Dietikon, Switzerland).…”