Milk found effective, low-cost contrast agent
Patients find it more tolerable than VoLumen
Could whole milk work just as well as the more expensive, barium-based contrast agents for imaging of the gastrointestinal tract?
A new study by investigators from St. Luke's-Roosevelt Hospital Center in New York City suggests that when compared to VoLumen (E-Z-EM, Lake Success, NY), the answer is yes.1
In the study, lead by Chi Wan Koo, MD, a radiologist at St. Luke's, 215 patients scheduled for abdominal or pelvic CT were randomly assigned to receive whole milk or VoLumen. The results then were independently reviewed by two radiologists who did not know which contrast agent was used. The radiologists used a four-point scale to rate the degree of bowel distension, which is needed for optimal viewing of the bowel wall and contents, and they answered "yes" or "no" as to whether there was bowel wall visibility.
Investigators found that there were no statistically significant differences between the two contrast agents with respect to bowel distension or bowel wall visibility for all segments of the bowel that were studied, and this was true for both of the radiologist reviewers. Also, not surprisingly, patients reported that they preferred milk to VoLumen, and milk was associated with fewer abdominal side effects such as cramping, nausea, and diarrhea.
The biggest difference between the two contrast agents might have been cost: Investigators report that the per-patient cost for VoLumen was $18 versus $1.48 for milk. According to Woo, the only disadvantage of using whole milk is that patients who are lactose intolerant would not be able to tolerate it. Consequently, he would like to see another study conducted to see if lactose-free milk would be effective as a contrast agent.
Reference
- Koo CW, Shah-Patel L, Baer J, et al. Cost-effectiveness and patient tolerance of low-attenuation oral contrast material: milk versus VoLumen. Amer J Roent 2008; 190:1,307-1,313.
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