Cost-effectiveness and Patient Tolerance of Low Attenuation Oral Contrast: Milk versus VoLumen. Abstract SSG06-03]
Four percent whole milk that can be purchased by the quart for US$1.39 is not significantly different than US$18 VoLumen as a negative-contrast agent for visualizing abdominal organs on computed tomography (CT) scans, researchers reported here at the 92[nd scientific assembly and annual meeting of the Radiological Society of North America (RSNA).
"Milk costs less, is favored by patients and causes fewer abnormal symptoms in patients undergoing these procedures," said Lisa Shah-Patel, MD, radiology resident, St. Luke's-Roosevelt Hospital, New York, New York, who presented her study at a press briefing on November 29th.
When the computer-assisted tomography scans were reviewed by two independent radiologists, a trend toward greater clarity was seen among the VoLumen scans, but Dr. Shah-Patel said those differences failed to reach statistical significance.
David Brant-Zawadzki, MD, medical director of radiology, Hoag Memorial Hospital Presbyterian, Newport Beach, California, and the moderator of the press briefing conducted by the RSNA, said, "More and more hospitals and radiologists are seeking negative-contrast agents and studies, especially for patients undergoing CT scans for conditions such as irritable bowel syndrome and Crohn's disease.
"About 30 to 40 million CT scans are performed each year and about 30% of them are done for abdominal conditions. Using milk instead of VoLumen would save a tremendous amount of money. This is something I think that a lot of radiologists are going to be considering."
In her study, Dr. Shah-Patel and colleagues assigned 62 patients to drink VoLumen before undergoing CT scans and 102 patients to drink 4.25 cups of 4% whole milk. She said previous work demonstrated that whole milk provides better contrast details that low-fat milk.
In another study, 40% of patients who were assigned to VoLumen said they would have preferred milk, while 85% of the patients assigned to milk said they would select milk again, Dr. Shah-Patel said. Her work is continuing and researchers will eventually enroll 130 patients to receive both VoLumen and milk, she said.
"There needs to be more studies conducted that focus on milk as a viable alternative to other contrast agents," she said. "Milk may be an ideal contrast agent for those who refuse to drink traditional oral contrast agents, especially children."
Dr. Brant-Zawadzki suggested that some future studies use flavored milk -- specifically chocolate milk -- as an agent.
By Ed Susman November 30, 2006
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