Development of two oral contrast materials for CT evaluation of the esophagus

Abstract

Background: Computed tomography (CT) is a widely available modality in evaluating benign and malignant diseases of the esophagus. To date, there is no substantial consensus on the optimal and widely available method for opacifying the esophageal lumen exists for CT. Objective: The present study was performed for complete and continuous opacification of the esophagus using two developed oral contrast materials and a commercial barium paste formulated for CT. Material and Method: One hundred and seven adult patients were sent for spiral routine CT scan of the chest (Light speed plus; General Electric Medical System, Milwaukee, Wis., USA) to evaluate variety of clinical conditions at Ramathibodi Hospital. They were divided into three groups. Two developed oral contrast materials, 1.5%(wt/vol) carboxy-methyl cellulose sodium paste containing 2%(wt/vol) barium sulfate and 5.5%(wt/vol) potato starch containing 2%(wt/vol) barium sulfate, and a commercial barium paste were randomly administered. Data collection and analysis of the CT findings were performed double blindly. Results: The patients undergoing CT scan of the chest were performed with one of the oral contrast material. No streak artifact was present in any of the CT slices. Of the grade 1, contrast present without luminal distension and grade 2, contrast present with luminal distension, 1.5% CMC containing 2% barium sulfate was opacified in 36.48% and 17.45%, respectively. Opacification with 5.5% starch containing 2% barium sulfate was of 36.41% and 19.71% while that of 3% commercial barium paste was of 36.68% and 27.54%, respectively. Acceptable taste was also achieved. However, mild to moderate difficulty in swallowing occurred in 35% with no medication or intervention needed. Conclusion: All oral contrast materials tested were less continuous and did not opacified the esophageal lumen as much when compared with the prior studies [8-11]. However, acceptable taste, only mild to moderate difficulty in swallowing during the procedure, and significantly cheaper cost enable them to be used in selected cases in CT scan of the neck, chest, and upper abdomen for clarification of the problem areas.