Milk proves to be an alternative contrast agent to VoLumen

By Edward Susman

November 30, 2006 -- CHICAGO - Good old whole milk appears to be a viable alternative to VoLumen as a contrast agent for radiological studies of the abdomen, researchers said Wednesday at the 2006 RSNA meeting.

"Milk costs less, is favored by patients, and causes fewer abnormal symptoms in patients undergoing these procedures," said Dr. Lisa Shah-Patel, a radiology resident at St. Luke's-Roosevelt Hospital Center in New York City, who presented her group's study at a press briefing.

For the study, 62 patients were assigned to drink VoLumen before undergoing abdominal/pelvic CT scans, and their images were compared with those of 102 patients who drank 4¼ cups of 4% whole milk, Shah-Patel said. Previous work has demonstrated that whole milk provides better contrast details than low-fat milk, she added.

Of the patients who took VoLumen, 40% would have preferred milk, while 85% of the patients on milk said they would select milk again in another study, according to Shah-Patel.

Although there was a trend that favored VoLumen (E-Z-EM, Lake Success, NY) when the abdominal contrast studies were independently read by two radiologists, those differences failed to reach statistical significance, she said.

What was different, however, was the cost: For patients who had to drink the chalky-flavored VoLumen, their insurance agencies paid $18 for a standard dose of the contrast agent. The dose of milk cost $1.39.

"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," Dr. Michael Brant-Zawadzki, medical director of radiology at Hoag Memorial Hospital Presbyterian in Newport Beach, CA.

"About 30 to 40 million CT scans are performed each year and about 30% of them are done for abdominal conditions," he noted. "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."

The researchers are continuing their study, and will eventually enroll 130 patients to receive both VoLumen and milk.

"There needs to be more studies conducted that focus on milk as a viable alternative to other contrast agents," Shah-Patel said. "Milk may be an ideal contrast agent for those who refuse to drink traditional oral contrast agents, especially children."

Brant-Zawadzki suggested that some future studies use flavored milk -- specifically chocolate milk -- as an agent.

By Edward Susman contributing writer
November 30, 2006

Blueberry juice enhances pediatric MR urography, April 26, 2001

Copyright © 2006

Last Updated np 12/13/2006 12:35:40 PM

2 comments so far ...
11/30/2006 5:26:57 AM
Aziza Barbados
I am very pleased that a nicer alternative to theusual CT abdo contrast has been found. However, frankly this obviously will not suit everyone. The volume of milk I read as equalling a dose (4 1/2 CUPS!!!!!) would send most people to the toilet!!!
Lactose intolerance tends to be more prevalent in black populations, and here in the Caribbean where we really do need a cheaper more palatable alternative, the milk issue just won't do. Lactose intolerant or not, regardless, 4 1/2 cups is a LOT of fact it's a lot of any fluid to consume!!! I would honestly hesitate to tell any of my poor patients to drink that much milk.
I believe that the volumen or other CT contrasts, may be better toerated at those quantities than the milk.
The trend towards the use of natural products rather than pharmaceuticals is however a great one. I especially like the use of blueberry juice in paeds urinary MR.

11/30/2006 9:17:18 AM
4 1/2 cups is 36+ ounces, the equivalent of 3 Red Stripes.  Or more generically, 2 mouthfulls over a quart.  A lot to consume at one hurried sitting for sure, but consider the amount of GoLytely (an oxymoron, if you've ever done it):  4 litres, or roughly 1 gallon.  Or 16 cups, if you will.

Milk may be significantly less expensive, though with a much poorer shelf life compared to Volumen.