Safer pediatric imaging with fluroscopy: Change of contrast agent requires optimization

Congress:

EuroSafe Imaging 2020

Poster Number:

ESI-04988

Type:

EuroSafe Imaging

Keywords:

Performed at one institution, Experimental, Prospective, Quality assurance, Radiation safety, Contrast agent-oral, Barium meal, Fluoroscopy, Radiation physics, Paediatric, Contrast agents, Action 10 - EuroSafe Imaging Stars

Authors:

S. Mobini kesheh, W. Ekström Vanrillaer, G. Kullström, U. M. H. Ullberg

DOI:

10.26044/esi2020/ESI-04988

DOI-Link:

https://dx.doi.org/10.26044/esi2020/ESI-04988

Fig. 2: Contrast Phantom

Fig. 3: Attenuation: contrast agent compared to water

Fig. 4: Attenuation: contrast agent compared to air

Background/introduction

Optimization in pediatric patients' examinations is of great importance due to their high radiation sensitivity. Due to children's longer life expectancy, there is also a higher probability of late effects of radiation (ICRP 103). Contrast medium is necessary for abdominal fluoroscopy to outline the gastrointestinal lumen against surrounding soft tissues (figure 1). The purpose of this study was to investigate the consequence of a replacement of a contrast agent.

Description of activity and work performed

The Swedish Medical Products Agency, based on EU Regulation, prepares recommendations on the use of contrast agents for children. The barium sulphate suspension with registered trademark Mixobar was deregistered January 31, 2019, and is no longer provided in the market. Therefore, our center is substituting with Polibar (TM), the only alternative on the market. For pediatric fluoroscopy, our center uses a dedicated Artis Zee equipment (Siemens Healthcare GMbH). A difference in image quality in patient examinations has been noted after the change of contrast agents,...

Conclusion and recommendations

The mixtures of contrast medium Mixobar and Polibar respectively were tested and showed the same correlation compared to water and air with the use of the same organ program selection. Dicom images were analyzed with the ImageJ software program (National Institute of Health, USA). The same size region of interest (ROI) was used to measure signal value to correlate it to the signal for water and air. The phantom study showed about 20% signal reduction with the new contrast agent (figure 3,4). The fluoroscopy system...

Personal/organisational information

1Shahla Mobini keshehMSc,2Gunilla Kullström Radiographer, 2Wiveka Ekström Vanrillaer Radiographer,2Ulla Ullberg, MD, PhD, 1Department of Medical Radiation Physics and Nuclear Medicine, 2 Pediatric Radiology at Karolinska University Hospital, S-171 76 Stockholm Sweden

References

References: 1.ICRP. The 2007 Recommendations of the International Commission on Radiological Protection. ICRP publication no. 103. Elsevier Ltd, 2007. 2.MPA, Swedish Medical Products Agency, Medicinal Products, https://lakemedelsverket.se/LMF/Lakemedelsinformation