A novel food-based negative oral contrast agent compared with two conventional oral contrast agents in abdominal CT: a three-arm parallel blinded randomised controlled single-centre trial.

BACKGROUND: A negative oral contrast agent (OCA) has been long sought for, to better delineate the bowel and visualise surrounding structures. Lumentin® 44 (L44) is a new OCA formulated to fill the entire small bowel. The aim of this study was to compare L44 with positive and neutral conventional OCA in abdominal computed tomography (CT). METHODS: Forty-five oncologic patients were randomised to receive either L44 or one of the two comparators (MoviPrep® or diluted Omnipaque®). Abdominal CT examinations with intravenous contrast agent were acquired according to standard protocols. The studies were read independently by two senior radiologists. RESULTS: The mean intraluminal Hounsfield units (HU)-values of regions-of-interest (ROIs) for each subsegment of small bowel and treatment group were -404.0 HU for L44, 166.1 HU for Omnipaque®, and 16.7 HU for MoviPrep® (L44 versus Omnipaque, p < 0.001: L44 versus MoviPrep p < 0.001; Omnipaque versus MoviPrep, p = 0.003). Adverse events, only mild, using L44 were numerically fewer than for using conventional oral contrast agents. Visualisation of abdominal structures beyond the small bowel was similar to the comparators. CONCLUSIONS: L44 is a negative OCA with luminal radiodensity at approximately -400 HU creating a unique small bowel appearance on CT scans. The high bowel wall-to-lumen contrast may enable improved visualisation in a range of pathologic conditions. L44 showed a good safety profile and was well accepted by patients studied. TRIAL REGISTRATION: EudraCT (2017-002368-42) and in ClinicalTrials.gov (NCT03326518).

A novel food-based foam as oral contrast agent with negative Hounsfield units for demarcation of small bowel loops on abdominal CT: tolerability and bowel distension in 25 volunteers.

BACKGROUND: Diseases of the bowel are not always displayed on conventional abdominal computed tomography (CT). The studied oral contrast agent aims to improve this. PURPOSE: To investigate whether the use of a novel oral contrast for abdominal CT enables the same diagnostic advantages as seen in magnetic resonance imaging (MRI). MATERIAL AND METHODS: Twenty-five consented volunteers drank up to 1400 mL of a stable, drinkable foam. Comments on acceptance and side effects were noted immediately and 24 h later. Foam palatability was documented through interviews, and distribution in the small bowel by Hounsfield units from the CT software. The CT results were compared with age- and sex-matched controls, pretreated according to routine. A non-enhanced abdominal CT protocol of lowest possible radiation dose was used. External referees evaluated all data obtained. RESULTS: Foam was considered odd to swallow, and fullness was reported by all volunteers after 950 mL. Five had difficulties in drinking the last 320 mL and two abstained from it. All adverse symptoms were mild. The distribution in the small bowel was on par with standard agents. Foam density revealed stability with intraluminal values of around -550 HU from stomach to terminal ileum, satisfying the requirement of a great bowel lumen-to-wall contrast. External reviewers re-evaluated all our data, and one predicted the foam to offer a potential for improved diagnostics. CONCLUSION: A CT true-negative bowel filling agent was formulated, with high acceptance, few side effects, and a potential to mimic T1-weighted MRI images.

Inflammatory bowel disease-the role of cross-sectional imaging techniques in the investigation of the small bowel.

BACKGROUND: The diagnosis of inflammatory bowel disease (IBD) in children and adolescents is based on the integration of clinical, biological, endoscopic, histological and radiological data. METHODS: The most important part of the diagnosis is the histology, which is acquired by endoscopy. Imaging of the small bowel has changed in recent years, but the imaging goals are primarily to determine the extent of small bowel involvement, assess complications and define candidates for surgery. Imaging techniques are divided into conventional and cross-sectional ones. RESULTS: The spectrum of imaging findings of cross-sectional techniques is discussed, emphasising the advantages and limitations of each technique, acknowledging the specificities of the paediatric population. Cross-sectional techniques have advanced the ability to diagnose and monitor inflammatory disease of the small bowel. CONCLUSION: MR enterography is the technique of choice in children with known IBD, for the investigation of the small bowel and the whole GI tract. US should be the first choice examination in children with suspected IBD, while CT should be reserved for cases in which MRI is contraindicated or in acute emergency situations when US is inadequate. TEACHING POINTS: • Cross-sectional imaging of the small bowel is essential in paediatric IBD. • Endoscopy is unable to assess extramural disease and examine the entire small bowel. • US should be the first choice examination in children with suspected IBD. • MR enterography is the technique of choice in children with known IBD. • There are still controversies regarding the prediction of disease activity or fibrosis.

Electromagnetic scattering by an infinite cylinder of material or metamaterial coating eccentrically a dielectric cylinder.

The electromagnetic scattering by an infinite cylinder of dielectric material or metamaterial, coating eccentrically another infinite dielectric cylinder, is treated in this work. The problem is solved using classical separation of variables techniques. No use is made of the translational addition theorem. For small eccentricities h = d/a(≪ 1), where d is the distance between the axes of the cylinders and a the radius of the outer cylinder, we use instead the cosine and the sine laws to satisfy the boundary conditions at the surface of the outer cylinder. Keeping terms up to the order h2 we finally obtain exact, closed-form expressions for the expansion coefficients g(1) and g(2) in the relation S(h) = S(0)[1 + g(1)h + g(2)h2 + O(h3)], giving the scattered field and the scattering cross sections of the problem, where S(0) corresponds to the coaxial geometry, with h = 0 (d = 0). Both polarizations are considered for normal incidence. Numerical results are given for various values of the parameters, corresponding to materials or metamaterials. Our method is an alternative of the one using the translational addition theorem in the case of small eccentricities h.