Performance of a new natural oral contrast agent (LumiVision®) in dynamic MR swallowing

Christiane Kulinna-Cosentini; Michael A Arnoldner; Wolfgang Schima; Ivan Kristo; Sebastian F Schoppmann; Michael Weber; Enrico P Cosentini

doi:10.1007/s00330-021-07927-5

Performance of a new natural oral contrast agent (LumiVision®) in dynamic MR swallowing

Eur Radiol. 2021 Nov;31(11):8578-8585. doi: 10.1007/s00330-021-07927-5. Epub 2021 Apr 24.

Authors

Christiane Kulinna-Cosentini¹, Michael A Arnoldner², Wolfgang Schima³, Ivan Kristo⁴, Sebastian F Schoppmann⁴, Michael Weber², Enrico P Cosentini⁴

Affiliations

¹ Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. Christiane.Kulinna-Cosentini@meduniwien.ac.at.
² Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
³ Department of Diagnostic and Interventional Radiology, Göttlicher Heiland Krankenhaus, Barmherzige Schwestern Krankenhaus, and Sankt Josef Krankenhaus, Vienna, Austria.
⁴ Department of General Surgery, Medical University of Vienna, Vienna, Austria.

Abstract

Objectives: To evaluate image quality by first use of LumiVision® in dynamic MR swallowing, a contrast medium consisting of biological substances versus a gadolinium-buttermilk mixture in patients who underwent Nissen fundoplication due to gastroesophageal reflux disease (GERD).

Methods: The protocol of this retrospective study was approved by the local Institutional Review Board. A hundred twenty-nine patients (146 examinations) underwent a dynamic MR swallowing study (at 1.5 T or 3.0 T) and received an oral contrast agent. Two readers evaluated the distention of the esophagus, contrast, and traceability of the bolus in a 3-point scale. A steady-state coherent sequence (B-FFE, TrueFISP) was used. The patients were divided into 3 different groups: 53 patients received gadolinium chelate (Dotarem®)-buttermilk mixture (GBM) in a dilution of 1:40 as an oral contrast agent; 44 patients received LumiVision® water mixture (LWM) in a dilution of 1:1 and 49 patients received LumiVision® (L) undiluted.

Results: GBM showed significantly better results in overall evaluation for both readers in contrast to LWM (p = .003, p = .002). L also reached significantly better results in overall evaluation than LWM in both readers (p = .004, p = .042). There was no significant difference in the overall evaluation between L and GBM (p = .914, p = .376).According to Landis and Koch, interobserver agreement was "substantial" (Cohen's kappa = 0.738) between both readers.

Conclusion: LumiVision® undiluted showed equal image quality compared to gadolinium-buttermilk mixture. The constellation of LumiVision® water mixture led to a clearly negative result in relation to the image quality compared to LumiVision® undiluted. Therefore, oral ingestion of LumiVision® undiluted is recommended for MR swallowing examinations.

Key points: • LumiVision® undiluted shows significantly better image quality in comparison to LumiVision® diluted in oral application in swallowing MRI. • LumiVision® undiluted shows equal image quality in comparison to gadolinium-buttermilk mixture in oral application. • Oral ingestion of LumiVision® undiluted can replace gadolinium-buttermilk mixture in oral MR examinations.

Keywords: Esophagus; Fundoplication, contrast agent; Magnetic resonance imaging.

MeSH terms

Contrast Media*
Deglutition*
Gadolinium DTPA
Humans
Magnetic Resonance Imaging
Retrospective Studies

Substances

Contrast Media
Gadolinium DTPA