SA Journal of Radiology

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Comparison of barium and gastrograffin swallow for radiation therapy planning in carcinoma of the oesophagus

V Sharma, DN Gumbi, M Mbhele, B Donde


Background. Simulation of patients with carcinoma of the oesophagus
using radio-opaque contrast is a standard step in treatment planning prior to delivering radiation therapy. Various contrast mediums such as barium, gastrograffin and hexabrix have been used for simulation at different centres. Objective. The purpose of the study was to compare barium and gastrograffin as a useful and cost-effective contrast medium in simulation for delineation of site and length of the lesion. Materials and methods. Fifteen patients accepted for radiation therapy underwent simulation using oral barium and gastrograffin swallows prior to treatment. The amount of contrast material used was recorded for both the procedures. The X-rays were taken with both contrast agents keeping the same exposure factors. Results. The mean amount of barium used was 14 ml (range 10 - 20 ml) as compared to 27.66 ml of gastrograffin (range 10 - 70 ml). The mean
cost per patient was R4.40 for barium as against R70.80 for gastrograffin. No aspiration of contrast was noted in any patient. The opacification and delineation of the lesion on the X-ray films was much better with barium. Conclusion. Barium is a better contrast medium in simulation for delineation of lesion length and treatment planning compared with
gastrograffin. It is also cost effective. This comparison has changed the practice in our department, and it is recommended that it be evaluated by other centres.

South African Journal of Radiology Vol. 11 (2) 2007: pp. 14-16

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