Non-medicinal Oral Contrast in Upper Abdominal MRI for MR-guided Radiotherapy: A Scoping Review

Overview

Journal Radiography (Lond)

Date 2025 Jan 25

PMID 39863498

Authors

M R Beasley

A M Henry

J Bestall

V P Cosgrove

L J Murray

C Burnett

Affiliations

Soon will be listed here.

Abstract

Introduction: Using non-medicinal oral contrast agents may aid safe delivery of magnetic resonance image-guided (MR-guided) radiotherapy by improving the ability to visualise and avoid excessive radiation dose to adjacent bowel/stomach. This scoping review aims to map the literature on non-medicinal oral contrasts used in upper-abdominal diagnostic or therapeutic magnetic resonance imaging (MRI) to find potential candidates for employing in MR-guided radiotherapy and identify gaps in knowledge for further study.

Methods: A scoping review of non-medicinal oral contrast used in upper-abdominal MRI research followed a pre-defined protocol based on Arksey and O'Malley's framework. Data were charted and reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews reporting guidelines.

Results: Forty-seven studies from 1955 screened abstracts were charted. Thirty-one distinct non-medicinal oral contrast were identified, used primarily to enhance tissue visualisation (89 %) or observe motility (11 %) in diagnostic studies. All studies reported to be predominantly quantitative; only 13 % included participant experience via questionnaires and none used qualitative methods. No studies have examined the efficacy of non-medicinal oral contrasts in MR-guided radiotherapy planning or delivery.

Conclusion: Non-medicinal oral contrasts have been extensively investigated in diagnostic MRI to enhance gastrointestinal visualisation and assess motility. However, non-medicinal oral contrasts have not been investigated in the context of radiotherapy planning and treatment. Qualitative evaluation of the patient experience of non-medicinal oral contrasts in magnetic resonance image-guided radiotherapy should be considered alongside studies quantifying the potential clinical benefit.

Implications For Practice: This review summarises the properties of non-medicinal oral contrasts and identifies critical gaps in the current evidence, particularly the absence of qualitative research in this domain and the unexplored potential for their application in MR-guided radiotherapy planning and delivery.

References

Hiraishi K, Narabayashi I, Fujita O, Yamamoto K, Sagami A, Hisada Y . Blueberry juice: preliminary evaluation as an oral contrast agent in gastrointestinal MR imaging. Radiology. 1995; 194(1):119-23. DOI: 10.1148/radiology.194.1.7997537. View

Renzulli M, Caretti D, Pettinari I, Biselli M, Brocchi S, Sergenti A . Optimization of pineapple juice amount used as a negative oral contrast agent in magnetic resonance cholangiopancreatography. Sci Rep. 2022; 12(1):531. PMC: 8752728. DOI: 10.1038/s41598-021-04609-6. View

Choi J, Lee J, Sirlin C . CT and MR imaging diagnosis and staging of hepatocellular carcinoma: part I. Development, growth, and spread: key pathologic and imaging aspects. Radiology. 2014; 272(3):635-54. PMC: 4263631. DOI: 10.1148/radiol.14132361. View

Balzarini L, Aime S, Barbero L, Ceglia E, Petrillo R, Reyner J . Magnetic resonance imaging of the gastrointestinal tract: investigation of baby milk as a low cost contrast medium. Eur J Radiol. 1992; 15(2):171-4. DOI: 10.1016/0720-048x(92)90148-3. View

Ghanaati H, Rokni-Yazdi H, Jalali A, Abahashemi F, Shakiba M, Firouznia K . Improvement of MR cholangiopancreatography (MRCP) images after black tea consumption. Eur Radiol. 2011; 21(12):2551-7. DOI: 10.1007/s00330-011-2217-0. View

Cordova-Fraga T, De Araujo D, Sanchez T, Elias Jr J, Carneiro A, Brandt-Oliveira R . Euterpe Olerácea (Açaí) as an alternative oral contrast agent in MRI of the gastrointestinal system: preliminary results. Magn Reson Imaging. 2004; 22(3):389-93. DOI: 10.1016/j.mri.2004.01.018. View

Lukovic J, Henke L, Gani C, Kim T, Stanescu T, Hosni A . MRI-Based Upper Abdominal Organs-at-Risk Atlas for Radiation Oncology. Int J Radiat Oncol Biol Phys. 2020; 106(4):743-753. DOI: 10.1016/j.ijrobp.2019.12.003. View

Tang H, Song B, Huang Z, Yao H . [Application of black tea as a negative oral contrast in magnetic resonance cholangiopancreatography (MRCP)]. Sichuan Da Xue Xue Bao Yi Xue Ban. 2013; 44(3):476-80. View

Captur G, Bhandari A, Bruhl R, Ittermann B, Keenan K, Yang Y . T mapping performance and measurement repeatability: results from the multi-national T mapping standardization phantom program (T1MES). J Cardiovasc Magn Reson. 2020; 22(1):31. PMC: 7204222. DOI: 10.1186/s12968-020-00613-3. View

10.

Corradini S, Alongi F, Andratschke N, Belka C, Boldrini L, Cellini F . MR-guidance in clinical reality: current treatment challenges and future perspectives. Radiat Oncol. 2019; 14(1):92. PMC: 6551911. DOI: 10.1186/s13014-019-1308-y. View

11.

Kuehle C, Ajaj W, Ladd S, Massing S, Barkhausen J, Lauenstein T . Hydro-MRI of the small bowel: effect of contrast volume, timing of contrast administration, and data acquisition on bowel distention. AJR Am J Roentgenol. 2006; 187(4):W375-85. DOI: 10.2214/AJR.05.1079. View

12.

Sood R, Joubert I, Franklin H, Doyle T, Lomas D . Small bowel MRI: comparison of a polyethylene glycol preparation and water as oral contrast media. J Magn Reson Imaging. 2002; 15(4):401-8. DOI: 10.1002/jmri.10090. View

13.

Mohabir S, Pitcher R, Perumal R, Goodier M . The efficacy of pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography. SA J Radiol. 2020; 24(1):1875. PMC: 7433279. DOI: 10.4102/sajr.v24i1.1875. View

14.

Gupta M, Khatri G, Bailey A, Pinho D, Costa D, Pedrosa I . Endoluminal contrast for abdomen and pelvis magnetic resonance imaging. Abdom Radiol (NY). 2016; 41(7):1378-98. DOI: 10.1007/s00261-016-0668-0. View

15.

Khalil H, Peters M, Tricco A, Pollock D, Alexander L, McInerney P . Conducting high quality scoping reviews-challenges and solutions. J Clin Epidemiol. 2020; 130:156-160. DOI: 10.1016/j.jclinepi.2020.10.009. View

16.

Topriceanu C, Fornasiero M, Seo H, Webber M, Keenan K, Stupic K . Developing a medical device-grade T phantom optimized for myocardial T mapping by cardiovascular magnetic resonance. J Cardiovasc Magn Reson. 2023; 25(1):19. PMC: 10026458. DOI: 10.1186/s12968-023-00926-z. View

17.

Arruda Sanchez T, Elias Jr J, Colnago L, de Almeida Troncon L, de Oliveira R, Baffa O . Clinical feasibility of Açai (Euterpe olerácea) pulp as an oral contrast agent for magnetic resonance cholangiopancreatography. J Comput Assist Tomogr. 2009; 33(5):666-71. DOI: 10.1097/RCT.0b013e31819012a0. View

18.

Tart R, Li K, Storm B, Rolfes R, Ang P . Enteric MRI contrast agents: comparative study of five potential agents in humans. Magn Reson Imaging. 1991; 9(4):559-68. DOI: 10.1016/0730-725x(91)90043-l. View

19.

Scheibl K, Schreyer A, Kullmann F, Reichle A, Bolder U, Scholmerich J . Magnetic resonance imaging gastrography: evaluation of the dark lumen technique compared with conventional gastroscopy in patients with malignant gastric disease. Invest Radiol. 2005; 40(3):164-72. DOI: 10.1097/00004424-200503000-00006. View

20.

Cronin C, Dowd G, Ni Mhuircheartaigh J, DeLappe E, Allen R, Roche C . Hypotonic MR duodenography with water ingestion alone: feasibility and technique. Eur Radiol. 2009; 19(7):1731-5. DOI: 10.1007/s00330-009-1346-1. View