IV administered ultrasound contrast agents safe in pediatric oncology patients

The IV administration of ultrasound contrast agents is safe and well tolerated in the pediatric oncology population, according to a study published in the May issue of the American Journal of Roentgenology.

Given concerns about ionizing radiation exposure in the pediatric population, methods such as ultrasound are used whenever possible to avoid exposure. However, safety data regarding the use of contrast-enhanced ultrasound in children are lacking, particularly for those with cancer. Lead author Jamie L. Coleman, MD, of St. Jude Children’s Research Hospital in Memphis, Tenn., and colleagues assessed the safety profile of two ultrasound contrast agents administered via IV in pediatric patients with solid malignancies.

The study included 34 pediatric patients with solid malignancies who received IV bolus injections of one of two contrast agents that are approved by the FDA for use in adult cardiology patients. The researchers monitored heart rate, cardiac rhythm and oxygen saturation immediately before and 30 minutes after administration of the agent. A subject or guardian was also interviewed before and after the exam to assess for any adverse effects.

The study group ranged in age from eight months to 20.7 years, and 21 of the subjects were male and 13 were female. The 34 participants underwent 134 contrast-enhanced ultrasound examinations. The researchers found no detrimental change in hemodynamic status in any subject. Three participants, or 2.2 percent of the group, reported mild transient side effects, two had changes in taste and one reported mild transient tinnitus and lightheadedness. These reactions did not happen again.

Adverse reactions to the contrast agents in young patients who were unable to speak were not seen, and their guardians did not report any concerns.

“We found that IV-administered ultrasound contrast agents have an excellent safety profile in children and may be superior to other commonly used imaging contrast agents,” wrote Coleman and colleagues.

The authors continue to screen patients for contraindications to ultrasound contrast agents at their institution, but no longer require patient monitoring after administration. They suggested that future improvements in contrast imaging software could enable use of lower contrast agent doses.