CT best at uncovering drug mule payload

December 01, 2010

CHICAGO - According to a study presented today at the annual meeting of the Radiological Society of North America (RSNA), the best way to detect cocaine in the body of a human drug courier, known as a mule, is through computed tomography (CT).

"Cocaine from South America is making its way to Europe through Africa," said Patricia Flach, M.D., a radiologist at University Hospital of Berne and Institute of Forensic Medicine of Berne in Switzerland. "From Africa, drug mules most commonly try to enter the European Union and Switzerland."

When legal authorities suspect an individual of being a drug mule, they often turn to radiologists to help quickly detect the presence of cocaine concealed in the body. Cocaine containers, which may be swallowed or inserted in the vagina or rectum, can be as large as a banana or as small as a blueberry.

"In these cases it is important for us to know that we have identified all the drug containers in a body, both for legal purposes and for the health of the patient," Dr. Flach said. "However, there was no research telling us which imaging modality was best in detecting cocaine containers in the stomach, intestines or other body orifices."

Dr. Flach and colleagues analyzed images from 89 exams performed on 50 suspected drug mules over a three-year period at University Hospital. The study group included 45 men and five women between the ages of 16 and 45. Forty-three of the suspects were ultimately identified as drug mules.

Of the imaging exams conducted, 27 were CT, 50 were digital x-ray and 12 were low-dose linear slit digital radiography (LSDR), an extremely fast, high-resolution, full-body x-ray system primarily used for trauma patients. The radiologic findings were compared with a written record of the drug containers recovered from the feces of suspects.

"As we expected, CT imaging allowed us to see all the drug containers, especially when we knew what to look for," Dr. Flach said.

The results showed that the coating and manufacture of the containers changed their appearance, especially on CT images. Rubber coated condoms filled with cocaine appeared very hyper-dense, or white, on CT, while other containers of similar size with plastic foil wrapping appeared iso- to hypo-dense, or gray to black. This contradicts some previous reports that have suggested image density may correlate with the drug content.

The sensitivity of CT was 100 percent, meaning CT was able to find all cocaine containers that were present in the drug mules' bodies. LSDR had a sensitivity rate of 85 percent, and digital x-ray was able to identify the presence of cocaine containers only 70 percent of the time.

"There were positive findings on CT that were clearly not detectable on x-rays due to overlap of intestinal air, feces or other dense structures," Dr. Flach said.

While CT was clearly the most accurate imaging modality in detecting the drug containers, the increased ionizing radiation associated with the exam is a concern when imaging people who are presumably healthy.

"CT is the way to go," Dr. Flach said. "But low-dose protocols need to be implemented to ensure the safety of the people undergoing the procedure."
-end-
Coauthors are Steffen Ross, M.D., Gary Hatch, M.D., Ulrich Preiss, M.D., Thomas Ruder, M.D., Michael Thali, M.D., and Michael Patak, M.D.

Note: Copies of RSNA 2010 news releases and electronic images will be available online at RSNA.org/press10 beginning Monday, Nov. 29.

RSNA is an association of more than 46,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA.org)

Editor's note: The data in these releases may differ from those in the published abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting. To ensure you are using the most up-to-date information, please call the RSNA Newsroom at 1-312-949-3233.

For patient-friendly information on CT and x-ray exams, visit RadiologyInfo.org.

Radiological Society of North America

Related Cocaine Articles from Brightsurf:

Sleep-deprived mice find cocaine more rewarding
Sleep deprivation may pave the way to cocaine addiction. Too-little sleep can increase the rewarding properties of cocaine, according to new research in mice published in eNeuro.

Nucleus accumbens recruited by cocaine, sugar are different
In a study using genetically modified mice, a University of Wyoming faculty member found that the nucleus accumbens recruited by cocaine use are largely distinct from nucleus accumbens recruited by sucrose, or table sugar.

Astrocytes build synapses after cocaine use in mice
Drugs of abuse, like cocaine, are so addictive due in part to their cellular interaction, creating strong cellular memories in the brain that promote compulsive behaviors.

Of all professions, construction workers most likely to use opioids and cocaine
Construction workers are more likely to use drugs than workers in other professions, finds a study by the Center for Drug Use and HIV/HCV Research (CDUHR) at NYU College of Global Public Health.

Chronic cocaine use modifies gene expression
Chronic cocaine use changes gene expression in the hippocampus, according to research in mice recently published in JNeurosci.

Blocking dopamine weakens effects of cocaine
Blocking dopamine receptors in different regions of the amygdala reduces drug seeking and taking behavior with varying longevity, according to research in rats published in eNeuro.

Born to run: just not on cocaine
A study finds a surprising response to cocaine in a novel strain of mutant mice -- they failed to show hyperactivity seen in normal mice when given cocaine and didn't run around.

Cocaine adulterant may cause brain damage
People who regularly take cocaine cut with the animal anti-worming agent levamisole demonstrate impaired cognitive performance and a thinned prefrontal cortex.

Setting affects pleasure of heroin and cocaine
Drug users show substance-specific differences in the rewarding effects of heroin versus cocaine depending on where they use the drugs, according to a study published in JNeurosci.

One in 10 people have traces of cocaine or heroin on their fingerprints
Scientists have found that drugs are now so prevalent that 13 percent of those taking part in a test were found to have traces of class A drugs on their fingerprints -- despite never using them.

Read More: Cocaine News and Cocaine Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.