Enhancing Scintigraphy for Evaluation of Gastric, Small Bowel, and Colonic Motility

Maurer, Alan H.

doi:10.1016/j.gtc.2020.04.006

Cited by 5 publications

(4 citation statements)

References 86 publications

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“…Gastric emptying scintigraphy (GES) is the gold-standard test to determine stomach emptying, and it utilizes a radiolabeled low-fat meal (egg-white meal [EWM]) that has been unchanged for many years. 1 The two most common clinical indications of GES are gastroparesis and functional dyspepsia. 2,3 Both are distinct upper gastrointestinal (GI) sensorimotor disorders associated with meals and have significantly overlapping features.…”

Section: Introductionmentioning

confidence: 99%

“…It allows the assessment of different gastric functions in a single scan instead of conducting separate investigations with other modalities. 1,8,12 While the technique's early descriptions go back decades, 13 its practical realization is still lacking, and normative IMD 0h values remain scarce. 8 In light of new evidence on the associations between IMD patterns and symptom profiles, it is therefore relevant to explore and determine the normal IMD 0h .…”

Section: Introductionmentioning

confidence: 99%

“…High-calorie nutrient drinks are probably among the most promising candidates for alternative GES test meals. 1 Ensure ® Plus (Abbott Laboratories, USA) is a ready-to-drink bottled product typically used as an oral nutritional supplement to manage malnutrition or as a meal replacement. More recently, Ensure ® Plus has been increasingly used as the GES test meal of choice in the United States.…”

Section: Introductionmentioning

confidence: 99%

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Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital^® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Tagiling,

Ibrahim,

Lee

et al. 2024

J of Gastro and Hepatol

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Background and AimMeasurements of gastric emptying and accommodation for alternative test‐meal protocol during gastric emptying scintigraphy (GES), such as high‐calorie nutrient drinks, are not fully established. We aimed to compare the effects of standardized egg‐white meal (EWM) versus high‐calorie nutrient drink (Vital®; Abbott Laboratories) on global GES parameters and intragastric meal distribution at immediate scan (IMD0h).MethodsOf 84 screened participants, 60 asymptomatic healthy Asian population (38 females; 24.0 ± 1.5 years; 23.8 ± 2.6 kg/m2) were recruited in this 2 × 2 (AB/BA) crossover trial. Participants were randomized to a 4‐h GES with 99mTc‐radiolabeled EWM (~255.8 kcal), followed by a 200 mL Vital® (300 kcal), or vice versa, separated by a 2‐week washout period. Global meal retention (GMR), power‐exponential model emptying parameters (half‐emptying [T1/2], lag phases [Tlag2%, Tlag5%, Tlag10%]), and IMD0h were determined and compared.ResultsGMRs for both test meals were within the international standard references for solid GES. Compared to EWM, Vital® exhibited significantly lower GMRs (faster emptying) from 0.5 to 3 h (all P < 0.001) but comparable at 4 h (P = 0.153). Similar observations were found for the model‐based T1/2 and the different Tlag thresholds (all P < 0.001). Furthermore, IMD0h was found to be lower with Vital®, indicating lower gastric accommodation (faster antral filling) immediately post‐ingestion (P < 0.001). Both test meals showed significant moderate‐to‐strong positive associations at the late‐phase GE (GMR 2–4 h, T1/2) (all P < 0.05).ConclusionsOverall, Vital® is an acceptable alternative test meal to the EWM for GES; however, exercise caution when interpreting early‐phase GE. The normative values for global GES parameters and IMD0h are also established.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital^® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Tagiling,

Ibrahim,

Lee

et al. 2024

J of Gastro and Hepatol

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“…It also has the potential to help guide the assessment of response to therapy and to identify those patients with multiregional dysmotility, who are not easily distinguished clinically 1,2 . Currently, regional transit may be assessed using conventional methods, such as scintigraphy and radio‐opaque marker studies, 3–5 both of which are limited by lack of standardisation and radiation exposure. The wireless motility capsule (WMC) was approved by the Food and Drug Administration in 2006 and has been validated against these reference standard tests for use in gastroparesis and chronic idiopathic constipation 6,7 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of gastrointestinal landmarks using the gas‐sensing capsule and wireless motility capsule

Thwaites

Yao

Maggo

et al. 2022

Aliment Pharmacol Ther

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Background: Accurate definition of the gastroduodenal and ileocaecal junctions (GDJ, ICJ) is essential for the measurement of regional transit times. Aims:To compare the assessment of these landmarks using the novel gas-sensing capsule and validated wireless motility capsule (WMC), and to evaluate intra-subject variance in transit times Methods: Healthy subjects ingested the gas-sensing capsule and WMC tandemly in random order. Inter-observer agreement was evaluated by intra-class correlation coefficient (ICC). Agreement between the paired devices' transit times was assessed using Bland-Altman analysis; coefficient of variation was performed to express intraindividual variance in transit times. Similar analyses were completed with tandemly ingested gas-sensing capsules. Results:The inter-observer agreement for landmarks for both capsules was excellent (mean ICC ≥0.97) in 50 studies. The GDJ was identifiable in 92% of the gas-sensing capsule studies versus 82% of the WMC studies (p = 0.27); the ICJ in 96% versus 84%, respectively (p = 0.11). In the primary cohort (n = 26), median regional transit times differed by less than 6 min between paired capsules. Bland-Altman revealed a bias of −0.12 (95% limits of agreement, −0.94 to 0.70) hours for GDJ and − 0.446 (−2.86 to 2.0) hours for ICJ. Similar results were found in a demographically distinct validation cohort (n = 24). For tandemly ingested gas-sensing capsules, coefficients of variation of transit times were 11%-35%, which were similar to variance between the paired gas-sensing capsule and WMC, as were the biases. The capsules were well tolerated.Conclusions: Key anatomical landmarks are accurately identified with the gas-sensing capsule in healthy individuals. Intra-individual differences in transit times between capsules are probably due to physiological factors. Studies in populations with gastrointestinal diseases are now required.

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Gamma camera functional studies in gastroenterology

Low

Notghi

El-Sayed

2022

Nuclear Medicine and Molecular Imaging

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Enhancing Scintigraphy for Evaluation of Gastric, Small Bowel, and Colonic Motility

Cited by 5 publications

References 86 publications

Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital^® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital^® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Comparison of gastrointestinal landmarks using the gas‐sensing capsule and wireless motility capsule

Gamma camera functional studies in gastroenterology

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Enhancing Scintigraphy for Evaluation of Gastric, Small Bowel, and Colonic Motility

Cited by 5 publications

References 86 publications

Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Comparison of gastrointestinal landmarks using the gas‐sensing capsule and wireless motility capsule

Gamma camera functional studies in gastroenterology

Contact Info

Product

Resources

About

Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital^® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants

Randomized, crossover trial: comparing the effects of standardized egg‐white meal and Vital^® on global gastric emptying parameters and intragastric meal distribution in healthy Asian participants