Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting

Abstract

A simpler scintigraphic approach, using four rather than 13 samples, provides results comparable to those of the conventional technique. This simpler approach provides an economical, yet accurate, alternative to the techniques presently used and is applicable to a multicenter setting.

Effect of azithromycin on small bowel motility in patients with gastrointestinal dysmotility

“…Although all the patients in this study had gastroparesis per manometric criteria, slightly less than half (44%) of these patients fit criteria for gastroparesis as defined by gastric emptying scintigraphy, which does raise the question of the true prevalence of gastroparesis in our study population. However, the standard protocol for gastric emptying scintigraphy was not used in our institution, where continuous scanning was done only up to 2 h and the percent gastric retention was not recorded, likely resulting in decreased sensitivity in identifying patients with true gastroparesis by this method [25].…”

Diagnostic Assessment of Diabetic Gastroparesis

“…A consensus statement from the Society of Nuclear Medicine and Molecular Imaging and the American Neurogastroenterology and Motility Society recommends a single standardized GES protocol, with a universally acceptable test meal, and provides details on technical procedures intended for uniform adoption (13). A standard low-fat meal (27) is used to perform solid-phase GES to document delayed GE. Dual-isotope labeling of solid and liquid phases may also be performed.…”

“…The most commonly used meal is a 255 kcal low-fat test meal consisting of Egg Beaters (120 g) labeled with 0.5 mCi technetium-99m–S colloid radioisotope, two slices of bread, strawberry jam (30 g), and water (120 mL) (27). The stability of the radiolabel binding of this meal, important in ensuring that the isotope does not separate from the solid meal and empty with the liquid phase, has been validated in vitro under gastric conditions (27). Standard imaging of the gastric area with the patient standing is performed at baseline (after meal ingestion) and at 1, 2, and 4 h after meal ingestion.…”

“…1). GE is considered delayed if there is greater than 60% retention at 2 h or 10% retention at 4 h (13,27). Estimated T 1/2 may be calculated with the traditional power exponential curve (48) or by linear interpolation due to the relatively linear emptying of solids in the postlag phase (49).…”

Management of diabetic gastroparesis

“…[3334] Retention of more than 10% of the meal after 4 hours is considered abnormal. [35] Compared with the gold standard approach, the simplified approach has a specificity of 62% and a sensitivity of 93%. [36] However, as it provides the actual percentage of food emptied and requires fewer scans, the simplified approach is generally preferred.…”