The Gastric Emptying Study: Protocol Design Considerations

Klingensmith, William C.; Lawrence, Steven P.

doi:10.2967/jnmt.108.054817

Cited by 8 publications

(14 citation statements)

References 15 publications

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“…The adherence of a similar colloid label to oatmeal in gastric juice in vitro has been found to be satisfactory, at 82%-97% (11). And there is a relatively high correlation between the results with oatmeal and the more difficult-to-prepare scrambled egg (7).…”

Section: Discussionmentioning

confidence: 69%

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The Gastric Emptying Study with Oatmeal: Reference Range and Reproducibility as a Function of Age and Sex

Klingensmith

Rhea²,

Wainwright³

et al. 2010

Journal of Nuclear Medicine Technology

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This study evaluated the reference range and reproducibility of the gastric emptying study with oatmeal as a function of age and sex. Methods: Twenty-four healthy subjects, 12 men and 12 women, categorized into 3 age groups, 20-40, 40-60, and 60-80 y, were studied twice, 1 d apart, with instant oatmeal labeled with 99m Tc-sulfur colloid. Imaging was performed in the upright position using the left anterior oblique (LAO), right posterior oblique (RPO), anterior, and posterior projections. One-minute digital images acquired every 15 min for 60 min were used to calculate a simple half-time of emptying. Results: A strong correlation was found among half-times of gastric emptying calculated from the anterior projection, LAO projection, anterior-posterior geometric mean, and LAO-RPO geometric mean (P , 0.01). A significant inverse correlation was found between increasing age and decreasing half-time of emptying in men and women (P , 0.05). A reference range of 10-60 min is suggested for 20-to 40-y-old patients, 10-40 min for 40-to 60-y-olds, and 10-30 min for 60-to 80-y-olds. Halftimes of emptying tended to be longer for women than for men (not statistically significant). There was a large variation between the first and second studies, with a trend toward decreasing variation with increasing age in both men and women. In repeated studies, a reference range of variation of up to 30 min is suggested for 20-to 40-y-old patients, up to 20 min for 40-to 60-y-olds, and up to 15 min for 60-to 80-yolds. Conclusion: The reference range for half-time of gastric emptying with instant oatmeal decreases with increasing age in both men and women. Test-retest variation is relatively large and tends to decrease with increasing age in both men and women. Data from either the LAO projection or the anteriorposterior geometric mean are acceptable for calculating the half-time of gastric emptying.

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Section: Discussionmentioning

confidence: 69%

“…In addition, we calculated the gastric half-time of emptying by simply connecting the every-15-min data points, because the shape of the gastric emptying curve varies from patent to patient. Some of this variation may result from variable overlap of the stomach and the jejunum among patients (7).…”

Section: Discussionmentioning

confidence: 99%

The Gastric Emptying Study with Oatmeal: Reference Range and Reproducibility as a Function of Age and Sex

Klingensmith

Rhea²,

Wainwright³

et al. 2010

Journal of Nuclear Medicine Technology

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“…However, the same protocol used in our institution has been used in several others. 8,10 Nevertheless, the study was conducted at a single center, and therefore may not be generalizable to all centers.…”

Section: Discussionmentioning

confidence: 99%

“…Gastroparesis was defined as a T 1/2 > 60 minutes for a liquid meal, and > 90 minutes for a solid meal based on our institution’s pre-determined standards. 8-10 Patients 5 years of age and older who underwent a liquid GES were excluded, as were children under 4 years of age who underwent a solid GES, as there were few subjects in these groups and thus, they were outliers from the general population who underwent GES. Subjects who vomited during their GES were excluded.…”

Section: Methodsmentioning

confidence: 99%

Decreased Relative Diagnostic Yield of Esophagogastroduodenoscopy in Children With Gastroparesis

Wong

Shulman

Chiou

et al. 2014

Journal of Clinical Gastroenterology

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Background Esophagogastroduodenoscopy (EGD) and gastric emptying scintigraphy (GES) are commonly performed in the evaluation of children with upper gastrointestinal (GI) symptoms. It has been presumed, but not clarified, that gastroparesis increases the likelihood of identifying abnormalities on EGD. We sought to determine whether the presence of gastroparesis influenced the diagnostic yield of EGD in children. Methods We conducted a retrospective chart review of children who underwent both an EGD and gastric emptying scintigraphy (GES) within 3 months of each other for evaluation of upper GI symptoms (e.g. abdominal pain). Clinical history (symptoms, comorbidities, medications, and surgical procedures), GES results, and EGD histology reports were captured. Results 125 children (46% female) were included, of whom, 70 (56%) had gastroparesis. 33 (26%) children had liquid-meal GES (1.2 ± 1.1 years of age, mean ± SD) and 92 (64%) had solid-meal GES (12.4 ± 3.6 years of age). There was an overall trend toward a decreased frequency of biopsy abnormalities in those with gastroparesis (P=0.09). Those with gastroparesis identified via liquid-meal GES were less likely to have reflux esophagitis on biopsy (P=0.002). Those with gastroparesis identified on solid-meal GES were less likely to have gastritis (P=0.04). Symptoms, comorbidities, or medications were not predictive of GES or EGD results. Conclusions Children with gastroparesis may be less likely to have biopsy abnormalities identified on EGD in comparison to those without gastroparesis. Further prospective, larger, and multicenter studies are needed to validate our findings.

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“…Delayed imaging is performed if the patient does not reach the half-time of emptying by the end of the routine imaging time (12). …”

Section: Discussionmentioning

confidence: 99%

In Vitro Evaluation of Tc-99m Radiopharmaceuticals for Gastric Emptying Studies

Ertay¹,

Doğan²,

Ülker³

et al. 2014

Mirt

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Objective: Gastrointestinal motility and functional motility disorders causing either delayed or accelerated gastric emptying (GE) may result in similar symptoms including nausea, vomiting, early satiety, fullness, bloating, and abdominal discomfort or pain. Hence, it is important to evaluate patients for both rapid and delayed GE in the same test. The gold standard technique to measure GE is scintigraphy by radiolabeled test meals. The aim of this study was to test alternative Tc-99m agents to label eggs as the solid meal and compare to Tc-99m sulfur colloid (SC) for gastric emptying studies.Methods: In search of alternative agents for gastric emptying studies, we mixed and fried eggs with four different particulate compounds (Tc-99m labeled SC, tin colloid, nanocolloid and MAA), as well as with free pertechnetate and Tc-99m DTPA. We then measured the stability of these compounds in simulated gastric juice.Results: Our experiments demonstrated that in addition to Tc-99m sulfur colloid;Tc-99m MAA, Tc-99m nanocolloid and Tc-99m tin colloid also appear to make stable complexes with eggs in acidic environment.Conclusion: Therefore, these agents may be used for gastric emptying studies which could be more practical in routine conditions.Conflict of interest:None declared.

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The Gastric Emptying Study: Protocol Design Considerations

Cited by 8 publications

References 15 publications

The Gastric Emptying Study with Oatmeal: Reference Range and Reproducibility as a Function of Age and Sex

The Gastric Emptying Study with Oatmeal: Reference Range and Reproducibility as a Function of Age and Sex

Decreased Relative Diagnostic Yield of Esophagogastroduodenoscopy in Children With Gastroparesis

In Vitro Evaluation of Tc-99m Radiopharmaceuticals for Gastric Emptying Studies

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