Use of 99mTc-Labeled Triethylenetetramine–Polystyrene Resin for Measuring the Gastric Emptying Rate in Humans

Digenis, George A.; Beihn, Robert M.; Theodorakis, Michael C.; Shambhu, Manvendra B.

doi:10.1002/jps.2600660338

Cited by 25 publications

(6 citation statements)

References 11 publications

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“…There has been 1 previous report of a reference range for gastric emptying using a test meal of oatmeal, but it was performed with non-commercially available oatmeal, in the supine position, with a noncommercially available 99m Tc-colloid, and using a nonrigo- rous method of determining the reference range (12,13). We propose a reference range for instant oatmeal that is the same for men and women and decreases with age ( Table 4).…”

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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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: 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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Section: Noninvasive Methodologiesmentioning

confidence: 99%

“…Techniques previously used by physiologists include gastric intubation to sample dye dilution, sampling of gastric meal volumes (recoverable after different periods; Hunt, 1963), or the movement of radio-opaque markers using X-rays. The principle of incorporating gamma-emitting radiopharmaceuticals into a food matrix or a formulation allowed the non-invasive visualization of the ligand with a much reduced dose compared to X-rays and less interference with normal function (Digenis et al, 1977).Studies of GE using scintigraphic techniques with radiolabeled standard meals were introduced by Griffith and colleagues in 1966 (Griffith et al, 1966) and further refined in the seventies with the introduction of simultaneous measurement of GE of both solids and liquids in 1976 (Heading et al, …”

mentioning

confidence: 99%

Exploring gastrointestinal variables affecting drug and formulation behavior: Methodologies, challenges and opportunities

Hens

Corsetti

Spiller

et al. 2017

International Journal of Pharmaceutics

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(2017) Exploring gastrointestinal variables affecting drug and formulation behavior: methodologies, challenges and opportunities. International Journal of Pharmaceutics, 519 (1-2). pp. 79-97. ISSN 1873-3476Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/39960/1/FinalVersion-Revised-FOR_EPRINTS_1_YEAR_EMBARGO_ELSEVIER.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial No Derivatives licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc-nd/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. After oral intake, a drug formulation is challenged by several gastrointestinal (GI) barriers. Complex variables such as pH, GI secretions and GI transit/motility along the GI tract can affect drug release and absorption in a positive or negative way depending on the physicochemical properties of the drug compound (e.g. pH/pKa interplay for ionizable drugs) and/or the formulation characteristics (e.g. pHsensitive coating). In addition, inter-subject variability in characteristics of the GI environment may cause variable drug absorption and systemic drug availability (Riethorst et al., 2015). Determining the median and range for specific GI variables, and understanding how they influence oral drug behavior along the GI tract, will be helpful in the field of drug development. 2The present review provides an overview of different methodologies that can be applied to study physiological variables of the human GI tract and their impact on oral drug absorption in healthy and patient populations. The methodologies have been subdivided into two groups: (i) noninvasive and (ii) invasive methodologies. Although some of the methodologies are more historical than operational, they have been of paramount importance for innovations in drug and formulation development; in addition, they have created the basis for several novel methodologies, leading to an in-depth comprehension of different GI variables: gastric emptying (magnetic resonance imaging (MRI), scintigraphy, acetaminophen absorption technique, ultrasonography, breath test, intraluminal sampling and telemetry), motility (MRI, small intestinal/colonic manometry and telemetry), GI volume changes (MRI and ultrasonography), temperature (telemetry) and GI pH (intraluminal sampling and telemetry). Noninvasive methodologiesa. Scintigraphy Disturbances in the normal movement of food along the GI tract can be associated with abdominal pain, early satiety and nausea. Measurement of GI transit, es...

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“…Dowex 2X8 is an inert and non-toxic polystyrene resin. It does not adhere to the gastric mucosa, is not absorbable and is stable in both gastric and intestinal fluids [4]. Its excellent binding qualities in respect of pertechnetate with simple stirring and without additional chemical treatment recommend its use as a tracer.…”

Section: Discussionmentioning

confidence: 99%

A simple scintigraphic method for continuous monitoring of gastric emptying

et al. 1993

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A new and simple scintigraphic method for the measurement of gastric emptying was developed and validated. The test meal consists of 200 g potato mash mixed with 0.5 g Dowex 2X8 particles (mesh 20-50) labelled with 37 MBq (1 mCi) technetium-99m. After ingestion of the meal, sequential dynamic 15-s anteroposterior exposures in the supine position are obtained for 90 min. A second recording sequence of 20 min is added after a 30-min interval. The results can be displayed as immediate cine-replay, as time-activity diagrams and/or as activity retention values. Complicated mathematical fittings are not necessary. The method lends itself equally to the testing of in- and outpatients.

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Use of 99mTc-Labeled Triethylenetetramine–Polystyrene Resin for Measuring the Gastric Emptying Rate in Humans

Cited by 25 publications

References 11 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

Exploring gastrointestinal variables affecting drug and formulation behavior: Methodologies, challenges and opportunities

A simple scintigraphic method for continuous monitoring of gastric emptying

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