Multicenter Validation of a Shortened Gastric-Emptying Protocol

Pelletier‐Galarneau, Matthieu; Sogbein, Oyebola O.; Pham, Xuan; Hao, Jason Jishun; Le, Jenna; Strober, Mark D.; Middleton, Michael L.; Kikut, Janusz; Freeman, Leonărd M.; Zuckier, Lionel S.

doi:10.2967/jnumed.115.155366

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…Delayed gastric emptying is one of the causes of FD. Gastric emptying can be measured by several kinds of methods, such as gastric emptying scintigraphy, barium-sandwich emptying radiography, gastric emptying ultrasound and 13 C-acetate breath test [5,6,7]. The 13 C-acetate breath test is widely used for the indirect assessment of gastric emptying [5].…”

Section: Introductionmentioning

confidence: 99%

Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia

Mori¹,

Suzuki

Matsuzaki³

et al. 2017

Digestion

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Background and Aim: Delayed gastric emptying is one of the reasons why functional dyspepsia (FD) occurs. The ¹³C-acetate breath test is widely used to evaluate gastric emptying. Nevertheless, the standard value of ¹³C-acetate breath test has not taken into account the gender difference of gastric emptying among healthy individuals. The main aim of this study was to readjust the standard value of ¹³C-acetate breath test in the light of gender differences. In addition, we clarified the prevalence and clinical characteristics of delayed gastric emptying in patients with FD using the modified standard values of ¹³C-acetate breath test. Methods: Fifty-two healthy individuals and 126 patients with patients with FD were enrolled. Gastric emptying was evaluated by the ¹³C-acetate breath test. The cut-off points of T_max for the diagnosis of delayed gastric emptying were determined on the basis of results from healthy individuals making a distinction of genders. Gastroesophageal reflux symptoms, dyspeptic symptoms, scores of anxiety and depression, age, body mass index (BMI), smoking and alcohol consumption were compared between the delayed gastric emptying group and the non-delayed gastric emptying group. Results: Since gastric emptying was delayed in healthy women compared with that in healthy men (T_max, 53.6 ± 19.3 vs. 42.7 ± 16.9 min, p = 0.04), we set the cut-off points of T_max at 60 min in men and at 75 min in women. In patients with FD, the prevalence of delayed gastric emptying was not different between men and women with the modified standard values of ¹³C-acetate breath test. (31.0 vs. 27.4%, p = 0.68). BMI was lower in the delayed gastric emptying group than in the non-delayed group among the male patients. Reflux symptoms were more severe in delayed gastric emptying group than in the non-delayed group among the female patients. Conclusion: The standard values of ¹³C-acetate breath test should be modified bearing the gender difference in mind. It provides us more appropriate information to understand the mechanisms of FD.

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Section: Introductionmentioning

confidence: 99%

Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia

Mori¹,

Suzuki

Matsuzaki³

et al. 2017

Digestion

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“…Scintigraphic quantification of gastric emptying is the most appropriate method for evaluating gastrointestinal motility-related diseases [ 21 , 26 ]. In this study, scintigraphy was used to measure first- and second-hour gastric emptying before and after IGB placement, according to the short validation protocol proposed by Pelletier et al [ 27 ], which promotes greater adherence and better acceptance by patients [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Gastric Emptying and Its Correlation With Weight Loss and Body Mass Index in Patients With an Intragastric Balloon: A Prospective Study With Six Years of Follow-Up

Barrichello¹,

Ribeiro²,

Souza³

et al. 2022

Cureus

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BackgroundObesity is the most well-established and prolonged pandemic in modern society. Having a better understanding of the available tools is important to improve weight loss and make the strategies more productive. This study aims to evaluate the effect of intragastric balloon (IGB) on gastric emptying time, its relationship with weight loss after IGB removal, and weight maintenance after six years. MethodologyThis prospective study analyzed data from patients undergoing IGB placement. A six-years follow-up was performed and data about weight maintenance were collected. We analyzed the impact of the IGB on gastrointestinal motility and its correlation with weight loss. ResultsOf the 20 patients included in the study, 52.4% were diagnosed with class I obesity and 47.6% with class II obesity. The mean weight of the patients was 96.5 ± 11.9 kg at baseline, 79.6 ± 11.4 kg at the time of IGB removal, 81.8 ± 9.1 kg at six months, and 93.2 ± 14.3 kg six years after IGB removal. The mean difference between the initial weight and that measured immediately after IGB removal was 16.68 ± 5.71 kg. Regarding gastric emptying time, there was a difference in retention on comparing the measurement before balloon placement to that after the balloon was in place (72.9% vs. 86.8%) after one hour of food intake. Comparing two hours after food intake, patients before IGB placement had a 30.6% food retention, while patients with IGB in place had a 69.2% retention. ConclusionsIn patients with class I or II obesity, the use of an IGB delayed gastric emptying of foods but showed no direct correlation with weight loss. Weight loss achieved after IGB placement was maintained in half of the patients at a six-year follow-up.

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“…The consensus protocol recommends imaging until up to 4 h for improved sensitivity in detecting delayed gastric emptying. The literature has suggested that retention of more than 10% of the meal at 4 h is abnormal and is the best discriminator between normal and abnormal results (4,16,17). Recently published articles suggest that a shortened protocol may be a satisfactory compromise (16), but consensus has not yet been established in the literature.…”

Section: Ges Variabilitymentioning

confidence: 99%

“…A final impediment may be the controversy in the recent literature suggesting that assessment of liquid emptying may be more important than previously realized, as well as controversy about the most expedient duration of imaging for GES (16,17). These unresolved issues may cause practitioners to question whether a protocol change is warranted (27).…”

Section: Guideline Implementationmentioning

confidence: 99%

Compliance with Gastric-Emptying Scintigraphy Guidelines: An Analysis of the Intersocietal Accreditation Commission Database

Farrell¹,

Costello²,

McKee

et al. 2017

J. Nucl. Med. Technol.

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CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than March 2020. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test.Many variables can influence the results of gastric emptying scintigraphy (GES). A lack of methodologic standardization may cause variability, limit comparisons, and decrease the credibility of the test. To address this, in 2009, the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published a procedure guideline describing a standardized, validated GES protocol for adults. Laboratories must closely follow the consensus protocol to provide valid and standardized results and improve patient care. The Intersocietal Accreditation Commission (IAC) evaluates compliance with guidelines as part of the accreditation process. The rate of compliance with the GES guideline at a national level has not been assessed. The aim of this study was to quantify compliance with the standardized protocol in a large cohort of laboratories from different institutions and practice settings across the United States. Methods: The IAC Nuclear/PET database was used to extract GES protocols from all laboratories applying for accreditation from 2013 to 2015. Each protocol was assessed for compliance with the methods described in the SNMMI GES procedure guidelines. Fourteen binary variables were assessed: patient preparation (4 variables), meal content (5 variables), acquisition (2 variables), and processing (3 variables). Results: Protocols from 127 labs demonstrated that patient preparation was the category with which the laboratories were least compliant. Instructions for blood glucose monitoring and withholding of medications were problematic. Overall, 69.3% of protocols were not compliant with the content or preparation of the consensus meal: 47.3% used whole eggs instead of egg whites, and additional ingredients not recommended in the guidelines were also frequently used. Only 3.1% of laboratories were fully compliant with all 14 variables. Over half the laboratories were compliant with only 5 variables or less. Conclusion: Almost 8 y after the publication of the SNMMI GES guidelines, there is low protocol adherence among laboratories applying for IAC Nuclear/PET accreditation. This substantial degree of guideline noncompliance is concerning. The variability in GES protocols may have a significant effect on patient management, as results may be inaccurate. Consistent use of the standardized GES protocol permits interpretation of results in...

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Multicenter Validation of a Shortened Gastric-Emptying Protocol

Cited by 7 publications

References 10 publications

Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia

Gender Difference of Gastric Emptying in Healthy Volunteers and Patients with Functional Dyspepsia

Gastric Emptying and Its Correlation With Weight Loss and Body Mass Index in Patients With an Intragastric Balloon: A Prospective Study With Six Years of Follow-Up

Compliance with Gastric-Emptying Scintigraphy Guidelines: An Analysis of the Intersocietal Accreditation Commission Database

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