Normal Values for Sincalide Cholescintigraphy: Comparison of Two Methods

Abstract

A 3-minute infusion of sincalide, 0.01 microg/kg, produces too variable a GBEF response to establish a clinically useful normal range. With 0.01 microg/kg infused for 60 minutes, clinically useful normal values were established at 45 and 60 minutes.

Variabilities of gallbladder contraction indices and a simple regression model for gallbladder and gastric emptying ratio

“…The decrease in variability as timing increases and the decrease in variability with milk dilution observed in this study and compared to a previous study, [8] are congruent to the study by Ziessman et al [7]. This showed that a 3-minute infusion of sincalide, 0.01µg/kg, produces too variable a gallbladder ejection fraction (GBEF) response to establish a useful normal range.…”

“…Neither spontaneous alterations of gallbladder size nor the variability of repeated measures have been considered or standardized. This makes it difficult to compare contradictory reports in literature [7,16]. The results of this study show that the GBCI values at some periods followed Gaussian response (normal distribution) and at some others were non Gaussian.…”

“…Ultrasonography is also a valid method for these studies but has the advantage of being safe, cheap, non invasive and does not make use of ionizing radiation. Some previous studies used CCK-infusion to induce contraction of the gallbladder [7,14] It has also noted that the use of CCK does not offer any advantage over the ingestion of fatty meals in radiographic studies involving induced contractions [15]. At present, literature has not shown any generally recognized parameter for quantification of gallbladder motility.…”

“…In 2001, Ziessman and co-authors reported that a 3-minute infusion of sincalide (0.01 µg/kg), produces too variable a gallbladder ejection fraction (GBEF) response to establish a useful normal range. With a 0.01 µg/kg, diluted in a 30 ml volume, infused for 60 minutes, clinical useful normal values were established at 40 and 60 minutes [7]. A previous study utilized undiluted full cream milk and assessed gallbladder motility for just 20minutes.…”

Significance of Cholescintigraphy in Gallbladder Dysfunction

“…When used for the diagnosis of diseases involving morphological abnormalities (e.g., gallbladder stones, polyps and cancer), cholescintigraphy is much less useful than US or CT. For the diagnosis of gallbladder dyskinesia which involves gallbladder dysfunction, cholescintigaphy has been rated as the most useful modality and standard criteria for cholescintigraphy have been explored (8,9). Gallbladder contractility, as evaluated by cholecystokinin (CCK) stimulated cholescintigraphy, is expressed as gallbladder ejection fraction.…”