Radionuclide transit studies in the detection of oesophageal dysmotility.

Abstract

SUMMARY A scintigraphic method is described to measure the transit of a fluid bolus through the oesophagus. Transit times in 16 normal subjects ranged from five to 15 seconds and were highly reproducible. Prolonged transit times were observed in 16 of 19 patients with known oesophageal motility disorders, and in these patients inspection of the time activity curves frequently permitted an adynamic oesophagus to be distinguished from one showing excessive incoordinate contractions. The technique was then applied prospectively to 50 patients referred for oesophageal motility studies and a comparison made between the oesophageal transit measurements and the findings on conventional oesophageal manometry. There was agreement between these tests in 42 (84%) of the 50 patients. The measurement of oesophageal transit may be made quickly and safely, without causing discomfort to the patient, and it appears to be at least as sensitive as manometry in the detection of oesophageal motility disorders.Investigation by contrast radiology and upper gastrointestinal endoscopy provides a precise diagnosis in most patients with symptoms suggestive of oesophageal disease. When such symptoms are due to oesophageal motility disorders, however, the diagnosis is often more elusive. Manometry is currently the definitive investigation whereby motility disorders may be recognised but suffers the disadvantage of causing some discomfort to the patients and demands a considerable outlay of both time and expertise in the performance of the study and in the interpretation of the recording. In consequence, a quick and reliable procedure to detect oesophageal motor dysfunction would be of considerable value.Stimulated by these considerations we have assessed a scintigraphic technique' using a radionuclide tracer and gamma camera for the quantitation of the rate of passage of bolus through the oesophagus. The procedure was first validated in normal subjects and in patients with previously diagnosed oesophageal motility disorders, and was then applied prospectively to 50 consecutive patients in whom an oesophageal motility disorder was suspected.

Radionuclide Esophageal Transit Scintigraphy in Primary Hypothyroidism

“…7,8 RETS using a radioactive liquid bolus is convenient, safe, and reproducible technique for quantification of ETT. [11][12][13][14][15]18 A sensitivity of 97% has been reported with RETS in detecting esophageal motor disorders using esophageal manometry as the gold standard. 15 The whole body effective radiation dose from the RETS procedure is approximately 5 mrad that is comparable to a chest CT scan and most of other nuclear medicine procedures.…”

“…The useful technique of radionuclide esophageal transit scintigraphy (RETS) is substantially reported in literature for evaluating esophageal motility disorders like achalasia, diffuse esophageal spasm, and nutcracker esophagus. [10][11][12][13][14][15] In patients of symptomatic dysphagia and a normal endoscopy, RETS is a noninvasive, safe, and reproducible technique for quantification of global and segmental esophageal transit time. 14,15 In this study we aim to study the esophageal motility in primary hypothyroidism by quantification of esophageal transit time of a radioactive liquid bolus in patients of hypothyroidism.…”

Evidence of Abnormal Esophageal Motility in Syndrome X by Radionuclide Esophageal Transit Test

“…They concluded that the RETT is more reliable than barium studies or manometry of esophagus [20]. Blackwell et al [21]compared the method designed by Russel et al [20]with traditional esophageal manometry. They found that the diagnostic sensitivities of RETT and manometry are similar, but RETT is easier, more rapid, safer, and more noninvasive [21].…”

“…Blackwell et al [21]compared the method designed by Russel et al [20]with traditional esophageal manometry. They found that the diagnostic sensitivities of RETT and manometry are similar, but RETT is easier, more rapid, safer, and more noninvasive [21]. Svedberg [15]developed data processing of condensed images and Klein and Wald [14]invented new computer processing, which have been used to more precisely predict esophageal motility disorders.…”

A functional study of caustic strictures of the esophagus in children

“…Scintigraphy is considered to be the most reliable procedure for evaluating esophageal motility (14)(15)(16)(17). However, manometry is considered to be more sensitive to identify nonspecific abnormalities in patients with non-cardiac chest pain (18).…”