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Standard Adult Gastric Emptying Scintigraphy Criteria Is Applicable for Partial Meal Ingestion

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Abstract

Background/Aims

Gastric emptying scintigraphy is commonly performed to assess for dysmotility. A standardized meal with associated threshold criteria was established in 2000 to enable robust interpretation. However, no guidance is available to interpret results when patients do not ingest the entire meal. The purpose of this study is to determine the continued appropriateness of the threshold criteria in contemporary clinical practice and its relevance for partially ingested meals.

Methods

This retrospective study analyzed patients (n = 1365 total) who underwent solid-phase gastric emptying scintigraphy at an academic medical center. Patients were stratified based on their completion of the standard meal. Patients were further stratified into normal and delayed gastric emptying cohorts based on the current criteria. Percent gastric retention values at 1, 2, 3, and 4 h were compared.

Results

Median (95% upper reference) normal gastric retention values for the complete standard meal were 64% (87%) at 1 h, 25% (60%) at 2 h, 13% (54%) at 3 h and 4% (9%) at 4 h. Consumption of at least 50% of the standard meal yielded similar retention; 53% (86%) at 1 h, 19% (58%) at 2 h, 6% (29%) at 3 h and 3% (10%) at 4 h. There was no significant age- or gender-specific differences using the current criteria, and no differences were observed based on diabetic status. Retention values matched well with the current criteria and validated with data-driven clustering.

Conclusion

Adult normative standards for gastric emptying scintigraphy are appropriate for differentiating normal and delayed populations and can be applied to partial meals with at least 50% completion.

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Acknowledgments

We thank the dedicated nuclear medicine technical staff who performed the studies. Dr. David Gilmore provided helpful insights. This study is supported in part by a Thrall Innovation Grant from the Massachusetts General Hospital Department of Imaging.

Funding

Thrall Innovation Grant, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Author information

Author notes

  1. Hina Shah and Reethy Sundar have equal contribution.

Authors and Affiliations

  1. Joint Program in Nuclear Medicine, Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02114, USA

    Hina Shah, Jian W. Dong, Stephan D. Voss, Heather A. Jacene, Matthew S. Robertson & Thomas S. C. Ng

  2. Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, 405 Brookline Ave, Boston, MA, 02114, USA

    Hina Shah, Heather A. Jacene & Thomas S. C. Ng

  3. Brandeis University, 415 South St, Waltham, MA, 02453, USA

    Reethy Sundar

  4. Center for Systems Biology, Massachusetts General Hospital, Harvard Medical School, 165 Cambridge St, Boston, MA, 02115, USA

    David E. Arboleda Prado & Thomas S. C. Ng

  5. Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, White 427, Boston, MA, 02115, USA

    David Z. Chow & Thomas S. C. Ng

  6. Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Boston, MA, 02115, USA

    Braden Kuo

  7. Department of Radiology, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA

    Stephan D. Voss & Thomas S. C. Ng

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Contributions

The work was conceived by TN and HS. HS, RS, JD. DAP and TN performed the analyses. HS, RS and TN wrote the manuscript with input from all authors. All authors have seen and approved the final content of the manuscript.

Corresponding author

Correspondence to Thomas S. C. Ng.

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Shah, H., Sundar, R., Prado, D.E.A. et al. Standard Adult Gastric Emptying Scintigraphy Criteria Is Applicable for Partial Meal Ingestion. Dig Dis Sci 68, 541–553 (2023). https://doi.org/10.1007/s10620-022-07667-6

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