Digestive Diseases and Sciences

, Volume 38, Issue 5, pp 803–810

Reliability and interobserver variability of ultrasonographic measurement of gastric emptying rate

  • E. Jan Irvine
  • Gervais Tougas
  • Ray Lappalainen
  • Nicholas C. Bathurst
Original Articles

Abstract

Scintigraphy and real-time ultrasound are valid techniques to measure parameters of gastric emptying. However, scintigraphy involves exposure to ionizing radiation, while the precision of real-time ultrasound has not been previously evaluated. The objectives of the present study were to determine the inter observer and day-to-day variability of liquid gastric emptying rate measured by real-time ultrasonography in healthy volunteers and to compare the gastric emptying rate of males and females. Twenty healthy volunteers had ultrasonographic measurement of gastric emptying rate after ingestion of 300 ml beef broth. Nine subjects had a concurrent assessment by a second observer. Nine subjects had two studies performed on different days by the same sonographer. TheT1/2 for 20 subjects was 24.77±6.84 min with no difference between the half-emptying time for males (25.89±6.99 min) and females (24.02±6.94 min). The Pearson and intraclass correlation coefficients for observations made by two observers were 0.83 and 0.625, with a difference due to observer of 2.37 min±5.26 (NS). The test-retest reliability across successive days was 0.136, representing considerable day-to-day variability within subjects. The variability between subjects was also large, explaining up to 79% of the total variance. We conclude that ultrasound is a useful method to evaluate gastric emptying with good interobserver agreement. Due to substantial day-to-day variability, sample sizes larger than previously suggested are required to demonstrate clinically important changes in gastric emptying rate in clinical trials.

Key Words

gastric emptying real-time ultrasound reliability observer variability 

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References

  1. 1.
    Elashoff JD, Reedy TJ, Meyer JH: Analysis of gastric emptying data. Gastroenterology 83:1306–1312, 1982Google Scholar
  2. 2.
    Mamtora H, Thompson DG: Gastric Ultrasound,In Gastrointestinal Motility: Which Test? NW Read (ed.) Petresfield, Wrightson Biomedical Publishing, 1989, pp 99–104Google Scholar
  3. 3.
    Read NW, Al Janabi MN, Bates TE, Barber DC: Effects of gastro-intestinal intubation on the passage of a solid meal through the stomach and small intestine in humans. Gastroenterology 84:1568–1572, 1983Google Scholar
  4. 4.
    Horowitz M, Collins PJ, Shearman DJC: Disorders of gastric emptying in humans and the use of radionuclide techniques. Arch Intern Med 145:1467–1472, 1985Google Scholar
  5. 5.
    Heading RC, Tothill P, McLoughlin GP, Shearman DJC: Gastric emptying rate measurement in man. A double isotope scanning technique for simultaneous study of liquid and solid components of a meals. Gastroenterology 71:45–50, 1976Google Scholar
  6. 6.
    Collins PJ, Horowitz M, Cook DJ, Harding PE, Shearman DJC: Gastric emptying in normal subjects—a reproducible technique using a single scintillation camera and a computer system. Gut 24:1117–1125, 1983Google Scholar
  7. 7.
    Holt S, Cervantes J, Wilkinson AA, Wallace JHK: Measurement of gastric emptying rate in humans by real-time ultrasound. Gastroenterology 90:918–923, 1986Google Scholar
  8. 8.
    Bateman DN, Whittingham TA: Measurement of gastric emptying by real-time ultrasound. Gut 23:524–527, 1982Google Scholar
  9. 9.
    Camilleri M, Brown ML, Malagelada JR: Relationship between impaired gastric emptying and abnormal gastrointestinal motility. Gastroenterology 91:94–98, 1986Google Scholar
  10. 10.
    Bolondi L, Bortolotti M, Santi V, Galletti T, Gaiani S, Labo G: Measurement of gastric emptying time by real time ultrasonography. Gastroenterology 89:752–759, 1985Google Scholar
  11. 11.
    Marzio L, Neri M, Di Giammarco AM, Cuccurullo F: Evaluation of gastric emptying and motility by means of real-time ultrasonography. Clin Adva Ultrasono 1:169–174, 1983Google Scholar
  12. 12.
    Marzio L, Neri M, Di Giammarco AM, Cuccurullo F: Gastric filling and emptying of liquids evaluated by real-time ultrasonography. Clin Adv Ultrasonol 2:81–85, 1984Google Scholar
  13. 13.
    Datz FL, Christian PE, Moore J: Gender-related differences in gastric emptying. J Nucl Med 28:1204–1207, 1987Google Scholar
  14. 14.
    Gill RC, Murphy PD, Hooper HR, Bowes KL, Kingma YJ: Effect of the menstrual cycle on gastric emptying. Digestion 36:168–174, 1987Google Scholar
  15. 15.
    Brophy CM, Moore JG, Christian BS, Egger MJ, Taylor AT: Variability of gastric emptying measurements in man employing standardized radiolabeled meals. Dig Dis Sci 31:799–806, 1986Google Scholar
  16. 16.
    Hutson WR, Roehrkasse RL, Wald A: Influence of gender and menopause on gastric emptying and motility. Gastroenterology 96:11–17, 1989Google Scholar
  17. 17.
    Heading RC, Tothill P, Laidlaw AJ, Shearman DJC: An evaluation of 113-indium DPTA chelate in the measurement of gastric emptying by scintiscanning. Gut 12:611–615, 1971Google Scholar
  18. 18.
    Moore JG, Christian PE, Taylor AT, Alazraki N: Gastric emptying measurements: Delayed and complex emptying patterns without appropriate correction. J Nucl Med 26:1206–1210, 1985Google Scholar
  19. 19.
    Moore JG, Christian PE, Brown JA, Brophy C, Datz F, Taylor A, Alazraki N: Influence of meal weight and caloric content on gastric emptying of meals in man. Dig Dis Sci 29:513–519, 1984Google Scholar
  20. 20.
    Calderon M, Sonnemaker RE, Hersh T, Burdine JA: 99-Tc-Human albumin microspheres (HAM) for measuring the rate of gastric emptying. Radiology 101:371–374, 1971Google Scholar
  21. 21.
    Chaudhuri TK: Use of 99-Tc-DPTA for mesuring gastric emptying time. J Nucl Med 15:391–395, 1973Google Scholar
  22. 22.
    Tothill P, McLoughlin GP, Heading RC: Techniques and errors in scintigraphic measurements of gastric emptying. J Nucl Med 19:256–261, 1978Google Scholar
  23. 23.
    Sheiner HJ: Gastric emptying tests in man. Gut 16:235–247, 1975Google Scholar
  24. 24.
    Collins PJ, Houghton LA, Read NW, Horowitz M, Chatterton BE, Heddle R, Dent J: Role of the proximal and distal stomach in mixed solid and liquid meal emptying. Gut 32:615–619, 1991Google Scholar

Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • E. Jan Irvine
    • 1
  • Gervais Tougas
    • 1
  • Ray Lappalainen
    • 1
  • Nicholas C. Bathurst
    • 1
  1. 1.Department of Medicine (Division of Gastroenterology), and Department of Radiology, Room 4W8 HSCMcMaster University Medical CentreHamiltonCanada

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