Global and Regional Gastric Emptying Parameters: Establishment of Reference Values and Comparison of Different Camera View Methods

Tabassum Saifi; Abhinav Singhal; Priyanka Gupta; Khangembam Bangkim Chandra; Anil Kumar Pandey; Chetan Patel; Rakesh Kumar

doi:10.4103/ijnm.ijnm_113_21

Global and Regional Gastric Emptying Parameters: Establishment of Reference Values and Comparison of Different Camera View Methods

Indian J Nucl Med. 2022 Jan-Mar;37(1):12-22. doi: 10.4103/ijnm.ijnm_113_21. Epub 2022 Mar 25.

Authors

Tabassum Saifi¹, Abhinav Singhal², Priyanka Gupta¹, Khangembam Bangkim Chandra¹, Anil Kumar Pandey¹, Chetan Patel¹, Rakesh Kumar¹

Affiliations

¹ Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.
² Department of Nuclear Medicine, National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Purpose of the study: The purpose of the study is to establish the reference values of global and regional gastric emptying parameters (GEPs) using a standard vegetarian meal acceptable to the Indian population and compare the values derived on different camera view methods.

Materials and methods: Thirty-six consecutive healthy subjects with age ≥18 years underwent gastric emptying scintigraphy using anterior, posterior, and left anterior oblique (LAO) views. GEP was derived based on decay corrected counts in regions of interest defined on the whole and proximal stomach. Counts in the anterior and posterior view images were used to derive GEP based on geometric mean (GM) method. Comparison of GEP among different camera view methods was done with Friedman test and post hoc Wilcoxon signed-rank test after Bonferroni correction. Reference values were derived based on percentiles.

Results: Rapid gastric emptying based on GM method was defined as percent retention <20% at 1 h while delayed emptying as percent retention >40% and >5% at 2 h and 4 h, respectively. The reference range of half-time of gastric emptying was 23-109 min. The reference value of intragastric meal distribution at time t = 0 was >64%, while the reference range of retention index was 0.7-1.3. Although the overall distribution of GEP derived on different camera view methods could be statistically significant (P < 1.00), the small differences in the derived reference values are likely to be of no clinical significance.

Conclusion: The reference values of GEPs established in this study can be generalized for the Indian population and may be applied to aid in clinical decision making. We recommend the GM method as the preferred method, although single view method (LAO preferred over anterior) can also be an acceptable alternative.

Keywords: global gastric emptying; Different camera views; fundic accommodation; gastric emptying scintigraphy; normal values; radiolabeled meal; reference values; regional gastric emptying.