gastric emptying study
{{Short description|Nuclear medicine study of the stomach's ability to empty}}
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| name = Gastric emptying study
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| caption = Example gastric emptying images
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| synonyms = Gastric emptying sccan, gastric emptying scintigraphy
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| ICD10 = {{ICD10PCS|CD171ZZ|C/D/1/7}}
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| OPS301 = {{OPS301|3-707}}
| LOINC = {{LOINC|39768-7}}
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A gastric emptying study is a nuclear medicine study which provides an assessment of the stomach's ability to empty. It may be used if there are complications after gastric surgery, for gastric reflux, or suspected gastroparesis amongst other indications.{{cite web|title=Gastric Emptying Guideline|url=https://www.bnms.org.uk/images/Guideline_for_Gastric_Emptying_2016.pdf|publisher=BNMS|date=March 2015}} Scintigraphy that uses gamma cameras to create two-dimensional images is generally regarded as the gold standard for gastric emptying.{{cite journal|last1=Schmidt|first1=Peter Thelin|last2=Abrahamsson|first2=Hasse|last3=Dolk|first3=Anders|last4=Hausken|first4=Trygve|last5=Karling|first5=Pontus|last6=Lindberg|first6=Greger|last7=Nyhlin|first7=Henry|last8=Ohlsson|first8=Bodil|last9=Simrèn|first9=Magnus|last10=Sjölund|first10=Kristina|last11=Stotzer|first11=Per-Olof|last12=Törnblom|first12=Hans|title=Methods to assess gastric motility and sensation|journal=Scandinavian Journal of Gastroenterology|date=8 July 2009|volume=43|issue=11|pages=1285–1295|doi=10.1080/00365520802240263|pmid=18618332|s2cid=24056361}}{{cite journal|last1=Masaoka|first1=Tatsuhiro|last2=Tack|first2=Jan|title=Gastroparesis: Current Concepts and Management|journal=Gut and Liver|date=30 September 2009|volume=3|issue=3|pages=166–173|doi=10.5009/gnl.2009.3.3.166|pmid=20431741|pmc=2852706}}
Procedure
Having fasted for around four hours before the study, the patient is given a solid or semi-solid meal, such as scrambled eggs on toast or porridge, which has been prepared with a radiopharmaceutical component. Typically technetium-99m sulphur colloid or DTPA is used.{{cite book |last1=Zolle |first1=Ilse |title=Technetium-99m Pharmaceuticals: Preparation and Quality Control in Nuclear Medicine |date=2007 |publisher=Springer Science & Business Media |isbn=9783540339908 |page=300 |url=https://books.google.com/books?id=o2pPP81jWDYC&pg=PA300 |language=en}}{{cite journal|last1=Donohoe|first1=K. J.|last2=Maurer|first2=A. H.|last3=Ziessman|first3=H. A.|last4=Urbain|first4=J.-L. C.|last5=Royal|first5=H. D.|last6=Martin-Comin|first6=J.|title=Procedure Guideline for Adult Solid-Meal Gastric-Emptying Study 3.0|journal=Journal of Nuclear Medicine Technology|date=19 August 2009|volume=37|issue=3|pages=196–200|doi=10.2967/jnmt.109.067843|pmid=19692450|doi-access=free}} Some studies may also involve a liquid component, which is labelled with indium-111 DTPA. Images are acquired with a gamma camera, initially dynamically and then at intervals for up to 2-3 hours.{{cite journal|last1=Seok|first1=Ju Won|title=How to Interpret Gastric Emptying Scintigraphy|journal=Journal of Neurogastroenterology and Motility|date=30 April 2011|volume=17|issue=2|pages=189–191|doi=10.5056/jnm.2011.17.2.189|pmid=21602998|pmc=3093013}}
Analysis
The stomach time-activity curve is produced from geometric mean of anterior and posterior imaging. Half-emptying time, the lag-phase duration for solid studies, and percentage of food left at various time points are calculated.{{cite book |last1=Watson |first1=Nick |title=Chapman & Nakielny's Guide to Radiological Procedures |date=15 November 2013 |publisher=Elvesier Health Sciences |isbn=9780702054792 |page=88 |url=https://books.google.com/books?id=0URYAQAAQBAJ |access-date=22 December 2020}}