skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Patient motion artifacts on scintigraphic gastric emptying studies

Abstract

Patient motion during scintigraphic gastric emptying studies can result in the false diagnosis of gastroesophageal reflux or of accelerated gastric emptying. A simple means of detecting patient motion, by generating a time-activity curve from a region of interest drawn about a Tc-99m marker, is described.

Authors:
;
Publication Date:
Research Org.:
Univ. of Michigan Medical Center, Ann Arbor
OSTI Identifier:
5905960
Resource Type:
Journal Article
Resource Relation:
Journal Name: Radiology; (United States); Journal Volume: 154:2
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; STOMACH; DYNAMIC FUNCTION STUDIES; SCINTISCANNING; TECHNETIUM 99; DTPA; ESOPHAGUS; ISOMERIC NUCLEI; MOTION; PATIENTS; AMINO ACIDS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BODY; CARBOXYLIC ACIDS; CHELATING AGENTS; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DRUGS; GASTROINTESTINAL TRACT; HOURS LIVING RADIOISOTOPES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; NUCLEI; ODD-EVEN NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOPROTECTIVE SUBSTANCES; TECHNETIUM ISOTOPES; YEARS LIVING RADIOISOTOPES; 550601* - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Glowniak, J.V., and Wahl, R.L.. Patient motion artifacts on scintigraphic gastric emptying studies. United States: N. p., 1985. Web. doi:10.1148/radiology.154.2.3966143.
Glowniak, J.V., & Wahl, R.L.. Patient motion artifacts on scintigraphic gastric emptying studies. United States. doi:10.1148/radiology.154.2.3966143.
Glowniak, J.V., and Wahl, R.L.. 1985. "Patient motion artifacts on scintigraphic gastric emptying studies". United States. doi:10.1148/radiology.154.2.3966143.
@article{osti_5905960,
title = {Patient motion artifacts on scintigraphic gastric emptying studies},
author = {Glowniak, J.V. and Wahl, R.L.},
abstractNote = {Patient motion during scintigraphic gastric emptying studies can result in the false diagnosis of gastroesophageal reflux or of accelerated gastric emptying. A simple means of detecting patient motion, by generating a time-activity curve from a region of interest drawn about a Tc-99m marker, is described.},
doi = {10.1148/radiology.154.2.3966143},
journal = {Radiology; (United States)},
number = ,
volume = 154:2,
place = {United States},
year = 1985,
month = 2
}
  • We measured gastric emptying of fat and water from a solid-liquid meal in healthy volunteers using a tubeless scintigraphic method. /sup 75/Se glycerol triether, incorporated in butter, was the lipid-phase marker, and /sup 99m/Tcm, ingested with 250 ml water, the non-lipid phase marker. In seven of these subjects we also measured the gastric emptying of solids and liquids with /sup 99m/Tc bound to cooked egg whites as the solid-phase marker and /sup 111/In ingested with 250 ml water as the marker of the solid and aqueous phases. Emptying and intragastric repartition of each marker were measured by detection of radioactivitymore » changes over the abdominal area using a gamma-camera. The stability and the specificity of the labeling was checked for each marker. Mean gastric emptying rate (expressed as percentage ingested marker emptied per hr) of lipids (17.4 +/- 2.4) was much lower than that of the rest of the meal (34.2 +/- 1.8) and slightly, but significantly, lower than that of solids (22.8 +/- 1.8). An intragastric layering of fat above nonlipids was observed only after the first postprandial hour and remained moderate. Thus, lipids are emptied more slowly than any other component of an ordinary meal, and this is not due only to layering of fat above water.« less
  • For the monitoring of gastric emptying, a gamma camera or scanner operating from one side of the patient is subject to variations of counting efficiency due to the changing depth of radioactivity. A double-headed scanner was used to investigate the effects of such changes. Tc-99m and In-113m were used as labels for the solid and liquid components of a meal. It was found that the depth of Tc-99m within the stomach decreased by a mean of 13 mm during the first half hour of emptying. Anterior detection alone underestimated emptying rates by an average of 26 percent. Depth changes alsomore » introduced errors into ''early emptying'' measurements made unilaterally. Such artifacts of measurement may compromise mathematical analyses of emptying patterns.« less
  • Previous methods for correction of depth used geometric means of simultaneously obtained anterior and posterior counts. The present study compares this method with a new one that uses computations of depth based on peak-to-scatter (P:S) ratios. Six normal volunteers were fed a meal of beef stew, water, and chicken liver that had been labeled in vivo with both In-113m and Tc-99m. Gastric emptying was followed at short intervals with anterior counts of peak and scattered radiation for each nuclide, as well as posteriorly collected peak counts from the gastric ROI. Depth of the nuclides was estimated by the P:S methodmore » as well as the older method. Both gave similar results. Errors from septal penetration or scatter proved to be a significantly larger problem than errors from changes in depth.« less
  • A standard, dual-isotope meal (Tc-99m-egg sandwich and In-111 DTPA in water) was administered to 14 normal volunteers and 37 patients, who had not undergone gastric surgery, to determine if the emptying characteristics of the liquid phase alone could accurately predict delayed solid emptying. Delayed gastric emptying was defined clinically as a solid half-emptying time more than two standard deviations greater than the mean for normal volunteers. Linear regression analysis was performed on the natural logarithm of liquid fractional retention at each time interval to yield a slope and y-intercept for each subject. There was no significant difference (0.6 less thanmore » P less than 0.8) between volunteers and patients with normal solid emptying for the liquid slope. In patients who exhibited delayed gastric emptying for solids, the liquid slopes were significantly different from the normal values (P less than .001). There was a high correlation of liquid slope to solid half-emptying time in all patients and volunteers (r = -0.80, P less than .001). Comparison of the liquid slope measurement to solid half-emptying time criteria revealed a sensitivity of 96%, a specificity of 100%, and a predictive value of 100% for the slope test. These results suggest that delayed gastric emptying can be accurately detected with a liquid-solid meal using only a single-liquid label.« less
  • A polystyrene resin, suitable for semi-solid gastric emptying studies, was rapidly (less than 20 min) and conveniently prepared using commercially available reagents. Using the outlined procedure, Chelex-100 resin bound Tc-99m with greater than 98% labeling efficiency. The resulting Tc-99m Chelex-100 resin demonstrated excellent in vitro and in vivo stability. The clinical application of Tc-99m Chelex-100 resin, mixed with oatmeal, was tested in normal subjects and in various patient groups, including diabetic autonomic neuropathy, pyloric obstruction, postoperative dumping syndrome, and morbidly obese patients before and after gastroplasty.