Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting

OBJECTIVE: Scintigraphy remains the gold standard to study gastric emptying . The technique is onerous and normal values vary between centers. Standard ized protocols, although desirable, are not presently available. We validat ed a simplified scintigraphic protocol in a multicenter setting. METHODS: In 69 healthy volunteers from seven Canadian institutions, gastric emptying of a standard meal (Tc-99m-labeled beef liver) was assessed by sc intigraphy every 10 min for 1 h, then every 20 min for the next 2 h. Gastri c retention was fitted to a power exponential model, Prop(t) = {-(kappa t)( beta)} with Prop(t) = proportion of retention at time t, either using all 1 3 time intervals (conventional technique) or using measurements at 0, 1, 2, and 3 b (simplified technique). RESULTS: The power exponential model yielded identical emptying curves and T 1/2 values with both techniques. Gastric emptying was more rapid in men t han in women ( 35 yr (p < 0.01) and in younger than in older men (p < 0.005 ). Gastric emptying was slower in women from Quebec than in women from Onta rio (P < 0.04). Gastric retention was similar at 1, 2, and 3 h among the se ven centers. Gastric emptying of a beef liver meal was slower than that of a low fat egg substitute (p < 0.03). CONCLUSIONS: A simpler scintigraphic approach, using four rather than 13 sa mples, provides results comparable to those of the conventional technique. This simpler approach provides an economical, yet accurate, alternative to the techniques presently used and is applicable to a multicenter setting.