Image processing in esophageal scintigraphy: topography of transit times

In the investigation of esophageal transport, the knowledge provided by sci ntigraphy is mostly based upon the extraction as well as representation of the information obtained. Recently, new tools have been developed for use i n computer-based image processing which have made visualization and quantit ation of esophageal bolus transport possible through depiction of the 'topo graphy of transit times'. Data extracted from the images obtained in multip le swallowing studies from a single healthy volunteer as well as in patient s suffering from gastroesophageal reflux disease (GERD) and from Barrett's esophagus are compressed, filtered and depicted in quantifiable concise plo ts or multidimensional images. Profile plots demonstrated a considerable in crease in local transit times along the esophagus superimposed, however, by a distinctive pattern of local delays. Above the level of the lower esopha geal sphincter (LES), the bolus accumulates in a functional ampulla. Subpro cesses of bolus transit through the LES, disclosed by spatiotemporal enhanc ement, allow for the differentiation between mass transit of the bolus and closure of the LES which was considerably retarded in the case of the patie nt with Barrett's esophagus. The image-processing tools developed for topog raphic visualization of transit times for esophageal bolus transport have g reatly improved the extraction and quantifiable depiction of information ob tained by scintigraphy. This can be used for definition of pathognomonic in dices.