A simple method to increase the diagnostic efficiency of gastroesophageal scintigraphy using the knee-chest position.
OBJECTIVE
The influence of patient posture on the incidence and severity of gastroesophageal reflux is well known. Scintigraphic imaging, however, is routinely performed with the patient lying in the supine position, because current gamma camera designs do not allow for changes to the angle of the patient table.


METHODS
To overcome this difficulty and to increase the diagnostic sensitivity of scintigraphy, we used an alternative patient position. Twenty-seven adult patients (eight men, 19 women; mean age, 47.5+/-11.5 years) with gastroesophageal reflux disease were prospectively studied consecutively using two body positions, the supine and the knee-chest positions. Each consisted of dynamic acquisition of 450 seconds. An entire study for each patient required only 15 minutes. Images were interpreted qualitatively by three observers.


RESULTS
Although gastroesophageal reflux was positively identified in only 9 of 27 (33%) patients using the supine position, 20 of 27 (74%) patients were shown to have gastroesophageal reflux in the knee-chest position (P < 0.05). No reflux was detected in seven patients using both positions. In five patients, whose study results were positive using both positions, the number of reflux episodes was greater in the knee-chest position compared with the supine position.


CONCLUSIONS
The knee-chest position increases the diagnostic efficiency of gastroesophageal reflux scintigraphy.
Akbunar
A T
AT
Department of Internal Medicine, Uludag University School of Medicine, Bursa, Turkey. atakp@uu20.bim.uludag.edu.tr
Alper
E
E
Nak
S G
SG
Konuk
N
N
Erkal
B
B
Tamgac
F
F
D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010833:Phytic Acid; D011187:Posture; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D016683:Supine Position; D013997:Time Factors
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C026177:technetium phytate; D010833:Phytic Acid