title: Assessment of gastric emptying using a low fat meal: establishment of international control values.
abstract: OBJECTIVE
  The diagnosis of gastroparesis implies delayed gastric emptying. The diagnostic gold standard is scintigraphy, but techniques and measured endpoints vary widely among institutions. In this study, a simplified scintigraphic measurement of gastric emptying was compared to conventional gastric scintigraphic techniques and normal gastric emptying values defined in healthy subjects.
  
  
  METHODS
  In 123 volunteers (aged 19-73 yr, 60 women and 63 men) from 11 centers, scintigraphy was used to assess gastric emptying of a 99Tc-labeled low fat meal (egg substitute) and percent intragastric residual contents 60, 120, and 240 min after completion of the meal. In 42 subjects, additional measurements were taken every 10 min for 1 h. In 20 subjects, gastric emptying of a 99Tc-labeled liver meal was compared with that of the 99Tc-labeled low fat meal.
  
  
  RESULTS
  Median values (95th percentile) for percent gastric retention at 60, 120, and 240 min were 69% (90%), 24% (60%) and 1.2% (10%) respectively. A power exponential model yielded similar emptying curves and estimated T50 when using images only taken at 1, 2 and 4 h, or with imaging taken every 10 min. Gastric emptying was initially more rapid in men but was comparable in men and women at 4 h; it was faster in older subjects (p < 0.05) but was independent of body mass index.
  
  
  CONCLUSIONS
  This multicenter study provides gastric emptying values in healthy subjects based on data obtained using a large sample size and consistent meal and methodology. Gastric retention of >10% at 4 h is indicative of delayed emptying, a value comparable to those provided by more intensive scanning approaches. Gastric emptying of a low fat meal is initially faster in men but is comparable in women at 4 h; it is also faster in older individuals but is independent of body mass.
authors.affiliation: Intestinal Disease Research Program, McMaster University, Hamilton, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Tougas
authors.forename: E Y
authors.initials: EY
authors.lastname: Eaker
authors.forename: T L
authors.initials: TL
authors.lastname: Abell
authors.forename: H
authors.initials: H
authors.lastname: Abrahamsson
authors.forename: M
authors.initials: M
authors.lastname: Boivin
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: M P
authors.initials: MP
authors.lastname: Hocking
authors.forename: E M
authors.initials: EM
authors.lastname: Quigley
authors.forename: K L
authors.initials: KL
authors.lastname: Koch
authors.forename: A Z
authors.initials: AZ
authors.lastname: Tokayer
authors.forename: V
authors.initials: V
authors.lastname: Stanghellini
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.forename: J D
authors.initials: JD
authors.lastname: Huizinga
authors.forename: J
authors.initials: J
authors.lastname: Rydén
authors.forename: I
authors.initials: I
authors.lastname: Bourgeois
authors.forename: R W
authors.initials: RW
authors.lastname: McCallum
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology; D000818:Animals; D015992:Body Mass Index; D002417:Cattle; D004041:Dietary Fats / Q000008:administration & dosage*; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007391:International Cooperation; D008099:Liver; D008297:Male; D008460:Meat; D008875:Middle Aged; D012016:Reference Values; D012727:Sex Characteristics; D013997:Time Factors
chemical_list: D004041:Dietary Fats