Simultaneous assessment of gastric accommodation and emptying: studies with liquid and solid meals.
The aim of this study was to develop a scintigraphic test to measure gastric emptying and accommodation simultaneously.


METHODS
Gastric emptying and accommodation were measured in healthy subjects. To determine gastric accommodation, the stomach was imaged with SPECT 20 min after intravenous administration of 185 MBq (5 mCi) (99m)Tc-pertechnetate. After ingestion of 11 MBq (300 micro Ci) (111)In-diethylenetriaminepentaacertic acid in a liquid nutrient drink or an (111)In-oxine-labeled egg sandwich, dual-isotope imaging assessed SPECT gastric dimensions and gastric emptying every 20 min up to 240 min. Gastric accommodation was calculated as the percentage change in planar (2-dimensional) gastric cross-sectional area (CSA) using a left anterior oblique planar projection and the percentage change in total SPECT gastric voxel counts (3-dimensional) compared with the baseline image.


RESULTS
With the liquid nutrient drink (9 subjects), maximal mean CSA (158% +/- 12% of baseline; P < 0.05) occurred 40 min after meal ingestion, when only 69% +/- 3% of the radiolabeled liquid nutrient drink remained in the stomach. At 120 min, mean CSA was 125% +/- 8% of baseline, but only 35% +/- 3% of the liquid nutrient drink remained in the stomach. Using SPECT to measure 3-dimensional volumes, maximal gastric volume occurred 20 min after meal ingestion (189% +/- 25% of baseline). With the solid egg meal (10 subjects), maximal total CSA (159% +/- 13% of baseline) occurred immediately after meal ingestion; total CSA remained significantly increased above baseline for the first 3 h after ingestion of the egg meal, despite only 12% +/- 4% gastric retention at 3 h. Using SPECT to measure 3-dimensional volumes, maximal gastric volume occurred immediately after the meal (184% +/- 19% of baseline).


CONCLUSIONS
This method permits simultaneous measurement of gastric emptying and accommodation. In healthy subjects, the gastric accommodation response is prolonged and persists despite nearly complete emptying of a liquid or solid meal.
Simonian
Hrair P
HP
Gastroenterology Section, Department of Medicine, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
Maurer
Alan H
AH
Knight
Linda C
LC
Kantor
Steve
S
Kontos
Despina
D
Megalooikonomou
Vasileios
V
Fisher
Robert S
RS
Parkman
Henry P
HP
D000284:Administration, Oral; D000328:Adult; D019412:Anatomy, Cross-Sectional / Q000379:methods*; D004415:Dyspepsia / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000502:physiology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007275:Injections, Intravenous; D008297:Male; D015282:Octreotide / Q000008:administration & dosage / Q000031:analogs & derivatives*; D009942:Organometallic Compounds / Q000008:administration & dosage; D015125:Oxyquinoline / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004369:Pentetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives*; D019047:Phantoms, Imaging; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000008:administration & dosage; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013670:Sodium Pertechnetate Tc 99m / Q000008:administration & dosage; D013270:Stomach / Q000000981:diagnostic imaging* / Q000502:physiology*
D009942:Organometallic Compounds; D019275:Radiopharmaceuticals; C071632:SDZ 215-811; C032950:indium oxine; D015125:Oxyquinoline; D004369:Pentetic Acid; D013670:Sodium Pertechnetate Tc 99m; D015282:Octreotide