Comprehensive radionuclide esophagogastrointestinal transit study: Methodology, reference values, and initial clinical experience

Alexander J. Antoniou, Shreya Raja, Riham El-Khouli, Esther Mena, Martin Lodge, Richard L. Wahl, John O. Clarke, Pankaj Jay Pasricha, Harvey Ziessman

Research output: Contribution to journalArticle

Abstract

A radionuclide methodology and reference values have been developed for a single gastrointestinal transit study including esophageal transit, liquid and solid gastric emptying, and small- and large-bowel transit, using 111In-diethylenetriaminepentaacetic acid (DTPA) with the standardized 99mTc-labeled solid meal. Methods: Eighteen healthy subjects and 18 patients were investigated. The esophageal transit study was performed with 3.7 MBq (0.1 mCi) of 111In-DTPA in 15 mL of water. A liquid-only 30-min gastric-emptying study followed, with ingestion of 3.7 MBq (0.1 mCi) of 111In-DTPA in 300 mL of water. Then, a simultaneous solid-liquid emptying study was acquired after ingestion of a solid 99mTc-sulfur colloid-labeled meal and 7.4 MBq (0.2 mCi) of 111In-DTPA in 120 mL of water. Images were acquired intermittently for 4 h. Additional 111In images were acquired at 5 and 6 h to measure small-bowel transit, and at 24, 48, and 72 h for large-bowel transit. Results: Reference values were determined for esophageal transit (transit time, percentage emptying at 10 s), liquid-only gastric emptying (emptying half-time), liquid and solid emptying in a dual-phase solid-liquid study (emptying half-time and percentage emptying at 1, 2, 3, and 4 h), small-bowel transit index (percentage transit to ileocecal valve at 6 h), and colonic transit (geometric center and percentage colonic emptying) at 24, 48, and 72 h. Results from the first 18 patients found abnormal transit in 72% (13/18); clinical management changed in 61% (11/18). Conclusion: We have developed a radionuclide methodology and derived reference values for a comprehensive gastrointestinal transit study using 111In-DTPA with the standardized 99mTc-labeled solid meal. Our initial clinical experience suggests clinical value.

Original languageEnglish (US)
Pages (from-to)721-727
Number of pages7
JournalJournal of Nuclear Medicine
Volume56
Issue number5
DOIs
StatePublished - May 1 2015

Fingerprint

Radioisotopes
Reference Values
Gastric Emptying
Acids
Gastrointestinal Transit
Meals
Water
Eating
Ileocecal Valve
Colloids
Sulfur
Healthy Volunteers

Keywords

  • Esophageal scintigraphy
  • Gastric emptying
  • Gastrointestinal scintigraphy
  • Intestinal transit

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Comprehensive radionuclide esophagogastrointestinal transit study : Methodology, reference values, and initial clinical experience. / Antoniou, Alexander J.; Raja, Shreya; El-Khouli, Riham; Mena, Esther; Lodge, Martin; Wahl, Richard L.; Clarke, John O.; Pasricha, Pankaj Jay; Ziessman, Harvey.

In: Journal of Nuclear Medicine, Vol. 56, No. 5, 01.05.2015, p. 721-727.

Research output: Contribution to journalArticle

Antoniou, Alexander J. ; Raja, Shreya ; El-Khouli, Riham ; Mena, Esther ; Lodge, Martin ; Wahl, Richard L. ; Clarke, John O. ; Pasricha, Pankaj Jay ; Ziessman, Harvey. / Comprehensive radionuclide esophagogastrointestinal transit study : Methodology, reference values, and initial clinical experience. In: Journal of Nuclear Medicine. 2015 ; Vol. 56, No. 5. pp. 721-727.
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AU - Raja, Shreya

AU - El-Khouli, Riham

AU - Mena, Esther

AU - Lodge, Martin

AU - Wahl, Richard L.

AU - Clarke, John O.

AU - Pasricha, Pankaj Jay

AU - Ziessman, Harvey

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AB - A radionuclide methodology and reference values have been developed for a single gastrointestinal transit study including esophageal transit, liquid and solid gastric emptying, and small- and large-bowel transit, using 111In-diethylenetriaminepentaacetic acid (DTPA) with the standardized 99mTc-labeled solid meal. Methods: Eighteen healthy subjects and 18 patients were investigated. The esophageal transit study was performed with 3.7 MBq (0.1 mCi) of 111In-DTPA in 15 mL of water. A liquid-only 30-min gastric-emptying study followed, with ingestion of 3.7 MBq (0.1 mCi) of 111In-DTPA in 300 mL of water. Then, a simultaneous solid-liquid emptying study was acquired after ingestion of a solid 99mTc-sulfur colloid-labeled meal and 7.4 MBq (0.2 mCi) of 111In-DTPA in 120 mL of water. Images were acquired intermittently for 4 h. Additional 111In images were acquired at 5 and 6 h to measure small-bowel transit, and at 24, 48, and 72 h for large-bowel transit. Results: Reference values were determined for esophageal transit (transit time, percentage emptying at 10 s), liquid-only gastric emptying (emptying half-time), liquid and solid emptying in a dual-phase solid-liquid study (emptying half-time and percentage emptying at 1, 2, 3, and 4 h), small-bowel transit index (percentage transit to ileocecal valve at 6 h), and colonic transit (geometric center and percentage colonic emptying) at 24, 48, and 72 h. Results from the first 18 patients found abnormal transit in 72% (13/18); clinical management changed in 61% (11/18). Conclusion: We have developed a radionuclide methodology and derived reference values for a comprehensive gastrointestinal transit study using 111In-DTPA with the standardized 99mTc-labeled solid meal. Our initial clinical experience suggests clinical value.

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KW - Gastrointestinal scintigraphy

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