Is the 13C-acetate breath test a valid procedure to analyse gastric emptying in children?

Abstract

Background/purpose: Scintigraphy is regarded as the "gold standard" procedure in measuring gastric emptying (GE) rates. 13C-acetate breath test (ABT), which already has been validated in adults, is a noninvasive and nonradioactive alternative method. The aim of the current study was to validate ABT against technetium Tc 99m scintigraphy in children affected by delayed GE.

Methods: Sixty children were recruited and divided into 2 groups: group A, 30 healthy controls; group B, 30 patients with gastroesophageal reflux, and scintigraphy-documented DGE (15 neurologically impaired). After an overnight fast, all of them underwent ABT using 25 to 150 mg 13C-acetate. Breath samples were obtained at baseline and then every 10 minutes for 2 hours. The 13CO2 to 12CO2 ratio in breath samples was analysed by isotope ratio mass spectrometry. Data are expressed as follows: time of peak 13C exhalation (tP13CO2b) and half emptying time in ABT (t(1/2b)), and scintigraphy half emptying time (t(1/2s)).

Results: In controls tP13CO2b was 37 +/- 13 minutes and t(1/2b) 74 +/- 12 minutes. In patients tP13CO2b and t(1/2b) were, respectively, 65 +/- 26 minutes and 104 +/- 18 minutes t(1/2s) was 91 +/- 21 minutes. In group B tP13CO2b and t(1/2b) were delayed significantly compared with controls, respectively, P < .03 and P < .01. In group B significant correlation between t(1/2s) and t(1/2b) was noted (r1 = 0.97). A close correlation was also observed between t(1/2s) and tP13CO2b (r2 = 0.95).

Conclusion: The 13C ABT is an easy, reliable, and less expensive procedure for measuring GE, and its results closely correlate with those of scintigraphy in a paediatric population.