Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;31(6):e13581.
doi: 10.1111/nmo.13581. Epub 2019 Mar 13.

Gastric accommodation measurements by single photon emission computed tomography and two-dimensional scintigraphy in diabetic patients with upper gastrointestinal symptoms

Victor Chedid  1 , Houssam Halawi  1 , Justin Brandler  1 , Duane Burton  1 , Michael Camilleri  1
Affiliations

Gastric accommodation measurements by single photon emission computed tomography and two-dimensional scintigraphy in diabetic patients with upper gastrointestinal symptoms

Victor Chedid et al. Neurogastroenterol Motil. 2019 Jun.

Abstract

Objective: To compare estimates of gastric accommodation (GA) with single photon emission computed tomography (SPECT) to measurements based on intragastric meal distribution immediately post-meal ingestion (IMD0 ).

Methods: We evaluated 108 diabetics with upper gastrointestinal (UGI) symptoms who had undergone gastric emptying of solids (GE) by scintigraphy and GA measurements by SPECT. Immediately after ingestion of a 99m Tc-labeled egg meal (time 0), we estimated IMD0 as radioactive counts or area of the proximal half of the stomach on two-dimensional images. Gastric volume (GV) during fasting and after 300 mL Ensure® was measured by SPECT to quantify accommodation volume (AV) or postprandial to fasting volume ratio (GVR). From the measured proximal gastric area, we estimated the volume of proximal stomach (4/3 × π × r3 ). We performed regression analyses to assess relationships between IMD0 and GA (AV) and GVR.

Results: There was a significant correlation between area and radioactivity counts in the proximal stomach (r = 0.67, P < 0.001); however, there was considerable interpersonal variation [bias 0.20 (95% CI -0.07, 0.47)]. There were no significant correlations between total GV or AV or VR by SPECT and measurements using IMD0 : proximal gastric counts, area, and estimated volume as continuous variables of dichotomized patient groups, based on published cutoff values. There were no significant differences in total gastric area or the IMD0 parameters (% area or % radioactive counts) between those with and without UGI symptoms except for fullness and satiety.

Conclusions: Intragastric meal distribution immediately post-meal ingestion is not significantly correlated with GA measurement by SPECT.

Keywords: dyspepsia; gastroparesis.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Relationship between counts and area of proximal stomach at IMD0
Figure 2.
Figure 2.
Bland-Altman graph comparing percent counts and calculated area of proximal stomach
Figure 3.
Figure 3.. Relationship between total stomach area or proportion of proximal gastric area (relative to whole stomach area) based on 2-dimensional imaging and SPECT-measured gastric accommodation volume.
The correlation between total gastric area and gastric accommodation by SPECT was not statistically significant (r=0.12, p=0.217).
Figure 4.
Figure 4.. Relationship between estimated proximal gastric volume based on 2-dimensional imaging and SPECT-measured gastric accommodation volume.
Note the weak, but statistically significant correlation based on spheroid or ellipsoid volume assumptions.
See this image and copyright information in PMC

References

    1. Tack J, Piessevaux H, Coulie B, et al. Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology 1998;115:1346–1352 - PubMed
    1. Thumshirn M, Camilleri M, Saslow SB, Williams DE, Burton DD, Hanson RB. Gastric accommodation in non-ulcer dyspepsia and the roles of Helicobacter pylori infection and vagal function. Gut 1999;44:55–64 - PMC - PubMed
    1. Pauwels A, Boecxstaens V, Broers C, Tack JF. Severely impaired gastric accommodation is a hallmark of post-Nissen functional dyspepsia symptoms. Neurogastroenterol Motil 2017;29. doi: 10.1111/nmo.13063. Epub 2017 Mar 20. - DOI - PubMed
    1. Janssen P, Verschueren S, Ly HG, Vos R, Van Oudenhove L, Tack J. Intragastric pressure during food intake: a physiological and minimally invasive method to assess gastric accommodation. Neurogastroenterol Motil. 2011. Apr;23(4):316–22, e153–4. - PubMed
    1. Park SY, Acosta A, Camilleri M, Burton D, Harmsen WS, Szarka LA, et al. Gastric motor dysfunction in patients with functional gastroduodenal symptoms. Am J Gastroenterol 2017;112:1689–1699 - PubMed

Publication types